Paradoxical pattern in a patient with previous myocardial infarction F. Mut, M. Kapitan
|
|
|
- Nelson Tucker
- 5 years ago
- Views:
Transcription
1 Paradoxical pattern in a patient with previous myocardial infarction F. Mut, M. Kapitan Nuclear Medicine Service, Italian Hospital Montevideo, Uruguay
2 Clinical history Woman 66 y.o. Previous MI. Dyspnea and non-specific chest discomfort. ECG: Q waves V3-V5. Echo: LVEF 48%, apical hypokinesia. Referred for MPS w/ pharmacologic stress. Dipyridamole + rest (2-day protocol), 99mTc-MIBI. Well tolerated, no symptoms, no ECG changes, BP 130/80 mmhg at rest, 120/75 mmhg during the test.
3 Stress/rest myocardial perfusion study
4 Stress/rest myocardial perfusion study
5 How would you interpret the study? a) Normal. b) Equivocal. c) Apical infarction + ischemia. d) Apical infarction, no ischemia.
6 How would you interpret the study? a) Normal. b) Equivocal. c) Apical infarction + ischemia. d) Apical infarction, no ischemia. There seems to be normal perfusion at stress with an apical defect at rest (paradoxical pattern). However, stress images are too noisy, raising the suspicion of a technical artefact - so the interpretation should be categorized as equivocal since the presence of ischemia cannot be ruled out. Technical parameters should be verified to check for artefact.
7 SPECT QC raw data Motion was excluded, but low-count statistics in stress study was detected. Partial extravasation of the dose was confirmed. stress rest Total counts 72,678 Total counts 287,085
8 What would you do now? a) Release an indeterminate report. b) Report the rest result only. c) Try to repeat the stress portion of the study. d) Report paradoxical pattern.
9 What would you do now? a) Release an indeterminate report. b) Report the rest result only. c) Try to repeat the stress portion of the study. d) Report paradoxical pattern. The best option in these cases is to repeat the defective study whenever possible, which may cause additional discomfort to the patient but ensures a reliable result. Any other option would be of little help for the referring cardiologist and the patient.
10 Myocardial perfusion study (repeated stress)
11 Myocardial perfusion study (repeated stress)
12 Polar maps Stress #1 Stress #2 Rest Rest
13 How would you interpret the study now? a) Normal. b) Equivocal. c) Apical infarction + ischemia. d) Apical infarction, no ischemia.
14 How would you interpret the study now? a) Normal. b) Equivocal. c) Apical infarction + ischemia. d) Apical infarction, no ischemia. The new stress study is of good diagnostic quality and paradoxical pattern is no longer present. Is possible to conclude that there is an extense apical MI with no significant induced ischemia. Any other option would be of little help for the referring cardiologist and the patient.
15 Teaching points Myocardial necrosis with a paradoxical pattern (PP) is observed in a few proportion of patients with myocardial necrosis. Necrotic areas with PP have preserved myocardial flow, owing to either patency of the culprit artery, or the presence of collateral circulation to this territory when the artery is occluded. Patients exhibiting a PP on MPS with Tc-99m-labeled tracers have a better prognosis and better LV function than patients with a non-pp pattern in necrotic myocardial regions. PP can also be observed as an artefact in studies with low-count statistics, or if there is dominant attenuation during the stress portion. QC data should be always checked before interpreting MPS.
