A 47-year-old patient is shown 2 months after successful stenting of the LAD and experienced mild angina. The perfusion CMR study during hyperemia (at 0.1 mmol/kg gadolinium – DTPA) demonstrates a perfusion deficit in the subendocardium of the lateral wall (b and c; arrow head) appreciated by all three readers. SPECT in this patient was positive for the presence of CAD for one reader only. Coronary X-ray angiography demonstrated a significant stenosis in the circumflex coronary artery. Perfusion in the anterior wall was assessed correctly by both techniques (normal perfusion) despite a stent in the LAD. CAD, coronary artery disease; DTPA, diethylenetriaminepentaacetic acid; LDA, left anterior descending artery; MR-IMPACT, Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary Artery Disease Trial; SPECT, single-photon emission computed tomography. Reproduced with permission from [13].