Treadmill Exercise Produces Larger Perfusion Defects Than Dipyridamole Stress N-13 Ammonia Positron Emission Tomography
|
|
- Joleen Farmer
- 5 years ago
- Views:
Transcription
1 Journal of the American College of Cardiology Vol. 47, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.00 Published by Elsevier Inc. doi: /j.jacc Treadmill Exercise Produces Larger Perfusion Defects Than Dipyridamole N-13 Ammonia Positron Emission Tomography Cardiac Imaging Benjamin J. W. Chow, MD, FRCPC, FACC,* Rob S. Beanlands, MD, FRCPC, FACC,* Andrea Lee,* Jean N. DaSilva, PHD,* Robert A. dekemp, PHD,* Abdulkareem Alkahtani, MD,* Terrence D. Ruddy, MD, FRCPC, FACC* Ottawa, Ontario, Canada OBJECTIVES BACKGROUND METHODS RESULTS CONCLUSIONS The aim of this study was to compare treadmill exercise (TEX) and dipyridamole stress on the uptake and retention of N-13 ammonia. Size and severity of stress-induced myocardial perfusion defects are clinically important. Because ammonia uptake and retention seems to be related to perfusion, viability, and metabolism, exercise stress might induce larger perfusion defects than dipyridamole stress. Twenty-six patients underwent TEX and dipyridamole stress N-13 ammonia positron emission tomography (PET). Images were assessed with a 17-segment model and a five-point score. Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were calculated. Left ventricular (LV) defect sizes were measured quantitatively with a 70% threshold for abnormal perfusion. Compared with dipyridamole stress, TEX yielded larger SSS ( vs ; p 0.01), SDS ( vs ; p 0.02), and percentage of LV stress defect ( % vs %; p 0.02). In patients achieving adequate exercise, TEX N-13 ammonia PET myocardial perfusion imaging (MPI) yields larger stress perfusion defects than dipyridamole stress and might reflect the true myocardial ischemic burden. Treadmill exercise might be the preferred method of stress for routine N-13 ammonia PET MPI. (J Am Coll Cardiol 2006;47: 411 6) 2006 by the American College of Cardiology Foundation Size and severity of stress-induced myocardial perfusion defects are clinically important. Differences in perfusion defects with various stressors might have prognostic implications (1,2). Positron emission tomography (PET) is traditionally performed with vasodilator stress, and the evaluation of treadmill exercise (TEX) PET myocardial perfusion imaging (MPI) is limited. A previous study comparing TEX versus dipyridamole stress rubidium-82 PET showed that defect size and severity were similar (3). Because ammonia uptake and retention seems to be related to perfusion, viability, and metabolism (glutamine pathway), exercise stress might induce larger perfusion defects than with dipyridamole stress (4 7). The objective of this study was to compare TEX and dipyridamole stress on the uptake and retention of N-13 ammonia in patients able to perform adequate exercise stress. From the *Division of Cardiology, University of Ottawa Heart Institute, and the Division of Nuclear Medicine, Ottawa Hospital, Ottawa, Ontario, Canada. Dr. Beanlands was supported by the Canadian Institute of Health Research and the Ontario Premier s Research Excellence Award. This research was supported in part by the Ontario Research and Development Challenge Fund (#00-May-0710) for the Ontario Consortium of Cardiac Imaging. Manuscript received April 5, 2005; revised manuscript received August 30, 2005, accepted September 8, METHODS Patients. Between August 2003 and September 2004, 31 patients, able to perform adequate exercise stress, were prospectively referred to this single-center, randomized, single-blinded study. All patients had documented coronary artery disease (CAD) or an intermediate-to-high pre-test probability for CAD (3). Patients lacking informed consent, age 18 years, unable to exercise, or with a contraindication to dipyridamole or radiation were excluded. This study was approved by the University of Ottawa Heart Institute Human Research Ethics Board. The order of stress was randomized (dipyridamole vs. TEX). Dipyridamole and TEX stress N-13 ammonia PET were performed on different days, and each was preceded by rest imaging. Patients abstained from caffeine, xanthine derivatives, and atrioventricular nodal blocking drugs 12 h and fasted (except for medications) 6 h before each study. PET imaging. The PET images were acquired with an ECAT ART scanner (Siemens/CTI, Knoxville, Tennessee). A 4-min Cesium-137 singles transmission scan was acquired to confirm proper patient positioning and for attenuation correction (8). Ten millicuries (370 MBq) of N-13 ammonia was injected at rest and with stress. Static images were created by summing 17 min of emission data.