16 Bibliography Takeishi Y, Sukekawa H, Fujiwara S, et al. Reverse redistribution of technetium-99m-sestamibi following direct PTCA in acute myocardial infarction. J Nucl Med 1996; 37: Araujo W, DePuey EG, Kamran M, et al. Artifactual reverse distribution pattern in myocardial perfusion SPECT with technetium- 99m sestamibi. J Nucl Cardiol 2000; 7: Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. J Nucl Med Technol 2006; 34: Pizzi MN, Sabate-Fernandez M, Aguade-Bruix S, et al. Paradoxical scintigraphic pattern in regions with myocardial necrosis on myocardial perfusion gated SPECT with 99m Tc-tetrofosmin. J Nucl Cardiol 2012; 19:
Previous MI with no intervention
Previous MI with no intervention F. Mut, M. Beretta Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Clinical history Woman 68 y.o. Recent acute MI (3 weeks) with no intervention. Discharged
Single episode of chest pain post-ptca, with normal ECG and enzymes
Single episode of chest pain post-ptca, with normal ECG and enzymes F. Mut, M. Kapitan Nuclear Medicine Service, Italian Hospital Montevideo, Uruguay Clinical history 54 y.o. woman. Smoker, dyslipidemic,
Atypical 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
MPS and Calcium Score in asymptomatic patient F. Mut, J. Vitola
MPS and Calcium Score in asymptomatic patient F. Mut, J. Vitola Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Quanta Diagnostico Nuclear Curitiba, Brazil Clinical history Male 63 y.o.,
Typical 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,
Pearls & 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
ORIGINAL 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
Myocardial 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
Fundamentals 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
CHRONIC 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
How to Report Effectively on a Nuclear Cardiology Study
How to Report Effectively on a Nuclear Cardiology Study A/Prof. NATHAN BETTER Cardiologist and Deputy Director of Nuclear Medicine Royal Melbourne Hospital University of Melbourne December 2012 The case
Abnormal, 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:
Hybrid 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
MPI Overview. Artifacts and Pitfalls in MPI. Acquisition and Processing. Peeyush Bhargava MD, MBA
Artifacts and Pitfalls in MPI MPI Overview Peeyush Bhargava MD, MBA www.nuclearmd.com ~ 40% of all Nuclear Medicine Procedures ~ 9 million procedures every year in US >95% are SPECT,
Stress only Perfusion Imaging
European Society of Cardiology Annual meeting, 2010, Stockholm, Sweden Stress only Perfusion Imaging Oliver Gaemperli, MD Cardiovascular Center, University Hospital Zurich, Switzerland Male patient, 48
Le 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
Nuclear 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
Normal Stress-Only Versus Standard Stress/Rest Myocardial Perfusion Imaging
Journal of the American College of Cardiology Vol. 55, No. 3, 2010 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.09.022
a Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of
Original article Reverse perfusion pattern in myocardial perfusion imaging using technetium-99m-sestamibi in patients with intermediate risk for coronary artery disease in relation to the time of acquisition
Role 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
Je 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
Nuclear medicine in general practice. Dr Reza Garzan MD, FRACP, FAANMS
Nuclear medicine in general practice Dr Reza Garzan MD, FRACP, FAANMS Myocardial perfusion study Bone scans in general practice Thyroid scans in general practice Gamma camera Detection of gamma rays Myocardial
1. 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,
SPECT-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
Radiologic 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
Rational 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
INTRAVENOUS ADENOSINE MYOCARDIAL PERFUSION STUDY (rest/pharmacologic stress SPECT with gated SPECT wall motion studies at rest and post-stress)
nucware.com, LLC Product Demo Anytown Cardiac Specialists, Inc. Janet Jones, MD, FACC Ed Wilson, MD, FACC Tom Smith, MD, FACC Jim Wilson, MD, FACC John Womack, MD, FACC JOHNSON, VICTOR DOB: 09/06/1938
Diagnosis of CAD S Richard Underwood
Diagnosis of CAD S Richard Underwood Professor of Cardiac Imaging Royal Brompton Hospital & Imperial College Faculty of Medicine London, UK The history and diagnosis 89% Non-cardiac chest pain 50% Atypical
ASNC CONSENSUS STATEMENT REPORTING OF RADIONUCLIDE MYOCARDIAL PERFUSION IMAGING STUDIES. Approved August 2003
ASNC CONSENSUS STATEMENT REPORTING OF RADIONUCLIDE MYOCARDIAL PERFUSION IMAGING STUDIES Approved August 2003 Robert C. Hendel, M.D. Frans J. Th. Wackers, M.D., Ph.D. Daniel S. Berman, M.D. Edward Ficaro,
The use of Cardiac CT and MRI in Clinical Practice
The use of Cardiac CT and MRI in Clinical Practice Matthew W. Martinez, MD Assistant Professor of Medicine LVPG - Lehigh Valley Heart Specialists Lehigh Valley Health Network Oct. 3, 2009 DISCLOSURE Relevant
OTHER 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
Long-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
Update in Nuclear Cardiology: Patient-Centered Imaging Radiation Dose Reduction
Update in Nuclear Cardiology: Patient-Centered Imaging Radiation Dose Reduction E. Gordon DePuey, M.D. Icahn School of Medicine ant Mt. Sinai New York, NY Disclosures: Grant Support: Michael J. Fox Foundation
Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users
Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users February 1 5, 2011 University of Santo Tomas Hospital Angelo King A-V Auditorium Manila,
Tc-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
Click here for Link to References: CMS Website HOPPS CY 2018 Final Rule. CMS Website HOPPS CY2018 Final Rule Updated November 2017.
