Zahid Rahman Khan, MD(USA), MS Diplomate American Board of Nuclear Medicine Consultant t Nuclear Medicine
|
|
- Julie Parsons
- 5 years ago
- Views:
Transcription
1 Zahid Rahman Khan, MD(USA), MS Diplomate American Board of Nuclear Medicine Consultant t Nuclear Medicine i North West Armed Forces Hospital Tabuk, KSA. 1
2 Introduction Hibernation: Term coined by Rahimtoola 1. Chronically ischemic myocardium with decreased blood flow & down regulation of contractility; reversible with blood flow restoration 2. Meta-analysis 3088 patients(24 studies), annual mortality with viability was 16% with medical tx & 3.3% with revascularization (p<0.0001) 0001) Barrington SF. Left ventricular dysfunction. In: Cook CRJ, Maisey MN, Britton KE, Chengazi V. Clinical Nuclear Medicine. 4 th edition. London: Hodder Arnold; 2006: Ziessman HA, O Malley JP, Thrall JH. Cardiac System. In: Ziessman HA, O Malley JP, Thrall JH. Nuclear Medicine The Requisites. 3rd edition. Philadelphia: Mosby; 2006: Allman et al. Myocardial viability testing & impact of revascularization on prognosis in patients with CAD & LVD: a metaanalysis. J Am Coll Cardiol 2000;39: Introduction The role of MIBI is well established in detection of severely ischemic but viable myocardium 1. Used alone Tc-99m MIBI may underestimate the viable myocardium 2,3. Nitrates have been used to augment uptake of Tc tracers. It dilates epicardial vessels and flow through collateral vessels increase Bono RO, Dilsizian V. Thalium-201 and Tc-99m MIBI for assessing voable myocardium. J Nucl Med 1992; 33: Maurea S, Cuocolo A, Pace L, Nappi A, Imbriaco M, Morisco C, et al. Rest injected Thalium 201 redistribution and resting Tc-99m sestamibi uptake in coronary heart disease. Eur J of Nucl Med; 1993;20: Marzullo P, Sambuceti G, Parodi O. The role of sestamibi scintigraphy in the radioisotopic assessment of myocardial viability. J Nucl Med 1992;33: He Z, Verani MS. Evaluation of myocardial viability by myocardial perfusion imaging: should nitrates be used? J of Nucl Cardiology 1998;5:
3 Diagnostic techniques Myocardial Metabolism: PET (FDG)- Gold standard. Cell membrane integrity: Rb & Tl-201. Cellular metabolism: 99m Tc-MIBI & 99m Tc-tetrophosmine (Nitrates/trimetazidine enhanced). Contractility: LDD Echo & LDD MRI. Microvascular damage: Delayed enhancement MRI. Barrington SF. Left ventricular dysfunction. In: Cook CRJ, Maisey MN, Britton KE, Chengazi V. Clinical Nuclear Medicine. 4 th edition. London: Hodder Arnold; 2006: SPECT imaging withtc-99m MIBI Diffuses across cell membrane & sequestered in mitochondria. Retention dependent on cell membrane integrity & mitochondrial function (depends on active metabolism) 1. For hibernating myocardium Sensitivity (rest) : 80%, Specificity: 60-70% 2. With nitrate Sensitivity :77-95%, Specificity: 69-88% in small groups of patients Barrington SF. Left ventricular dysfunction. In: Cook CRJ, Maisey MN, Britton KE, Chengazi V. Clinical Nuclear Medicine. 4 th edition. London: Hodder Arnold; 2006: Bax JJ, et al. J Am Coll Cardiol1997;30: , Wijns W, et al. N Engl J Med 1998;339: Bisi G, et al. J Am Coll of Cardiol 1994;24:1282-9, Sciagra R, et al. Eur J Nucl Med 2001;28:680-7., Maurea S, et al. J Nucl Med 1995;36: , Li ST et al. J Nucl Cardiol 1996;3(6 Pt 1):
4 Aims and Objectives of the study To assess myocardial viability with nitrate enhanced Tc- 99m sestamibi Gated Single Photon Emission Computed Tomography (GSPECT) in patients with coronary artery disease. 7 Materials and Methods A prospective study of 48 patients with known CAD & history of myocardial infarction was done from Jan 2009 to Jan Inclusion criteria 1. Consecutive patients referred to Nuclear Cardiology section of Lady Reading Hospital Peshawar, Pakistan. 2. History of MI. Exclusion criteria 1. Hypotension. 8 4
5 Materials and Methods 99m Tc-MIBI Gated SPECT: 1. Patient preparation: - Through explanation of procedure - H & P examination using a comprehensive proforma - Informed consent. 2. Pre-procedure pertinent information: - Fasting for at least 4 hours. 3. Dose: ,110 MBq (25-30mCi) 99m Tc-MIBI, Intravenously. - Medi-MIBI 500µgm kit from Hungary was used. Image : Abdel-Dayem H M. practical demonstration: scintimammography procedures. St. Vincents Hospital and Medical Center,, New York Medical College, Valhalla, New York 9 Materials and methods 4. Instrumentation: - Large FOV Siemens gamma camera - ecam signature series single head system with LEHR collimator. - Symmetric 15% energy window centered over the 140kev photopeak. 5. Patient position: - Supine. 10 5