2 412 Chow et al. JACC Vol. 47, No. 2, 2006 Exercise Versus Dipyridamole N-13 Ammonia PET January 17, 2006:411 6 Abbreviations and Acronyms CAD coronary artery disease LV left ventricle/ventricular MPI myocardial perfusion imaging PET positron emission tomography SDS summed difference score SPECT single-photon emission tomography SRS summed rest score SSS summed stress score TEX treadmill exercise An 8-min transmission scan was acquired post-stress for attenuation correction (Fig. 1). Dipyridamole stress. The dipyridamole stress protocol has been previously described (3); N-13 ammonia was administered over 30 s, and static uptake images were created by summing 17 min of emission data. TEX stress. Symptom-limited Bruce protocol was performed. During the last 1.5 min of peak exercise, N-13 ammonia was administered. Patients were immediately repositioned in the PET camera, and a 17-min emission scan was acquired and used to create static images. Electrocardiography and image analysis. Electrocardiography analysis has been previously described (3). The PET images were assessed with a 17-segment model and a five-point grading system by two expert observers blinded to stress (2). Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were calculated. Images were also analyzed by a sectored analysis approach with a 70% threshold cutoff for abnormal perfusion (3). Image quality was assessed visually and quantitatively on the basis of myocardial count density (Bq/cc) and target/ background ratios (3). Statistical analysis. With SPSS version 11.5 (Chicago, Illinois), paired and independent samples of continuous variables were evaluated with the paired or unpaired t test and non-continuous variables with the McNemar test. The concordance of the observer grading of the exercise Table 1. Patient Demographics Demographics, n 26 Age (yrs) Gender (men) 23 (89) BMI (kg/m 2 ) Hypertension 20 (78) Diabetes 3 (12) Dyslipidemia 24 (92) Smoker 14 (54) Family history of CAD 8 (31) Cardiac history Myocardial infarction 11 (42) Percutaneous coronary intervention 9 (35) Coronary artery bypass surgery 4 (15) Medications Anti-platelet 23 (88) Beta-blocker 20 (78) Statin 21 (81) ACE-I or ARB 17 (65) Values are n (%) or mean SD. ACE-I angiotensin-converting enzyme inhibitor; ARB angiotensin receptor blocker; BMI body mass index; CAD coronary artery disease. and dipyridamole stress scans was evaluated with Kappa scores. Perfusion defects (summed scores and percentage of left ventricular [LV] defect) were correlated with a Pearson correlation coefficient and Bland-Altman plot analyses. RESULTS Patient population. Thirty-one patients were referred to our study. Four patients were excluded because of left bundle branch block (n 1), uncontrolled atrial tachyarrhythmia (n 2), and insufficient dose of N-13 ammonia (n 1). One patient was withdrawn from the study because of extensive severe ischemia with TEX N-13 ammonia PET. The remaining 26 patients underwent both TEX and dipyridamole stress N-13 ammonia PET MPI (Table 1). Treadmill test. The mean time interval between TEX and dipyridamole stress PET was days (Table 2). Peak stress heart rate and blood pressure were significantly higher Figure 1. Rest and stress N-13 ammonia positron emission tomography protocol.