Final Compared to 3Q 2017 Rates Medicare Hospital Outpatient Prospective Payment System HOPPS () Nuclear Cardiology Procedures, Radiopharmaceuticals, and Drugs Click here for Link to References: CMS Website
NUCLEAR 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
RADIOTRACERS 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:
Appropriateness 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
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
Qualitative 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,
Reverse Redistribution Phenomenon In Patients With Normal Coronary Epicardial Arteries And Its Relationship To Systolic Left Ventricular Dysfunction
ISPUB.COM The Internet Journal of Cardiology Volume 4 Number 1 Reverse Redistribution Phenomenon In Patients With Normal Coronary Epicardial Arteries And Its Relationship To Systolic Left Ventricular Dysfunction
Conflict 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
Cardiovascular nuclear imaging employs non-invasive techniques to assess alterations in coronary artery flow, and ventricular function.
National Imaging Associates, Inc. Clinical guidelines CARDIOVASCULAR NUCLEAR MEDICINE -MYOCARDIAL PERFUSION IMAGING -MUGA Original Date: October 2015 Page 1 of 9 FOR CMS (MEDICARE) MEMBERS ONLY CPT4 Codes:
The 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
Nuclear 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
CONFUSION IN CARDIAC TESTING. Bilal Aijaz M.D FACC FSCAI
CONFUSION IN CARDIAC TESTING Bilal Aijaz M.D FACC FSCAI WHY DOES CARDIOLOGY HAVE SO MANY TESTS? to create confusion (of course) to generate more business (maybe?) to accommodate the ever expanding patient
I 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
Dual-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
Cardiovascular nuclear imaging employs non-invasive techniques to assess alterations in coronary artery flow, and ventricular function.
National Imaging Associates, Inc. Clinical guidelines CARDIOVASCULAR NUCLEAR MEDICINE -MYOCARDIAL PERFUSION IMAGING -MUGA CPT4 Codes: Refer to pages 6-9 LCD ID Number: L33960 J 15 = KY, OH Responsible
Cardiovascular Disease
증상, 진단및임상양상의차이 2013.6.15 충남대학교의학전문대학원의학과박재형 Cardiovascular Center, Chungnam National University Hospital 1 Cardiovascular Disease Cardiovascular Center, Chungnam National University Hospital 2 1 CVD Statistics,
Which Test When? Avoid the Stress of Stress Testing. Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute
Which Test When? Avoid the Stress of Stress Testing Marc Newell, MD, FACC, FSCCT Minneapolis Heart Institute Outline Understand the importance of coronary artery disease assessment Understand the basics
Dose Myocardial MIBI Washout Rate Has Relation to Risk Stratification of Coronary Artery Disease.
Editorial Dose Myocardial MIBI Washout Rate Has Relation to Risk Stratification of Coronary Artery Disease. Moustafa, M and Omar, M. Kasr Al-Ainy Center of Oncology and Nuclear Medicine, Faculty of Medicine,
The 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
SPECT 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
Case-Based Pitfalls of SPECT and PET: Recognizing and Working with Artifacts
2:20 PM Friday WORKSHOP V Case-Based Pitfalls of SPECT and PET: Recognizing and Working with Artifacts Sean W. Hayes, MD Associate Clinical Professor of Medicine UCLA School of Medicine Cedars-Sinai Heart
Pharmacological stress agents and protocols
Pharmacological stress agents and protocols João V. Vitola, MD, PhD Cardiologist and Nuclear Medicine Physician Quanta Diagnostico Nuclear Curitiba - Brazil DISCLOSURES Honorarium Research and Conferences
Value 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,
PHARMACOLOGICAL STRESS TESTING
PHARMACOLOGICAL STRESS TESTING Southwestern Chapter - SNMMI Warren H. Moore, MD, FACNM, FACC Baylor College of Medicine Dept. of Radiology Baylor St. Luke s Medical Center Texas Heart Institute Houston,
Zahid Rahman Khan, MD(USA), MS Diplomate American Board of Nuclear Medicine Consultant t Nuclear Medicine
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 Introduction Hibernation: Term coined by Rahimtoola
Nuclear 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
