RADIOISOTOPE STUDIES IN CARDIOLOGY
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1 RADIOISOTOPE STUDIES IN CARDIOLOGY
2 DEVELOPMENTS IN NUCLEAR MEDICINE Series editor Peter H. Cox Cox, P.H. (ed.): Cholescintigraphy ISBN Cox, P.H. (ed.): Progress in radiopharmacology 3. Selected Topics ISBN Jonckheer, M.H. and Deconinck, F. (eds.): X-ray fluorescent scanning of the thyroid ISBN X Kristensen, K. and N0fbygaard, E. (eds.): Safety and efficacy of radiopharmaceuticals ISBN Bossuyt, A. and Deconinck, F.: Amplitude/phase patterns in dynamic scintigraphic imaging ISBN Hardeman, M.R. and Najean, Y. (eds.): Blood cells in nuclear medicine I. Cell kinetics and bio-distribution ISBN Fueger, G.F. (ed.): Blood cells in nuclear medicine II. Migratory blood cells ISBN Biersack, H.J. and Cox, P.H. (eds.): Radioisotope studies in cardiology ISBN
3 Radioisotope studies in cardiology edited by H.J. BIERSACK Institute of Clinical and Experimental Nuclear Medicine University of Bonn Federal Republic of Germany P.H. cox Department of Nuclear Medicine Rotterdam Radio-Therapeutic Institute Rotterdam, The Netherlands 1985 MARTINUS NIJHOFF PUBLISHERS a member of the KLUWER ACADEMIC PUBLISHERS GROUP DORDRECHT / BOSTON / LANCASTER
4 Distributors jor the United States and Canada: Kluwer Academic Publishers, 190 Old Derby Street, Hingham, MA 02043, USA jor the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited, Falcon House, Queen Square, Lancaster LAI lrn, UK jor all other countries: Kluwer Academic Publishers Group, Distribution Center, P.O. Box 322, 3300 AH Dordrecht, The Netherlands Library of Congress Cataloging in Publication Data Main entry under title: Radioisotope studies in cardiology. (Developments in nuclear medicine) Includes index. 1. Radioisotope scanning. 2. Radioisotopes in cardiology. 3. Heart--Diseases--Diagnosis. 4. Diagnosis, Noninvasive. I. Biersack, H. J. II. Cox, Peter H. III. Series. [DNLM: 1. Cardiology--methods. 2. Heart- radionuclide imaging. 3. Radioisotopes--diagnostic use. Wi DE998KF / we R2 R129] RC683.5.R33R ' ISBN-13: : / e-isbn-13: Copyright 1985 by Martinus Nijhoff Publishers, Dordrecht. Softcover reprint of the hardcover I st edition 1985 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publishers, Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht, The Netherlands.
5 v CONTENTS Foreword Contributors H.J. Biersack, P.H. Cox vii viii I. BASIC SCIENCE Myocardial ischemia: a profile of its pathophysiological basis and its detection by nuclear cardiology W.J. Remme 3 Data processing in nuclear cardiology R. Knopp, C. Winkler 49 Radiopharmaceuticals P.H. Cox 63 The metabolism of radio iodinated free fatty acids in the heart S.N. Reske 83 II. GATED BLOOD-POOL IMAGING Assessment of left ventricular global function H.P. Breuel, M. Bahre Investigation of regional wall motion of the heart by means of radionuclide ventriculography (RNV) R. Bauer, H.W. Pabst, H. Langhammer Evaluation of regurgitation in aortic and mitral valve insufficiency H. Klepzig, G. Har Gold195m for assessment of cardiac function F.F.Th. Wackers, H.J. Berger, P.B. Hoffer, R.C. Lange, B.L. Zaret III. MYOCARDIAL PERFUSION Diagnostic utility of T1 201 imaging R. Schmoliner, R. Dudczak Visualization of myocardial blood-flow changes with intracoronary Kr81m W.J. Remme, P.H. Cox, X.H. Krauss, H.P.A.C.M. Kruyssen, C.J. Storm, D.C. van Hoogenhuyzen III
6 VI Tc99m_DMPE, a potential substitute for T1201 chloride? C. Schtimichen, P. Bergmann, M. Hall 283 IV. IMAGING WITH FATTY ACIDS, INFARCT IMAGING Imaging with labelled fatty acids R. Dudczak Myocardial infarct imaging with Tc 99m (Sn) pyrophosphate J. Dressler, G. Hor V. TOMOGRAPHIC TECHNIQUES Single photon emission computed tomography (SPECT) in nuclear cardiology H.J. Biersack, C. Winkler Positron emission tomography (PET) of the myocardium K. Vyska, L.E. Feinendegen VI. IMPACT OF RADIONUCLIDE TECHNIQUES ON CLINICAL CARDIOLOGY O. Pachinger Author index Subject index
7 VII FOREWORD During the last decade many significant advances have been made in the in vivo diagnosis of disease. An area of particular success has been the application of nuclear medical procedures to the detection of cardiac disease. Not only is it possible to detect infarction or ischemia by scintigraphic techniques but by the use of labelled metabolites and analogues of potassium the viability of myocardial tissue can be evaluated. The efficiency of the heart pump can be calculated and wall motility observed in one simple procedure. The use of ultra short life radionuclides has made the evaluation of rapid changes in myocardial function feasible. Altogether a broad and impressive diagnostic package. In this volume up-to-date reviews of all of the available techniques have been collected including methods which are still in the development phase. There is an inherent emphasis on European experience in Nuclear Cardiology which is then placed in context with world wide experience in the field. This volume will be of interest to all concerned with cardiac diseases and we hope that it will serve to stimulate further developments in the future. H.J. Biersack, Bonn P.H. Cox, Rotterdam
8 VIII CONl'RIBUTORS Bauer, R. Biersack, H.J. Breuel, H.P. Cox, P.H. Dressler, J. Dudczak, R. Klepzig jr., H. Knopp, R. Padl.inger, O. Rerrme, W.J. Reske, S.N. Schrroliner, R. Sdl.limichen, C. Vyska, K. Wackers, F.J. Th. - Nukleanredizinisdl.e Klinik und Poliklinik redl.ts der Isar der Tedlnisdl.en Universitat Mlinchen, FRS. - Institut fur klinisdl.e und experimentelle Nukleanredizin der Universitat Bonn, FRG. - Degussa Phanna Horrburg, Frankfurt 1, FRG. - Department of Nuclear Hedicine, Rotterdamsdl. Radio-Therapeutisdl. Insti tuut, Rotterdam, The Netherlands. - Abteilung Allgerreine Nuklearrredizin, Zentrum der Radiologie, Klinikum der Universitat, Frankfurt/ Main, FRS. - Department of Nuclear Medicine, I. Hedizinisdl.e Uni versi tatsklinik, Vienna, Austria. - Abteilung Kardiologie- ZIM Uni versi tatskliniken, Frankfurt/ Main, FRG. - Institut fur klinisdl.e und experimentelle Nukleanredizin der Universitat Bonn, FRG. - Kardiologisdl.e Universitats-Klinik, Wien, Austria. - Department of Cardiology, Zuiderziekenhuis, Rotterdam, The Netherlands. - Institut fur klinisdl.e und experirrentelle Nukleanredizin der Universitat Bonn, FRG. - First rredical department University of Vienna, Austria. - Department of Nuclear ~1edicine A1bert-Ludwigs-University of Freiburg i. Br., FRG - Institut fur Hedizin der Kernforschungsanlage Julidl., Fffi. - Cardiology Section, Yale University School of Nledicine, New Haven, Connecticut, USA.
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