3 JACC Vol. 47, No. 2, 2006 January 17, 2006:411 6 Chow et al. Exercise Versus Dipyridamole N-13 Ammonia PET 413 Table 2. Response to Treadmill Exercise and Dipyridamole (n 26) Exercise Dipyridamole p Value Duration of exercise (min) Age-predicted maximum HR (%) Patients achieving 85% APMHR 24 (92.3) Resting heart rate NS Peak stress HR Resting systolic blood pressure NS Resting diastolic blood pressure NS systolic blood pressure diastolic blood pressure Rate-pressure product 29,799 7,108 13,256 2, ST-segment depression 17 (65) 5 (19) Chest pain 4 (15) 14 (54) 0.01 Values are n (%) or mean SD. APMHR age-predicted maximal heart rate; HR heart rate. with exercise than dipyridamole stress. Chest pain was more common with dipyridamole, and ST-segment depression was more common with TEX. All five patients with dipyridamole-induced ST-segment depression had abnormal N-13 PET MPI. Mean time interval from onset of N-13 ammonia infusion to initiation of emission data acquisition was min. MPI. There was good correlation between dipyridamole and TEX stress N-13 PET (Fig. 2). defect sizes (percentage of LV) with a 70% threshold for abnormal had fair correlation between stressors (Table 3). Rest defect sizes (percentage of LV) before exercise and dipyridamole stress also had fair correlation. Treadmill exercise stress produced larger and more severe induced stress (SSS) and ischemic perfusion defects (SDS) compared with dipyridamole stress. Bland Altman analysis demonstrated a bias toward larger and more severe SSS and SDS with TEX than with dipyridamole stress (Fig. 3). The 17 patients with exercise-induced ischemic STsegment depression had larger perfusion defects (SSS) with exercise than with dipyridamole ( and , respectively; p 0.03) with good correlation (r 0.81). In the remaining nine patients without exercise-induced STsegment depression, there was a trend toward greater exercise SSS than dipyridamole SSS ( and , respectively; p 0.08). Furthermore, a similar trend was noted when patients with and without exercise-induced ST-segment depression were compared ( and , respectively; p 0.09). The interobserver variability of SSS showed good agreement with Kappa scores of 0.71 for exercise SSS (normal [SSS 4] or abnormal [SSS 4]) and 0.74 for dipyridamole SSS. Patients were categorized as having disease in the left anterior descending artery, left circumflex, and/or right coronary artery territories. Kappa analysis demonstrated fair correlation between exercise and dipyridamole stress in each territory (left anterior descending artery 0.57, left circumflex artery 0.69, and right coronary artery 0.54; p 0.01). Patients were also categorized as normal or singlevessel versus multivessel disease. Four of the 12 (33%) patients initially categorized as having normal or singlevessel disease with dipyridamole stress had multivessel disease with TEX N-13 ammonia PET. Furthermore, patients were categorized into normal to mildly abnormal SSS ( 8) and moderate to severely abnormal SSS ( 8). Five of the 18 (28%) patients with dipyridamole-induced normal or mildly abnormal SSS had moderate to severely abnormal SSS with TEX. Figure 2. (A) Correlation of exercise and dipyridamole summed stress score (SSS). (B) Correlation of exercise and dipyridamole summed rest score (SRS). (C) Correlation of exercise and dipyridamole summed difference score (SDS).
4 414 Chow et al. JACC Vol. 47, No. 2, 2006 Exercise Versus Dipyridamole N-13 Ammonia PET January 17, 2006:411 6 Table 3. Semi-Quantitative and Quantitative Analysis of N-13 PET Myocardial Perfusion Images Exercise Dipyridamole p Value Correlation Significance of Correlation Summed stress score Summed rest score NS Summed difference score LV defect size (stress) (%) LV defect size (rest) (%) NS Values are mean SD. LV left ventricle; PET positron emission tomography. Image quality. The TEX images demonstrated less infradiaphragmatic activity in 24 of the 26 patients (Fig. 4). Myocardial uptake count density was significantly lower with exercise than with dipyridamole (Table 4). DISCUSSION Most exercise stress PET MPI studies have focused on supine bicycle (9 11). Though TEX has been successfully Figure 3. (A) Bland Altman SSS (treadmill exercise [TEX] vs. dipyridamole). (B) Bland Altman SRS (TEX vs. dipyridamole). (C) Bland Altman SDS (TEX vs. dipyridamole). SD standard deviation; other abbreviations as in Figure 2. Figure 4. Larger stress defect with treadmill exercise than with dipyridamole stress. A mild (magenta) perfusion defect is present in the inferolateral wall and apex with dipyridamole stress. The size and severity (blue) of the defect is greater after exercise stress.