This information is current as of December 11, 2006
Noninvasive diagnosis of coronary artery stenosis in women with limited exercise capacity: comparison of dobutamine stress echocardiography and 99mTc sestamibi single-photon emission CT A Elhendy, RT van
A 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
PET 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,
Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study
Trägårdh et al. BMC Medical Imaging 2013, 13:14 RESEARCH ARTICLE Open Access Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study Elin Trägårdh *, Sven
The 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,
CASE from South Korea
CASE from South Korea Bon-Kwon Koo, MD, PhD, Seoul, Korea Outpatient clinic of a non-interventional cardiologist F/56 Chief complaint: Angina with recent aggravation, CCS II~III Brief history: # Stroke
Gated SPECT (gspect) offers the possibility of simultaneous
Calculation of the Left Ventricular Ejection Fraction Without Edge Detection: Application to Small Hearts Bing Feng, MS 1 ; Arkadiusz Sitek, PhD 1,2 ; and Grant T. Gullberg, PhD 1 1 Radiology Department,
EAE 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
Manifestations of 201 Tl Myocardial Single Photon Emission Computed Tomography in Patients with Myocardial Bridge
Manifestations of Tl Myocardial Single Photon Emission Computed Tomography in Patients with Myocardial Bridge Chiung-Zuan Chiu 1, Jun-Jack Cheng 1, Shen-Chang Lin 1, Shih-Huang Lee 1,Peiliang Kuan 1, Kuo-Gi,
Choosing the Appropriate Stress Test: Brett C. Stoll, MD, FACC February 24, 2018
Choosing the Appropriate Stress Test: Brett C. Stoll, MD, FACC February 24, 2018 Choosing the Appropriate Stress Test: Does it Really Matter? Brett C. Stoll, MD, FACC February 24, 2018 Conflicts of Interest
2019 Qualified Clinical Data Registry (QCDR) Performance Measures
2019 Qualified Clinical Data Registry (QCDR) Performance Measures Description: This document contains the 18 performance measures approved by CMS for inclusion in the 2019 Qualified Clinical Data Registry
FUTURE 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
Gated SPECT SPECT. small heart small heart 2. R-R SPECT. MBq Marconi/Shimadzu 3 R-R SPECT R-R R-R. (OdysseyFX) 16 8 QGS (Quantitative Gated SPECT)
97 Gated SPECT * * SPECT R-R R-R 20 ml small heart SPECT ( 39: 97 102, 2002) 1. SPECT SPECT R-R R-R * 13 11 21 1715 (0 270 1694) small heart small heart 2. R-R 12 48 99m Tc-tetrofosmin 740 MBq Marconi/Shimadzu
Echo in CAD: Wall Motion Assessment
Echo in CAD: Wall Motion Assessment Joe M. Moody, Jr, MD UTHSCSA and STVHCS October 2007 Relevant References ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography Bayes de
Cardiac Diagnostics Workshop. Lori Savard NP Cardiology Update 2015
Cardiac Diagnostics Workshop Lori Savard NP Cardiology Update 2015 Disclosure of Commercial Support Potential for conflict(s) of interest: none Objectives Increase understanding regarding stable IHD and
Nuclear Cardiology Imaging: Utility and Limitation for Decision Making in Coronary Interventions
20 Nuclear Cardiology Imaging: Utility and Limitation for Decision Making in Coronary Interventions RAJEEV GUPTA, RAJENDRA GUPTA, YOGESH VERMA, BS YADAV, DM GUPTA, SUDHA GUPTA, NEELU GUPTA INTRODUCTION
CASES IN ADVANCED IMAGING
CASES IN ADVANCED IMAGING DAVID A. ORSINELLI, MD PROFESSOR, CLINICAL INTERNAL MEDICINE THE OHIO STATE UNIVERSITY DIVISION OF CARDIOVASCULAR MEDICINE OHIO ACC ANNUAL CONFERENCE OCTOBER 2010 WHICH IMAGING
Low Event Rate for Stress-Only Perfusion Imaging in Patients Evaluated for Chest Pain
Journal of the American College of Cardiology Vol. 39, No. 6, 2002 2002 by the American College of Cardiology Foundation ISSN 0735-1097/02/$22.00 Published by Elsevier Science Inc. PII S0735-1097(02)01720-5
Gated 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
presenters 2010 Sameh Sabet Ain Shams University
Guidelines for PCI in late STEMI presenters 2010 Sameh Sabet Assistant Professor of Cardiology Ain Shams University 29% of MI patients have STEMI. NRMI 4 (Fourth National Registry of Myocardial Infarction),
Imaging ischemic heart disease: role of SPECT and PET. Focus on Patients with Known CAD
