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Federico Caobelli, Left ventricular segmentation in myocardial perfusion positron emission tomography: tailor-made or prêt-à-porter?, European Heart Journal - Cardiovascular Imaging, Volume 20, Issue 5, May 2019, Pages 502–503, https://doi.org/10.1093/ehjci/jey216
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This editorial refers to ‘Impact of individualized segmentation on diagnostic performance of quantitative positron emission tomography for hemodynamically significant coronary artery disease’, by M.J. Bom et al., pp. 525–532.
In the clinical practice, regional perfusion defects of the myocardium are usually assigned to the relevant vascular territories by applying a mental co-registration between single-photon-emission computed tomography (SPECT) or positron emission tomography (PET) imaging and standardized left ventricular (LV) segmentation models.1 Although the value of these models in clinical practice and in the research is widely recognized, still these models represent an ultra-simplification of the normal vascular distribution within the myocardium. As a matter of fact, the anatomy of the coronary tree can be highly variable among individuals, and it was reported that coronary artery anatomy may disagree with standardized vascular territories in a large proportion of patients referred to myocardial perfusion imaging (MPI).2
As such, there is great interest among clinicians and imaging professionals as to whether an accurate spatial co-localization of myocardial perfusion defects and subtending coronary arteries is needed.