| Detection of CAD: Symptomatic—evaluation of chest pain syndrome (use of vasodilator perfusion CMR or dobutamine stress function CMR) |
| Intermediate pre-test probability of CAD |
| ECG uninterpretable OR unable to exercise |
| Detection of CAD: Symptomatic—evaluation of intracardiac structures (use of MR coronary angiography) |
| Evaluation of suspected coronary anomalies |
| Risk assessment with prior test results (use of vasodilator perfusion CMR or dobutamine stress function CMR) |
| Coronary angiography (catheterisation or CT) |
| Stenosis of unclear significance |
| Structure and Function—evaluation of ventricular and valvular function |
| Procedures may include LV/RV mass and volumes, MR angiography, quantification of valvular disease, and delayed contrast enhancement |
| Assessment of complex congenital heart disease including anomalies of coronary circulation, great vessels, and cardiac chambers and valves |
| Procedures may include LV/RV mass and volumes, MR angiography, quantification of valvular disease, and contrast enhancement |
| Evaluation of LV function following myocardial infarction OR in heart failure patients |
| Patients with technically limited images from echocardiogram |
| Quantification of LV function |
| Discordant information that is clinically significant from prior tests |
| Evaluation of specific cardiomyopathies (infiltrative (amyloid, sarcoid), HCM, or due to cardiotoxic therapies) |
| Use of delayed enhancement |
| Characterisation of native and prosthetic cardiac valves—including planimetry of stenotic disease and quantification of regurgitant disease |
| Patients with technically limited images from echocardiogram or TEE</item></item-list> |
| Evaluation for arrhythmogenic right ventricular cardiomyopathy (ARVC) |
| Patients presenting with syncope or ventricular arrhythmia |
| Evaluation of myocarditis or myocardial infarction with normal coronary arteries |
| Positive cardiac enzymes without obstructive atherosclerosis on angiography |
| Structure and Function—evaluation of intracardiac and extracardiac structures |
| Evaluation of cardiac mass (suspected tumour or thrombus) |
| Use of contrast for perfusion and enhancement |
| Evaluation of pericardial conditions (pericardial mass, constrictive pericarditis) |
| Evaluation for aortic dissection |
| Evaluation of pulmonary veins prior to radiofrequency ablation for atrial fibrillation |
| Left atrial and pulmonary venous anatomy including dimensions of veins for mapping purposes |
| Detection of myocardial scar and viability—evaluation of myocardial scar (use of late gadolinium enhancement) |
| To determine the location and extent of myocardial necrosis including “no reflow” regions |
| Post acute myocardial infarction |
| To determine viability prior to revascularisation |
| Establish likelihood of recovery of function with revascularisation (PCI or CABG) or medical therapy |
| To determine viability prior to revascularisation |
| Viability assessment by SPECT or dobutamine echo has provided “equivocal or indeterminate” results |
*adapted from ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Cardiol 2006;48:1475–97.