5 JACC Vol. 47, No. 2, 2006 January 17, 2006:411 6 Chow et al. Exercise Versus Dipyridamole N-13 Ammonia PET 415 Table 4. Image Quality of N-13 Ammonia PET Myocardial Perfusion Images (Exercise vs. Dipyridamole) Exercise Dipyridamole p Value N-13 ammonia dose, rest (MBq) NS N-13 ammonia dose, stress (MBq) Rest myocardial uptake (Bq/cc) 20,272 7,846 18,578 7,510 NS myocardial uptake (Bq/cc) 19,271 10,278 26,224 10, Myocardium/lung rest Myocardium/lung stress NS Myocardium/gut rest NS Myocardium/gut stress NS Myocardium/liver rest NS Myocardium/liver stress NS Myocardium/blood pool rest NS Myocardium/blood pool stress NS Values are mean SD. PET positron emission tomography. performed with rubidium-82 and FDG PET MPI (3,12), this is the first study to combine TEX with N-13 ammonia PET. In patients who achieve adequate exercise, TEX N-13 ammonia PET seems to induce larger and more severe stress and ischemic perfusion defects than dipyridamole stress. Retention of N-13 ammonia is adenosine triphosphatedependant and requires the metabolism of ammonia to glutamine (13). Thus, uptake and retention might be altered by changes in metabolic state (14,15). Exercise-induced ischemia might cause metabolic stunning, reduce the metabolism of ammonia to glutamine, and attenuate N-13 ammonia retention in areas of ischemia. Exercise MPI has been compared with various vasodilator stressors (4,16 18) Comparing exercise, dipyridamole, and adenosine stress Tc-99m single-photon emission tomography (SPECT), exercise resulted in greater defect extent, severity, and reversibility than dipyridamole but no differences in defect size between exercise and adenosine (17). Treadmill exercise SPECT stress defects were larger than with dipyridamole in 45% of patients (16). Larger exercise stress defects were typically observed in patients with higher heart rates (16). Nishimura et al. (19) showed that adenosine stress induced larger defect sizes than exercise Tl-201 SPECT. Abe et al. (4) compared adenosine and TEX Tl-201 MPI and found no difference in patients who were able to perform adequate exercise. Though our study demonstrated that TEX provoked larger and more severe perfusion defects than dipyridamole stress, this was more apparent in patients with mild to moderate SSS and SDS with dipyridamole stress. This finding might be explained by: the high level of exercise achieved in our patients, which might have resulted in more ischemia; the superior accuracy of N-13 ammonia PET that might have enabled the detection of differences between exercise and dipyridamole; and the rapid return of flow to normal after exercise compared with a dipyridamoleaminophylline protocol, which might delay N-13 ammonia washout from normal tissue compared with ischemic tissue, thus amplifying the defect size. Five patients having normal to mildly abnormal SSS with dipyridamole were reclassified as having moderate to severely abnormal SSS with TEX. Similarly, four patients classified as normal or single-vessel disease with dipyridamole stress had evidence of multivessel disease with TEX N-13 ammonia PET. These differences in exercise and dipyridamole stress SSS, SDS, and defect size might be clinically relevant and might influence patient management. Although TEX does not permit the benefits of dynamic acquisition for the quantification of blood flow, it does provide information about exercise tolerance and is preferred by most patients (3). Resting myocardial/lung ratio was significantly different before exercise and dipyridamole stress. Because resting target/background ratios should not differ in the same patient, we believe that this finding likely occurred by chance. The successful performance of the TEX stress N-13 ammonia PET required the coordination of the cyclotron laboratory and the imaging team. The completion of N-13 ammonia synthesis and its delivery occurred simultaneously with the initiation of TEX. A surplus of N-13 ammonia was manufactured (2.5 times the injected dose) to ensure that an adequate quantity of radiotracer was available at peak exercise. Study limitations. Our patient population was predominantly male, and our small sample size is prone to patientrelated systematic errors and was not powered to detect significant differences in the subgroup analysis. Coronary angiography was not routinely performed to validate the accuracy of TEX versus dipyridamole N-13 ammonia PET and warrants further investigation. Conclusions. In patients achieving adequate exercise, TEX N-13 ammonia PET MPI yields larger and more severe defects than dipyridamole stress. Images acquired after TEX might reflect the true ischemic burden. Treadmill exercise
