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Role of non-invasive imaging in the management of coronary artery disease: an assessment of likely change over the next 10 years. A report from the British Cardiovascular Society Working Group
  1. A H Gershlick1,
  2. M de Belder2,
  3. J Chambers3,
  4. D Hackett4,
  5. R Keal5,
  6. A Kelion6,
  7. S Neubauer7,
  8. D J Pennell8,
  9. M Rothman9,
  10. M Signy10,
  11. P Wilde11
  1. 1Department of Cardiology, University of Leicester, Glenfield Hospital, Leicester, UK
  2. 2James Cook University Hospital, Middlesborough, Cleveland, UK
  3. 3Department of Cardiology, Guy’s & St Thomas’ Hospital, London, UK
  4. 4Cardiology Department, Hemel Hempstead General Hospital, Hemel Hempstead, UK
  5. 5Department of Radiology, Glenfield Hospital, Leicester, UK
  6. 6Department of Cardiology, Harefield Hospital, Harefield, Middlesex, UK
  7. 7John Radcliffe Hospital, Headington, Oxford, UK
  8. 8CMR Unit, Royal Brompton Hospital, London, UK
  9. 9Research & Development Office, London Chest Hospital, London, UK
  10. 10Worthing Hospital, West Sussex, UK
  11. 11Diagnostic Radiology, Department of Clinical Radiology, Bristol Royal Infirmary, Bristol, UK
  1. Correspondence to:
    Dr A H Gershlick


Coronary angiography has been the gold standard for determining the severity, extent and prognosis of coronary atheromatous disease for the past 15–20 years. However, established non-invasive testing (such as myocardial perfusion scintigraphy and stress echocardiography) and newer imaging modalities (multi-detector x ray computed tomography and cardiovascular magnetic resonance) now need to be considered increasingly as a challenge to coronary angiography in contemporary practice. An important consideration is the degree to which appropriate use of such techniques impacts on the need for coronary angiography over the next 10–15 years. This review aims to determine the role of the various investigation techniques in the management of coronary artery disease and their resource implications, and should help determine future service provision, accepting that we are in a period of significant technological change.

  • BCS, British Cardiovascular Society
  • CA, coronary angiography
  • CAD, coronary artery disease
  • CMR, cardiovascular magnetic resonance
  • ETT, exercise tolerance test
  • LV, left ventricular
  • MDCT, multi-detector x ray computed tomography
  • MPS, myocardial perfusion scintigraphy
  • PCI, percutaneous coronary intervention
  • PET, positron emission tomography
  • SE, stress echocardiography
  • SPECT, single photon emission computed tomography
  • SpR, specialist registrar

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  • Competing interests: None declared.

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