Diagnostic and clinical perspectives of fusion imaging in cardiology: is the total greater than the sum of its parts?

The constant development and refinement of non-invasive cardiac imaging over the past two decades have contributed to changing our pathophysiological understanding of many conditions. Clinically, these developments have provided new tools for the identification of preclinical disease and a better understanding of how disease evolves and reaches its terminal stage. The focus of this review is to summarise how positron emission tomography ( PET), cardiovascular magnetic resonance ( CMR) and multislice computed tomography ( MSCT) have contributed to this process and how their combination ( fusion) can further revolutionise cardiology. Obviously, other well-established techniques such as echocardiography and single photon emission computed tomography ( SPECT) will continue to be essential in clinical practice for disease diagnosis and stratification of patients, whereas these more expensive and less available techniques will provide clinicians with new tools for the exploration of very early and very late phases of cardiac diseases. Accordingly, this article is divided into two parts: the application of these imaging modalities to preclinical disease and the use of these techniques in patients with overt cardiovascular disease.