6 416 Chow et al. JACC Vol. 47, No. 2, 2006 Exercise Versus Dipyridamole N-13 Ammonia PET January 17, 2006:411 6 might be the preferred method of stress for routine N-13 ammonia PET MPI. Acknowledgments The authors extend their gratitude to the staff at the National Cardiac PET Centre for their technical expertise. Reprint requests and correspondence: Dr. Benjamin J. W. Chow, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada, K1Y 4W7. bchow@ottawaheart.ca. REFERENCES 1. Marwick TH, Shan K, Patel S, Go RT, Lauer MS. Incremental value of rubidium-82 positron emission tomography for prognostic assessment of known or suspected coronary artery disease. Am J Cardiol 1997;80: Hachamovitch R, Berman DS, Shaw LJ, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97: Chow BJW, Ananthasubramaniam K, dekemp RA, Dalipaj MM, Beanlands RSB, Ruddy TD. Comparison of treadmill exercise versus dipyridamole stress as an adjunct to myocardial perfusion imaging with 82Rb positron emission tomography. J Am Coll Cardiol 2005;45: Abe S, Takeishi Y, Chiba J, Ikeda K, Tomoike H. Comparison of adenosine and treadmill exercise thallium-201 stress tests for the detection of coronary artery disease. Jpn Circ J 1993;57: Schelbert HR, Phelps ME, Huang SC, et al. N-13 ammonia as an indicator of myocardial blood flow. Circulation 1981;63: Schwaiger M, Muzik O. Assessment of myocardial perfusion by positron emission tomography. Am J Cardiol 1991;67:35D 43D. 7. Rosenspire KC, Schwaiger M, Mangner TJ, Hutchins GD, Sutorik A, Kuhl DE. Metabolic fate of [13N]ammonia in human and canine blood. J Nucl Med 1990;31: Townsend DW, Beyer T, Jerin J, et al. The ECAT ART Scanner for positron emission tomography. 1. Improvements in performance characteristics. Clin Positron Imaging 1999;2: Krivokapich J, Smith GT, Huang SC, et al. 13N ammonia myocardial imaging at rest and with exercise in normal volunteers. Quantification of absolute myocardial perfusion with dynamic positron emission tomography. Circulation 1989;80: Camici P, Araujo LI, Spinks T, et al. Increased uptake of 18Ffluorodeoxyglucose in postischemic myocardium of patients with exercise-induced angina. Circulation 1986;74: Tamaki N, Yonekura Y, Senda M, et al. Myocardial positron computed tomography with 13N-ammonia at rest and during exercise. Eur J Nucl Med 1985;11: Marwick TH, MacIntyre WJ, Salcedo EE, Go RT, Saha G, Beachler A. Identification of ischemic and hibernating myocardium: feasibility of post-exercise F-18 deoxyglucose positron emission tomography. Cathet Cardiovasc Diagn 1991;22: DeGrado TR, Bergmann SR, Ng CK, Raffel DM. Tracer kinetic modeling in nuclear cardiology. J Nucl Cardiol 2000;7: Rauch B, Helus F, Grunze M, et al. Kinetics of 13N-ammonia uptake in myocardial single cells indicating potential limitations in its applicability as a marker of myocardial blood flow. Circulation 1985;71: Bergmann SR, Hack S, Tewson T, Welch MJ, Sobel BE. The dependence of accumulation of 13NH3 by myocardium on metabolic factors and its implications for quantitative assessment of perfusion. Circulation 1980;61: David N, Marie PY, Angioi M, et al. Dipyridamole and exercise SPET provide different estimates of myocardial ischaemic areas: role of the severity of coronary stenoses and of the increase in heart rate during exercise. Eur J Nucl Med 2000;27: Levine MG, Ahlberg AW, Mann A, et al. Comparison of exercise, dipyridamole, adenosine, and dobutamine stress with the use of Tc-99m tetrofosmin tomographic imaging. J Nucl Cardiol 1999;6: Iskandrian AS. Single-photon emission computed tomographic thallium imaging with adenosine, dipyridamole, and exercise. Am Heart J 1991;122: Nishimura S, Mahmarian JJ, Boyce TM, Verani MS. Equivalence between adenosine and exercise thallium-201 myocardial tomography: a multicenter, prospective, crossover trial. J Am Coll Cardiol 1992;20:
Comparison of Treadmill Exercise Versus Dipyridamole Stress With Myocardial Perfusion Imaging Using Rubidium-82 Positron Emission Tomography
Journal of the American College of Cardiology Vol. 45, No. 8, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.01.016
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 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 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 informationJournal of the American College of Cardiology Vol. 50, No. 11, by the American College of Cardiology Foundation ISSN /07/$32.