6 Materials and methods 6. Imaging protocol (Two-day): - Baseline study: rest and image acquisition 30-60min - Nitrate study: Sublingual nitrates (1-2 tablets) & RP after 15 minutes. Image minutes. Nitrate RP INJECTION 15 min 60 min Gated SPECT 11 Materials and methods 7. Image processing: - Data processing Syngo 2007A software. - Manual reconstruction & Butterworth filter applied. - Short axis, vertical long axis and horizontal long axial slices obtained. - Quantification & gated image acquisition- Corridor4DM v5.1 soft ware applied. 12 6
7 Materials and methods Image interpretation of Tc-99m GSPECT: - Two independent observers interpreted the studies. - Conventional slice display of SPECT images was done. - Perfusion defect severity & extent evaluated with Semiquantification method using 20 segment model. - Gated imaging quantified with Corridor4DM v5.1 software. Statistical analysis: - Paired t test. 13 Results Total of 48 patients (age range years) were included. 39 males, 9 females segments evaluated 40 A 30 LAD:480, g e 20 RCA:192, 10 0 LCx: Series1 14 7
8 Results Comparison of SPECT baseline and Nitrate enhanced study Territory segments Baseline study Nitrate study %age P valve (viable (viable improvement segments) segments) of viability with nitrates LAD % <0.01 RCA % LCx % <0.01 Total % < Results Gated study information for both rest and nitrate t enhanced study was also assessed for same 48 patients. For gated study total segments evaluated were 960 (LAD: 480, RCA: 192 & LCx: 288). 16 8
9 Results Comparison of Gated baseline & Nitrate enhanced study Territory segments Gated Gated Nitrate %age Pvalve Baseline study (viable improvement study (viable segments) of viability segments) with nitrates LAD % 0.16 RCA LCx % 0.86 Total Results Comparison of (SPECT + Gated) baseline & (SPECT + Gated) Nitrate t enhanced study Territory p value LAD RCA 1 LCx Total
10 Results Gated image acquisition in addition to SPECT: - P value was not significant when gated rest and gated nitrate study was compared. - But combination of both (SPECT+ Gated) baseline & (SPECT + Gated) nitrate t enhanced showed significant p value (0.001)
11
12 Results 23 Results 24 12
13
14
15
16
17 Literature Review Niyaz K, et al. 35 patients (31 M, 4F) hx of MI. Baseline and NTG Tc-99m MIBI (2 day protocol). 15 had Rest/redistribution Tl-201(3 day protocol). Images divided into seven segments for qualitative & semiquantitative analysis. > 55% tracer activity compared to max - viable. Niyaz K, et al.assessment of Viable Myocardium by Nitrate Augmented 99m Tc MIBI Myocardial Perfusion Imaging. JPMA 57:83; Literature Review Baseline 168/245 (68.57%) viable, to 197 (80.40%) in Nitrate MIBI (p=0.001 vs baseline). Concordance of viable segments detection between NTG MIBI & redistribution Tl-201 found in 100/105 segments (95.24%) for 15 pts. Nitrate MIBI SPECT results in improved detection of viable segments & achieves results similar to Tl rest/redistribution. Niyaz K, et al.assessment of Viable Myocardium by Nitrate Augmented 99m Tc MIBI Myocardial Perfusion Imaging. JPMA 57:83;
18 Literature Review Galli et al 54% patients showed significant decrease in mean perfusion defect after sublingual NTG 1. Maurea et al 27% perfusion defects showed improvement after NTG Galli M, Marcassa C, Imperato A et al. Effects of nitrogylcerine technitium- 99m sestamibi tomoscintigraphy on resting global myocardial hypoperfusion in stable patients with healed myocardial infarction. Am J Cardiol1994;74: Maurea S, Cuocolo A, Soricelli A et al. Enhanced dectection of viable myocardium by Tc-99m MIBI imaging after nitrate administration in chronic coronary artery disease. J Nucle med 1995;36: Limitations 1. Lack of Positron emission tomography or thalium-201 for comparison. 2. Need of follow-up studies to see the effect of revascularization. 3. Better attenuation correction
19 Conclusion Nitrate augmented Tc-99m sestamibi myocardial SPECT significantly improves detection of viable (Hibernating) myocardium. Gated images may further improve the accuracy of detection of hibernating myocardium in borderline cases
20 20
Myocardial viability testing. What we knew and what is new
Myocardial viability testing. What we knew and what is new Dr B K S Sastry, MD, DM. CARE Hospitals, Hyderabad What is Viability Viability Dysfunctional myocardium subtended by diseased coronary arteries
More informationEvaluation of Myocardial Viability: What Have We Learned from STICH? Professor of Medicine David Geffen School of Medicine at UCLA. Heart Failure (HF)
Evaluation of Myocardial Viability: What Have We Learned from STICH? Daniel S. Berman, MD Director, Cardiac Imaging Cedars-Sinai Heart Institute CSMC 2013 Professor of Medicine David Geffen School of Medicine
More informationGated blood pool ventriculography: Is there still a role in myocardial viability?