Imaging ischemic heart disease: role of SPECT and PET. Focus on Patients with Known CAD Hein J. Verberne Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands International Conference
Prognostic Value of Normal Stress-Only Technetium-99 m Myocardial Perfusion Imaging Protocol
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Imaging Prognostic Value of Normal Stress-Only Technetium-99 m Myocardial Perfusion Imaging
Non Invasive Diagnostic Modalities for Coronary Artery Disease. Dr. Amitesh Aggarwal
Non Invasive Diagnostic Modalities for Coronary Artery Disease Dr. Amitesh Aggarwal Ebers papyrus, ca. 1555 BCE If thou examine a man for illness in his cardia, and he has pains in his arms, in his breasts
EMPHISIS ON PHYSIOLOGY PHYSIOLOGY REQUIRES TIME QUALITATIVE vs. QUANTITATIVE ISOTOPES TO RADIOPHARMACEUTICALS
1926 Herman Blumgard used solutions of radon gas to measure what he called velocity of the circulation. 1927 Blumberg and Soma Weiss wrote article in (Journal of Clinical Investigation) 1929 Werner Forssmann
Enhanced regional washout of technetium-99m-sestamibi in patients with coronary spastic angina
ORIGINAL ARTICLE Annals of Nuclear Medicine Vol. 17, No. 5, 393 398, 2003 Enhanced regional washout of technetium-99m-sestamibi in patients with coronary spastic angina Souichi ONO,* Yasuchika TAKEISHI,**
Nuclear 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
Testing the Asymptomatic CAD Patient: When and Why?
Testing the Asymptomatic CAD Patient: When and Why? Timothy M. Bateman M.D. Co-Director, Cardiovascular Radiologic Imaging Mid America Heart Institute Professor of Medicine University of Missouri-Kansas
SPECT. 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
Stable Angina: Indication for revascularization and best medical therapy
Stable Angina: Indication for revascularization and best medical therapy Cardiology Basics and Updated Guideline 2018 Chang-Hwan Yoon, MD/PhD Cardiovascular Center, Department of Internal Medicine Bundang
Coronary Artery disease (CAD)
40 Diagnostic Accuracy of Stress Myocardial Perfusion Imaging in Diagnosing Stable Ischemic Heart Disease G Varadaraj 1*, GS Chowdhary 2, R Ananthakrishnan 3, MJ Jacob 4, P Mukherjee 5 Abstract Objective:
Division of Nuclear Medicine Procedure / Protocol
Division of Nuclear Medicine Procedure / Protocol MYOCARDIAL PLANAR STRESS &/OR REST CPT CODE: 78460-61, 78464-65, 78478, 78480 FOR USE WITH THALLIUM 201 AGENTS ONLY UPDATED: MARCH 2012 Indications: Diagnosis
Non-commercial use only
Heart International 2011; volume 6:e22 Triple vessel coronary artery disease presenting as a markedly positive stress electrocardiographic test and a negative SPECT-TL scintigram: a case of balanced ischemia
Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging
Trägårdh et al. EJNMMI Research 2012, 2:27 ORIGINAL RESEARCH Open Access Referring physicians underestimate the extent of abnormalities in final reports from myocardial perfusion imaging Elin Trägårdh
Value 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
Myocardial perfusion imaging
THEME Imaging Myocardial perfusion imaging A validated and mature cardiac imaging modality Alex Pitman BMedSci, MBBS, FRANZCR, is Professor and Director of Medical Imaging, Department of Medical Imaging,
Ventricular tachycardia and ischemia. Martin Jan Schalij Department of Cardiology Leiden University Medical Center
Ventricular tachycardia and ischemia Martin Jan Schalij Department of Cardiology Leiden University Medical Center Disclosure: Research grants from: Boston Scientific Medtronic Biotronik Sudden Cardiac
Sestamibi and tetrofosmin represent reliable alternative
Feasibility and Diagnostic Accuracy of a Gated SPECT Early-Imaging Protocol: A Multicenter Study of the Myoview Imaging Optimization Group Assuero Giorgetti, Massimiliano Rossi, Mario Stanislao, Guido
The 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,
Truncation in Myocardial Perfusion SPECT Imaging
International Journal of Nuclear Energy Scie nce and Engineering Vol. 2 Iss. 4, December 2012 Truncation in Myocardial Perfusion SPECT Imaging Brian Wosnitzer *, Marvin Friedman, Gordon DePuey Division