Journal of the American College of Cardiology Vol. 50, No. 11, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.05.035
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 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 informationNormal 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
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 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 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 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 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 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 informationMy Patient Needs a Stress Test
My Patient Needs a Stress Test Amy S. Burhanna,, MD, FACC Coastal Cardiology Cape May Court House, New Jersey Absolute and relative contraindications to exercise testing Absolute Acute myocardial infarction
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 information2019 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
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 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 information2017 Qualified Clinical Data Registry (QCDR) Performance Measures
2017 Qualified Clinical Data Registry (QCDR) Performance Measures Description: This document contains the 15 performance measures that were approved by CMS for use in ASC's 2017 Qualified Clinical Data
More informationTitle. CitationJournal of Nuclear Cardiology, 23(3): Issue Date Doc URL. Rights. Type. File Information
Title Incidental focal myocardial 18F-FDG uptake indicatin Aikawa, Tadao; Naya, Masanao; Manabe, Osamu; Obara, Author(s) Hiroyuki CitationJournal of Nuclear Cardiology, 23(3): 596-598 Issue Date 2016-06
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 informationCardiovascular 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
More informationA Prognostic Score for Prediction of Cardiac Mortality Risk After Adenosine Stress Myocardial Perfusion Scintigraphy
Journal of the American College of Cardiology Vol. 45, No. 5, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2004.08.069
More informationCardiovascular 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:
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 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 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 informationINTRODUCTION. Key Words:
Original Article Acta Cardiol Sin 2013;29:243 250 Coronary Artery Disease Prognostic Value of Functional Variables as Assessed by Gated Thallium-201 Myocardial Perfusion Single Photon Emission Computed
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 informationPET is currently the accepted gold standard in noninvasive
CT Attenuation Correction for Myocardial Perfusion Quantification Using a PET/CT Hybrid Scanner Pascal Koepfli, MD 1 ; Thomas F. Hany, MD 2 ; Christophe A. Wyss, MD 1 ; Mehdi Namdar, MD 1 ; Cyrill Burger,
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 informationRubidium-82 myocardial perfusion PET/CT
Rubidium- myocardial perfusion PET/CT A.M. Scholtens, MD 1 ; P.C. Barneveld, MD 2 Departments of Nuclear Medicine of 1 Meander Medical Center, Amersfoort, the Netherlands, and 2 Jeroen Bosch Hospital,
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 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 informationPhysiological Assessment of Myocardial Perfusion Using Nuclear Cardiology Would Enhance Coronary Artery Disease Patient Care
Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp CONTROVERSIES IN CARDIOVASCULAR MEDICINE Physiological Assessment of Myocardial Perfusion Using Nuclear
More informationEvidence for myocardial CT perfusion imaging in the diagnosis of hemodynamically significant coronary artery disease
Editorial Evidence for myocardial CT perfusion imaging in the diagnosis of hemodynamically significant coronary artery disease Zhonghua Sun Discipline of Medical Imaging, Department of Imaging and Applied
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 informationPatient-centered Imaging in Coronary Artery Disease. Jason H Cole, MD, MS, FACC January 10, 2015
Patient-centered Imaging in Coronary Artery Disease Jason H Cole, MD, MS, FACC January 10, 2015 Non-invasive coronary imaging Non-invasive cardiac imaging has improved assessment of cardiac function, anatomy,
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 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 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 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 informationJournal of the American College of Cardiology Vol. 49, No. 10, by the American College of Cardiology Foundation ISSN /07/$32.
