Added Value of Myocardial Blood Flow Quantification and Calcium Scoring During CZT SPECT Myocardial Perfusion Imaging for Coronary Artery Disease Screening Dedicated cadmium-zinc-telluride cardiac cameras have been shown to provide accurate measurements of absolute myocardial blood flow and flow reserve when PET is not available. We report the case of a 66-year-old woman who underwent 1-day stress/rest myocardial perfusion imaging (MPI) for coronary artery disease (CAD) screening. Relative MPI analysis was normal, whereas low-dose CT showed high calcium score. Myocardial blood flow and flow reserve were strongly impaired in all territories. Coronary angiography confirmed extended CAD. Flow parameters derived from cadmium-zinc-telluride SPECT MPI acquisition and calcium scoring can improve diagnostic accuracy and confidence of CAD. Received for publication March 17, 2019; revision accepted May 27, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Matthieu Bailly, MD, Service de Médecine Nucléaire, CHR Orleans, 14 Avenue de l'Hopital, 45100 Orleans, France. E-mail: matthieu.bailly@chr-orleans.fr. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.