Gated blood pool ventriculography: Is there still a role in myocardial viability? Oliver C. Alix, MD Adult Clinical and Nuclear Cardiology St. Luke s Medical Centre - Global City Case Presentation A 62-year-old
More informationSPECT TRACERS Tl-201, Tc-99m Sestamibi, Tc-99m Tetrofosmin
SPECT TRACERS Tl-201, Tc-99m Sestamibi, Tc-99m Tetrofosmin Elmer Jasper B. Llanes, M.D. Nuclear Cardiology St. Luke s Medical Center Outline Ideal Physiologic Characteristics of MPI radioactive tracers
More informationReversible defect of 123 I-15-(p-iodophenyl)-9-(R,S)-methylpentadecanoic acid indicates residual viability within infarct-related area
ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 16, No. 3, 183 187, 2002 Reversible defect of 123 I-15-(p-iodophenyl)-9-(R,S)-methylpentadecanoic acid indicates residual viability within infarct-related
More informationPearls & Pitfalls in nuclear cardiology
Pearls & Pitfalls in nuclear cardiology Maythinee Chantadisai, MD., NM physician Division of Nuclear Medicine, Department of radiology, KCMH Principle of myocardial perfusion imaging (MPI) Radiotracer
More informationRational use of imaging for viability evaluation
EUROECHO and other imaging modalities 2011 Rational use of imaging for viability evaluation Luc A. Pierard, MD, PhD, FESC, FACC Professor of Medicine Head, Department of Cardiology, CHU Liège, Belgium
More informationFUTURE CARDIAC EVENTS IN NORMALLY DIAGNOSED GATED MYOCARDIAL PERFUSION SPECT (GSPECT)
FUTURE CARDIAC EVENTS IN NORMALLY DIAGNOSED GATED MYOCARDIAL PERFUSION SPECT (GSPECT) Amer H., Niaz K. Jelani A. Alqaseer M. Saleem M. Sheikh M.Y. King Abdulaziz Hospital, National Guard Health Affairs
More informationAssessment of Local Myocardial Perfusion in SPECT Images when Bicycle Exercise Test is Noninterpretable
e 11 Assessment of Local Myocardial Perfusion in SPECT Images when Bicycle Exercise Test is Noninterpretable Ilona Kulakienė, Zigmundas Satkevičius, Juozas Kiudelis, Irena Milvidaitė 1 Kaunas Medical University,
More informationTypical chest pain with normal ECG
Typical chest pain with normal ECG F. Mut, C. Bentancourt, M. Beretta Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Clinical history Male 41 y.o. Overweight, hypertension, high cholesterol,
More informationRadiologic Assessment of Myocardial Viability
November 2001 Radiologic Assessment of Myocardial Viability Joshua Moss, Harvard Medical School Year III Patient EF 66yo female with a 3-year history of intermittent chest pain previously relieved by sublingual
More informationFundamentals of Nuclear Cardiology. Terrence Ruddy, MD, FRCPC, FACC
Fundamentals of Nuclear Cardiology Terrence Ruddy, MD, FRCPC, FACC Objectives To understand the Principles of Nuclear Cardiac Imaging Radiotracers Image acquisition and processing Stress protocols To appreciate
More informationReview Article: MYOCARDIAL VIABILITY- ASSESSMENT AND CLINICAL RELEVANCE
Review Article: MYOCARDIAL VIABILITY- ASSESSMENT AND CLINICAL RELEVANCE Summary: BASHIR HANIF *, ATIF BASHIR The assessment of myocardial viability is an important indication for noninvasive imaging in
More informationLe FDG dans l évaluation de la viabilité : Quelle place par rapport aux autres traceurs?
Le FDG dans l évaluation de la viabilité : Quelle place par rapport aux autres traceurs? Pierre-Yves MARIE, Médecine Nucléaire, CHU de Nancy PET Gated-SPECT MRI FDG imaging: effect of dietary status fasting
More informationNUCLEAR CARDIOLOGY UPDATE
Nuclear Cardiology David K. Shelton, Jr., MD NUCLEAR CARDIOLOGY UPDATE No Conflicts. No Disclosures. No Smoking. David K. Shelton UCDMC Nuclear Cardiology Nuclear Cardiology Radionuclide Ventriculography
More information@02-126_Coronary_calcification.ppt. Professor Molecular and Medical Pharmacology
Assessment of Myocardial Viability Jamshid Maddahi, M.D., FACC, FASNC Professor Molecular and Medical Pharmacology (Nuclear Medicine) and Medicine (Cardiology) David Geffen School of Medicine at UCLA Director,
More informationOTHER NON-CARDIAC USES OF Tc-99m CARDIAC AGENTS Tc-99m Sestamibi for parathyroid imaging, breast tumor imaging, and imaging of other malignant tumors.
