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Imaging Evaluation of Acute Chest Pain: Systematic Review of Evidence Base and Cost-effectiveness

Bamberg, Fabian MD, MPH*; Marcus, Roy P. BS*; Schlett, Christopher L. MD, MPH; Schoepf, U. Joseph MD; Johnson, Thorsten R. MD*; Nance, John W. Jr MD§; Hoffmann, Udo MD, MPH; Reiser, Maximilian F. MD*; Nikolaou, Konstantin MD*

doi: 10.1097/RTI.0b013e3182628053

Given the often inconclusive initial evaluation of patients presenting with acute chest pain in the Emergency Department, advanced imaging techniques have been evaluated in the quest for improving the current standard of care. In this article, we systematically compare and evaluate the available evidence and cost-effectiveness of radionucleotide myocardial perfusion imaging, cardiac computed tomography angiography, and cardiac magnetic resonance imaging using data from PubMed and EMBASE through January 2012. The obtained data were summarized and categorized according to the reached level of evidence and its impact on the decision-making process.

*Institute for Clinical Radiology, Ludwig-Maximilians University, Klinikum Grosshadern, Munich, Germany

Department of Radiology, Division of Cardiology, Cardiac MR PET CT Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA

Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC

§Department of Radiology, Johns Hopkins University, Baltimore, MD

The authors declare no conflicts of interest.

Reprints: Fabian Bamberg, MD, MPH, Institute for Clinical Radiology, Ludwig-Maximilians University, Marchioninistrasse 15, 81377 Munich, Germany (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.