Assessment of Coronary Calcium

Comprehensive assessment of a patient’s cardiovascular risk profile provides patient-specific treatment options. Advances in cardiac imaging have led to widespread adoption of the assessment coronary artery calcium (CAC) deposition as a useful tool for risk stratification and diagnosis of coronary artery disease. The accumulation of vascular calcium in the coronary arteries has been associated with vascular dysfunction and is associated with an increased risk of coronary artery disease syndromes. Assessment of coronary atherosclerosis with a coronary artery calcium score using CT imaging is a well-established tool and assists in guiding preventive treatment strategies. CAC detection may also be obtained as part of hybrid imaging with SPECT/CT or PET/CT and provide incremental information to that obtained with myocardial perfusion imaging and is useful in delineating microvascular versus epicardial CAD in patients with abnormal myocardial blood flow (see Chap. 17 ).