DEFINITION OF CARDIAC RADIOPHARMACEUTICAL: A radioactive drug which, when administered for purpose of diagnosis of heart disease, typically elicits no physiological response from the patient. Even though
More informationImaging and heart failure
Imaging and heart failure Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013 Research grants: Medtronic, Biotronik, Boston, St Jude, BMS imaging, GE Healthcare,
More informationThe Integral Role of Metabolic and Perfusion Imaging in Assessment of Myocardial Scar: Comparison between 18F-FDG PET and 99Tc-Sestamibi
Med. J. Cairo Univ., Vol. 82, No. 1, June: 285-289, 2014 www.medicaljournalofcairouniversity.net The Integral Role of Metabolic and Perfusion Imaging in Assessment of Myocardial Scar: Comparison between
More information1. LV function and remodeling. 2. Contribution of myocardial ischemia due to CAD, and
1 The clinical syndrome of heart failure in adults is commonly associated with the etiologies of ischemic and non-ischemic dilated cardiomyopathy, hypertrophic cardiomyopathy, hypertensive heart disease,
More informationDual-Tracer Gated Myocardial Scintigraphy
APPROVED BY: Director of Radiology Page 1 of 7 Dual-Tracer Gated Myocardial Scintigraphy Primary Indications: Evaluation of myocardial perfusion and viability in patients with known or suspected coronary
More informationA New Algorithm for the Quantitation of Myocardial Perfusion SPECT. II: Validation and Diagnostic Yield
A New Algorithm for the Quantitation of Myocardial Perfusion SPECT. II: Validation and Diagnostic Yield Tali Sharir, Guido Germano, Parker B. Waechter, Paul B. Kavanagh, Joseph S. Areeda, Jim Gerlach,
More informationNuclear Perfusion Imaging of Angina
January 2002 Nuclear Perfusion Imaging of Angina Davin Quinn HMS III Beth Israel Deaconess Medical Center Radiology Department Goals of Presentation Understand what a perfusion scan is Understand what
More informationSPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος
SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος Δρ Αναστασία Κίτσιου Διευθύντρια, Καρδιολογική Κλινική, Σισμανόγλειο ΓΝΑ Chair, Education Committee, Section on Nuclear Cardiology & Cardiac CT, EACVI, ESC
More informationPET for the Evaluation of Myocardial Viability
PET for the Evaluation of Myocardial Viability Myocardial viability assessment is an important part of cardiac PET to assist physicians to decide upon the best surgical or medical procedures. F-18 FDG
More informationResearch Article. Open Access. Mansour Al Moudi 1,2, Zhong-Hua Sun 2. 1 Introduction
Journal of Geriatric Cardiology (2014) 11: 229 236 2014 JGC All rights reserved; www.jgc301.com Research Article Open Access Diagnostic value of 18 F-FDG PET in the assessment of myocardial viability in
More informationTc-99m Sestamibi/Tetrofosmin Stress-Rest Myocardial Perfusion Scintigraphy
APPROVED BY: Director of Radiology Page 1 of 6 Tc-99m Sestamibi/Tetrofosmin Stress-Rest Myocardial Primary Indications: Evaluation of myocardial perfusion and viability in patients with known or suspected
More informationValue of Assessment of Viable and Ischemic Myocardium and Techniques Such as MRI, Radionuclide Imaging
Chapter 2 Imaging for Viable and Ischemic Myocardium Value of Assessment of Viable and Ischemic Myocardium and Techniques Such as MRI, Radionuclide Imaging Catalin Loghin and K. Lance Gould Introduction
More informationCardial MRI; Approaching the Level of Gold Standard for Viability Assessment
Cardial MRI; Approaching the Level of Gold Standard for Viability Assessment 용환석 고려대학교구로병원영상의학과 Viability Hibernating myocardium a state of myocardial hypocontractility during chronic hypoperfusion, in
More informationThe Role of Nuclear Imaging in Heart Failure
The Role of Nuclear Imaging in Heart Failure Mouaz H. Al-Mallah, MD MSc FESC Associate Professor of Medicine Consultant Cardiologist and Division Head, Cardiac Imaging King Abdulaziz Cardiac Centre, National
More informationOriginal Article Comparative evaluation of the diagnostic accuracy of 99m
Am J Nucl Med Mol Imaging 2014;4(1):10-16 www.ajnmmi.us /ISSN:2160-8407/ajnmmi1308002 Original Article Comparative evaluation of the diagnostic accuracy of Tc-sestamibi gated SPECT using five different
More informationCHRONIC CAD DIAGNOSIS
CHRONIC CAD DIAGNOSIS Chest Pain Evaluation 1. Approach to diagnosis of CAD 2. Classification of chest pain 3. Pre-test likelihood CAD 4. Algorithm for chest pain evaluation in women 5. Indications for
More informationsingle photon emission computed tomography (SPECT). MATERIALS AND METHODS
ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 16, No. 8, 563 568, 2002 Ischemic memory image in acute myocardial infarction of 123 I-BMIPP after reperfusion therapy: A comparison with 99m Tc-pyrophosphate
More informationNuclear Cardiology Pierre-Yves MARIE Department of Nuclear Medicine CHU-Nancy, FRANCE.
Nuclear Cardiology Pierre-Yves MARIE Department of Nuclear Medicine CHU-Nancy, FRANCE. Nuclear Cardiology I - A remaining need of a functional information on myocardial perfusion II - The future: - combining
More informationEvaluation of the impact of transmyocardial laser (CO ) 2 revascularisation on myocardial perfusion 6-months observations
Evaluation of the impact of transmyocardial laser (CO ) 2 revascularisation on myocardial perfusion 6-months observations Anna Teresińska 1, Marian Śliwiński 2, Joanna Potocka 1, Bożenna Szumilak 1, Elżbieta
More informationCardiac PET. John Buscombe
Cardiac PET John Buscombe Why PET? Improved resolution-not really required in cardiology Improved sensitivity this may be important-financially as reduced acquisition time Improved attenuation correction-good
More informationAbnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging. ID: GOLD Date: Age: 46 Sex: M John Doe Phone (310)
Background: Reason: preoperative assessment of CAD, Shortness of Breath Symptom: atypical chest pain Risk factors: hypertension Under influence: a beta blocker Medications: digoxin Height: 66 in. Weight:
More informationHybrid Imaging Improving Nuclear Cardiology Practice
Lippincott Williams & Wilkins, - Nuclear Medicine teaching File, 2009 Hybrid Imaging Improving Nuclear Cardiology Practice João V. Vitola, MD, PhD Cardiologist and Nuclear Medicine Physician Quanta Diagnostico
More informationSung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center
CMR Perfusion and Viability A STICH Out of Time? Sung A Chang Department of Internal Medicine, Division of Cardiology, Sungkyunkwan University School of Medicine, Samsung Medical Center Can Imaging Improve
More informationCardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures?
Keenan Research Centre Li Ka Shing Knowledge Institute Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Howard Leong-Poi, MD, FRCPC Associate Professor of Medicine St.
More informationM Faraggi, G Montalescot, L Sarda, J F Heintz, D Doumit, G Drobinski, I Sotirov, D Le Guludec, D Thomas
424 Nuclear Medicine Department, Bichat Hospital, 46, rue Henri Huchard, F75018, Paris, France M Faraggi L Sarda D Doumit D Le Guludec Cardiology Department, Pitié Hospital, Paris, France G Montalescot
More informationI have no financial disclosures
Manpreet Singh MD I have no financial disclosures Exercise Treadmill Bicycle Functional capacity assessment Well validated prognostic value Ischemic assessment ECG changes ST segments Arrhythmias Hemodynamic
More informationOld and new insights into viability:perfusion and Perfusion Reserve
Old and new insights into viability:perfusion and Perfusion Reserve R.Senior Professor of Clinical Cardiology Consultant Cardiologist and Director of Echo,Royal Brompton Hospital,London and Northwick Park
More informationAssessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99m Tc sestamibi
Journal of Physics: Conference Series PAPER OPEN ACCESS Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99m Tc sestamibi To cite this article: M R A Gani et al
More informationMyocardial blood flow PET evaluation and quantification. Dr. Erick Alexánderson. Rosas
Myocardial blood flow PET evaluation and quantification Dr. Erick Alexánderson Rosas Clinical case 62 year old female patient with a history of DM2 and chronic systemic hypertension She complains of progressive
More informationThe Value of Tc-99m MIBI Washout Rate in Detection of Ischemia compared with standard Myocardial Perfusion Imaging
Egyptian J. Nucl. Med., Vol. 10, No. 2, Dec 2014 18 Original article, Cardiology The Value of Tc-99m MIBI Washout Rate in Detection of Ischemia compared with standard Myocardial Perfusion Imaging Moustafa,
More informationRegional Left Ventricular Wall Thickening Relation to Regional Uptake of '8Fluorodeoxyglucose and 201T1
1125 Regional Left Ventricular all Thickening Relation to Regional Uptake of '8Fluorodeoxyglucose and 21T1 in Patients ith Chronic Coronary Artery Disease and Left Ventricular Dysfunction Pasquale Perrone-Filardi,
More informationTransmyocardial Laser Revascularization (TMLR) by Gated Myocardial Perfusion Scintigraphy
Evaluation of Transmyocardial Laser Revascularization (TMLR) by Gated Myocardial Perfusion Scintigraphy T. Grüning, 1 * J. Kropp, 1 S. Wiener, 1 W.-G. Franke, 1 S. M. Tugtekin 2, V. Gulielmos 2, and S.
More informationCoronary interventions
Controversial issues in the management of ischemic heart failure Coronary interventions Maciej Lesiak Department of Cardiology, University Hospital in Poznan none DECLARATION OF CONFLICT OF INTEREST CHF
More informationSPECT. quantitative gated SPECT (QGS) II. viability RH-2 QGS. Butterworth. 14% 10% 0.43 cycles/cm ( 39: 21 27, 2002) ( )
21 201 Tl SPECT * * * * * * * * SPECT QGS 99m Tc 201 Tl QGS 20 QGS Butterworth Butterworth 0.39 cycles/cm 14% 10% 0.43 cycles/cm ( r = 0.80 r = 0.86 r = 0.80) 201 Tl QGS ( 39: 21 27, 2002) I. quantitative
More informationJe bénéficie régulièrement de fonds privés, dans le cadre de projets de recherche ou d activités de formation.
Je bénéficie régulièrement de fonds privés, dans le cadre de projets de recherche ou d activités de formation. Ces fonds proviennent essentiellement d industriels travaillant dans les domaines de l imagerie
More informationPerspectives of new imaging techniques for patients with known or suspected coronary artery disease
Perspectives of new imaging techniques for patients with known or suspected coronary artery disease Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands Correspondence: Jeroen
More informationConflict of Interest Disclosure
Comparative Advantages of PET Over SPECT: Is PET Really Better? Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute Professor of Medicine University of Missouri-Kansas
More informationRole of Myocardial Perfusion Imaging in the Cardiac Evaluation of Aviators
Original Research Role of Myocardial Perfusion Imaging in the Cardiac Evaluation of Aviators Anil Kumar AVS *, Kumar PG +, Prakash MS # ABSTRACT In an attempt to provide more accurate and inclusive information
More informationCARDIAC PET PERFUSION IMAGING with RUBIDIUM-82
CARDIAC PET PERFUSION IMAGING with RUBIDIUM-82 Pr Denis AGOSTINI Président du Groupe de Cardiologie Nucléaire et IRM CHU Caen Bordeaux 2006 Cardiac Perfusion-Metabolism Mismatch with PET Cumulative Survival
More informationInsights into Viability- Function and Contractile Reserve
Insights into Viability- Function and Contractile Reserve Tom Marwick Cleveland Clinic Conflicts research grants and consulting with GE, Philips, Siemens Off-label use of Definity for assessment of myocardial
More informationAdvantages of PET Myocardial Imaging
Advantages of PET Myocardial Imaging Legal Disclaimers These materials were prepared in good faith by MITA as a service to the profession and are believed to be reliable based on current scientific literature.
More informationSPECT or PET for Cardiovascular Screening in High-Risk Patients
SPECT or PET for Cardiovascular Screening in High-Risk Patients Paeng, Jin Chul MD PhD Department of Nuclear Medicine Seoul National University Hospital Contents Recent Development in SPECT and PET Technology
More informationSurvivors of cardiac arrest attributable to life-threatening
Impact of Viability, Ischemia, Scar Tissue, and Revascularization on Outcome After Aborted Sudden Death Alida E. Borger van der Burg, MD; Jeroen J. Bax, MD; Eric Boersma, PhD; Ernest K.J. Pauwels, MD;
More informationPET myocard perfusion & viability Riemer Slart
PET myocard perfusion & viability Riemer Slart Nuclear Medicine Physician Dept. of Nuclear Medicine and Molecular Imaging University Medical Center Groningen, the Netherlands Professor in Molecular Imaging,
More informationORIGINAL ARTICLE. Iulia Heinle 1,*, Andre Conradie 2 and Frank Heinle 1
PJNM 2011, 1:42-48 331691 2011 Pakistan Society of Nuclear Medicine ORIGINAL ARTICLE A clinical and angiographic correlation of myocardial perfusion scintigraphy in the assessment of isolated apical/peri-apical
More informationCardiac Imaging. Kimberly Delcour, DO, FACC. Mahi Ashwath, MD, FACC, FASE. Director, Cardiac CT. Director, Cardiac MRI
Cardiac Imaging Kimberly Delcour, DO, FACC Director, Cardiac CT Mahi Ashwath, MD, FACC, FASE Director, Cardiac MRI Cardiac Imaging Discuss the clinical applications of and indications for: Cardiac CT Nuclear
More informationHow to Evaluate Microvascular Function and Angina. Myeong-Ho Yoon Ajou University Hospital
How to Evaluate Microvascular Function and Angina Myeong-Ho Yoon Ajou University Hospital Angina without Coronary Artery Disease (CAD) Prevalence: 20-30% going c-angiography, with a higher prevalence (almost
More informationCOLLATERAL FUNCTION IN PATIENTS WITH CORONARY OCCLUSION EVALUATED BY 201 THALLIUM SCINTIGRAPHY
& COLLATERAL FUNCTION IN PATIENTS WITH CORONARY OCCLUSION EVALUATED BY 201 THALLIUM SCINTIGRAPHY Aida Hasanović * Institute of Anatomy, University of Sarajevo, Faculty of Medicine, Čekaluša 90, 71 000
More informationAdriano Duatti Department of Chemical and Pharmaceutical Sciences University of Ferrara Via L. Borsari, 46, Ferrara, Italy
Adriano Duatti Department of Chemical and Pharmaceutical Sciences University of Ferrara Via L. Borsari, 46, 44121 Ferrara, Italy dta@unife.it adriano.duatti@unife.it Summary Approved tracers for myocardial
More informationPhoton Attenuation Correction in Misregistered Cardiac PET/CT
Photon Attenuation Correction in Misregistered Cardiac PET/CT A. Martinez-Möller 1,2, N. Navab 2, M. Schwaiger 1, S. G. Nekolla 1 1 Nuklearmedizinische Klinik der TU München 2 Computer Assisted Medical
More informationCardiac Viability Testing A Clinical Perspective Annual Cardiac Imaging Symposium. Lisa M Mielniczuk MD FRCPC University of Ottawa Heart Institute
Cardiac Viability Testing A Clinical Perspective Annual Cardiac Imaging Symposium Lisa M Mielniczuk MD FRCPC University of Ottawa Heart Institute 62 year old male Anterior STEMI late presentation, occluded
More informationGetting the Most Out of Stress Echo
Getting the Most Out of Stress Echo Vera H. Rigolin, MD, FASE, FACC, FAHA Professor of Medicine Northwestern University Feinberg School of Medicine Medical Director, Echocardiography Laboratory Northwestern
More informationEAE Teaching Course. Magnetic Resonance Imaging. Competitive or Complementary? Sofia, Bulgaria, 5-7 April F.E. Rademakers
EAE Teaching Course Magnetic Resonance Imaging Competitive or Complementary? Sofia, Bulgaria, 5-7 April 2012 F.E. Rademakers Complementary? Of Course N Engl J Med 2012;366:54-63 Clinical relevance Treatment
More informationAtypical pain and normal exercise test
Atypical pain and normal exercise test F. Mut, M. Beretta Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Clinical history 67-year old male with several coronary risk factors. Atypical
More informationMyocardial Perfusion: Positron Emission Tomography
Myocardial Perfusion: Positron Emission Tomography TH. Schindler, MD University Hospitals of Geneva, Cardiovascular Center, Geneva, Switzerland ESC 2010 Stockholm Personal Disclosure Research Grant support
More informationMaria Angela S. Cruz-Anacleto, MD
Maria Angela S. Cruz-Anacleto, MD 57/Female Menopausal Non-HTN, non-dm Hypothyroid (s/p RAI 1997) Levothyroxine 100 ug OD 5 Months PTA Chest discomfort Stress Echocardiography 5 Months PTA Chest discomfort
More informationHybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future
Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future Prof. Juhani Knuuti, MD, FESC Turku, Finland Disclosure: Juhani Knuuti, M.D. Juhani Knuuti, M.D. has financial
More informationCardiac Imaging Tests
Cardiac Imaging Tests http://www.medpagetoday.com/upload/2010/11/15/23347.jpg Standard imaging tests include echocardiography, chest x-ray, CT, MRI, and various radionuclide techniques. Standard CT and
More informationMR Assessment of Myocardial Viability
MR Assessment of Myocardial Viability Definition of Viability Clinical Metabolism: Presence of glucose uptake Perfusion / Perfusion reserve Morphology: Wall thickness, wall thickening Contractility: Recovery
More informationValue of Gating of Technetium-99m Sestamibi Single-Photon Emission Computed Tomographic Imaging
JACC Vol. 30, No. 7 December 1997:1687 92 1687 Value of Gating of Technetium-99m Sestamibi Single-Photon Emission Computed Tomographic Imaging PAOLA E. P. SMANIO, MD,* DENNY D. WATSON, PHD, DANA L. SEGALLA,
More informationPerfusion and Contractile Reserve in Chronic Dysfunctional Myocardium: Relation to Functional Outcome After Surgical Revascularization
Perfusion and Contractile Reserve in Chronic Dysfunctional Myocardium: Relation to Functional Outcome After Surgical Revascularization Jeroen J. Bax, MD; Don Poldermans, MD; Arend F.L. Schinkel, MD; Eric
More informationNuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb. Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN
Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN VUMC PET/CT conference 2009 82 Rb Cardiac Perfusion PET 82 Rb is
More informationMagnetic Resonance Imaging (MRI) for the Assessment of Myocardial Viability
Ontario Health Technology Assessment Series 2010; Vol. 10, No. 15 Magnetic Resonance Imaging (MRI) for the Assessment of Myocardial Viability An Evidence-Based Analysis Presented to the Ontario Health
More informationAssessment of Ischemia and Viability
EAE Teaching Course Bucharest, 2010 Assessment of Ischemia and Viability Jens-Uwe Voigt Dpt. of Cardiology University Leuven Belgium Assessment of Ischemia & Viability resting wall motion Stress Testing
More informationMethods. Salem and Charlottesville, Virginia
331 Comparison of Technetium-99m Tetrofosmin and Thallium-201 Single-Photon Emission Computed Tomographic Imaging for Detection of Myocardial Perfusion Defects in Patients With Coronary Artery Disease
More informationEmerging role of PET in nuclear cardiology. Dr. Erick Alexánderson. Rosas
Emerging role of PET in nuclear cardiology Dr. Erick Alexánderson Rosas PET principles e + e - 180 PET/CT Cyclotron Unit UNAM Cyclotron Radiopharmacy PET Camera CT PET PET CT Perfusion Anatomic evaluation
More informationParadoxical pattern in a patient with previous myocardial infarction F. Mut, M. Kapitan
Paradoxical pattern in a patient with previous myocardial infarction F. Mut, M. Kapitan Nuclear Medicine Service, Italian Hospital Montevideo, Uruguay Clinical history Woman 66 y.o. Previous MI. Dyspnea
More informationQualitative and Quantitative Assessment of Perfusion
APCDE 2011 Qualitative and Quantitative Assessment of Perfusion Hyun Ju Yoon Chonnam National University Hospital Gwangju, Korea ISCHEMIC CASCADE Blood flow mismatch Perfusion defects on nuclear imaging,
More informationA New Washout Rate Display Method for Detection of Endocardial and Pericardial Abnormalities Using Thallium-201 SPECT
A New Washout Rate Display Method for Detection of Endocardial and Pericardial Abnormalities Using Thallium-201 SPECT Mansour Jamzad, Hajime Murata, Hinako Toyama, Yuji Takao, and Akihiko Uchiyama School
More informationMyocardial Perfusion SPECT How to do it E. Moralidis
Myocardial Perfusion SPECT How to do it E. Moralidis Aristotelian University AHEPA Hospital Thessaloniki Myocardial perfusion SPECT procedure Stress Imaging Data analysis and reporting Myocardial perfusion
More informationNuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study is necessary
Trägårdh et al. BMC Medical Informatics and Decision Making 2012, 12:97 RESEARCH ARTICLE Open Access Nuclear medicine technologists are able to accurately determine when a myocardial perfusion rest study
More informationTW Hamilton, EP Ficaro, TA Mitchell, JN Kritzman, JR Corbett University of Michigan Health System, Ann Arbor, MI
Accuracy and Variability of of 3D-MSPECT for Estimating the Left Ventricular Ejection Fraction as as a Function of of Gating Frames and Reconstruction Filters TW Hamilton, EP Ficaro, TA Mitchell, JN Kritzman,
More informationPatients with chronic ischemic left ventricular (LV) dysfunction
Extensive Left Ventricular Remodeling Does Not Allow Viable Myocardium to Improve in Left Ventricular Ejection Fraction After Revascularization and Is Associated With Worse Long-Term Prognosis Jeroen J.
More informationThe diagnostic role of stress echocardiography in women with coronary artery disease: evidence based review John R. McKeogh
The diagnostic role of stress echocardiography in women with coronary artery disease: evidence based review John R. McKeogh Key points 1) Coronary artery disease in women differs from men in several ways,
More informationPromising New Fluorine-18 Labeled Tracers for PET Myocardial Perfusion Imaging
Journal of Nuclear Medicine, published on July 30, 2015 as doi:10.2967/jnumed.115.161661 Promising New Fluorine-18 Labeled Tracers for PET Myocardial Perfusion Imaging Richard C. Brunken MD, FACC, FAHA,
More informationAppropriateness of Stress Echocardiography and Nuclear Stress Thallium/Sesta Mibi Testing Methods
Appropriateness of Stress Echocardiography and Nuclear Stress Thallium/Sesta Mibi Testing Methods Review by Michael Devenport, MS, RDCS Objectives: A basic description and review of appropriate use of
More informationHospital, 6 Lukon Road, Lukong Town, Changhua Shien, Taiwan 505, Taiwan.
Volume 1, Issue 1 Image Article Resolution of Inferior Wall Ischemia after Successful Revascularization of LAD Lesion: The Value of Myocardial Perfusion Imaging in Guiding Management of Multi-vessel CAD
More informationLong-term outcome after normal myocardial perfusion imaging in suspected ischaemic heart disease
Dan Med J 65/2 February 2018 DANISH MEDICAL JOURNAL 1 Long-term outcome after normal myocardial perfusion imaging in suspected ischaemic heart disease Pia Hedegaard Johnsen 1, Martin Berg Johansen 1, 2
More informationConflict of Interest Disclosure
Challenges and Opportunities for SPECT & PET in 2013: Implementing Latest Acquisition and Processing Protocols Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute
More informationRADIOTRACERS FOR MYOCARDIAL PERFUSION IMAGING
RADIOTRACERS FOR MYOCARDIAL PERFUSION IMAGING RAYMOND TAILLEFER, M.D. FRCP(c), ABNM DIRECTOR, DEPARTMENT OF NUCLEAR MEDICINE HOPITAL ST-JEAN-SUR-RICHELIEU Disclosures to Report: Grant Research Support:
More informationA Comparison of Strategies for Summing Gated Myocardial Perfusion SPECT: Are False Negatives a Potential Problem?
ISPUB.COM The Internet Journal of Cardiology Volume 4 Number 1 A Comparison of Strategies for Summing Gated Myocardial Perfusion SPECT: Are False Negatives a Potential Problem? J Wheat, G Currie Citation
More informationTechnical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, May 2008 Vienna International Centre
Technical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, 5-95 9 May 2008 Vienna International Centre Evidence-based Nuclear Cardiology: Imaging of CAD The
More informationEffect of left ventricular function on diagnostic accuracy of FDG SPECT
ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 20, No. 1, 51 56, 2006 Effect of left ventricular function on diagnostic accuracy of FDG SPECT Ichiro MATSUNARI,* 1 Jeroen J. BAX,* 2 Paul K. BLANKSMA,*
More informationNew Challenges in Nuclear Cardiology Practice
New Challenges in Nuclear Cardiology Practice Brian G. Abbott, MD, FACC, FASNC, FAHA President, ASNC 2016 Associate Professor of Medicine Warren Alpert Medical School of Brown University Director, Cardiovascular
More information