Journal of the American College of Cardiology Vol. 49, No. 10, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.12.015
More informationValue of Stress Myocardial Perfusion Single Photon Emission Computed Tomography in Patients With Normal Resting Electrocardiograms
Value of Stress Myocardial Perfusion Single Photon Emission Computed Tomography in Patients With Normal Resting Electrocardiograms An Evaluation of Incremental Prognostic Value and Cost-Effectiveness Rory
More informationMyocardial 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 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 informationClick 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
More informationChoosing the Right Cardiac Test. Outline
Choosing the Right Cardiac Test Atif Qasim, M.D., M.S.C.E. University of California, San Francisco Disclosures: None 2013 Outline Focus on choosing the optimal tests for coronary disease evaluation Overview
More informationNon-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
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 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 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 informationRisk Stratification for CAD for the Primary Care Provider
Risk Stratification for CAD for the Primary Care Provider Shimoli Shah MD Assistant Professor of Medicine Directory, Ambulatory Cardiology Clinic Knight Cardiovascular Institute Oregon Health & Sciences
More informationPrognostic Value of Lung Sestamibi Uptake in Myocardial Perfusion Imaging of Patients With Known or Suspected Coronary Artery Disease
Journal of the American College of Cardiology Vol. 45, No. 10, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.02.059
More informationEvaluating Clinical Risk and Guiding management with SPECT Imaging
Evaluating Clinical Risk and Guiding management with SPECT Imaging Raffaele Giubbini Chair and Nuclear Medicine Unit University & Spedali Civili Brescia- Italy U.S. Congressional Budget Office. Technological
More informationCardiovascular Imaging Stress Echo
Cardiovascular Imaging Stress Echo Theodora A Zaglavara, MD, PhD Cardiac Imaging Department INTERBALKAN MEDICAL CENTER Thessaloniki GREECE Evolution of Stress Echo: From Innovation to a Widely Established
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 informationIs Myocardial Perfusion Imaging an Important Predictor of Mortality in Women
JACC: CARDIOVASCULAR IMAGING VOL. 4, NO. 8, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. DOI:10.1016/j.jcmg.2011.07.003 EDITORIAL VIEWPOINT
More informationComparison between 1-compartmental and 2-compartmental model in calculation of myocardium blood flow in 82 Rb PET imaging
ORIGINAL RESEARCH Comparison between 1-compartmental and 2-compartmental model in calculation of myocardium blood flow in 82 Rb PET imaging Karin Knesaurek, Josef Machac Division of Nuclear Medicine, the
More informationAchieving an Exercise Workload of >10 Metabolic Equivalents Predicts a Very Low Risk of Inducible Ischemia
Journal of the American College of Cardiology Vol. 54, No. 6, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.04.042
More informationEMPHISIS 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
More informationUtility of Myocardial Perfusion Imaging in Patients With Low-Risk Treadmill Scores
Journal of the American College of Cardiology Vol. 43, No. 2, 2004 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2003.09.029
More informationMPS 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.,
More informationDiagnostic Performance of Positron Emission Tomography in the Detection of Coronary Artery Disease: A Meta-analysis 1
Diagnostic Performance of Positron Emission Tomography in the Detection of Coronary Artery Disease: A Meta-analysis 1 Kiran R. Nandalur, MD, Ben A. Dwamena, MD, Asim F. Choudhri, MD Sirisha R. Nandalur,
More informationPrior research has revealed that event rates associated
Prognostic Value of Normal Exercise and Adenosine Tc-Tetrofosmin SPECT Imaging: Results from the Multicenter Registry of 4,728 Patients Leslee J. Shaw, PhD 1 ; Robert Hendel, MD 2 ; Salvador Borges-Neto,
More informationExercise echocardiography is a routine test in patients
Prediction of Mortality by Exercise Echocardiography A Strategy for Combination With the Duke Treadmill Score Thomas H. Marwick, MB, BS, PhD; Colin Case, MS; Charles Vasey, MD; Susan Allen, BS; Leanne
More informationF or many patients with chronic coronary artery disease,
v10 Assessment of prognosis in chronic coronary artery disease T M Bateman, E Prvulovich... F or many patients with chronic coronary artery disease, risk stratification as to likelihood of cardiac death
More informationDetection Of Functional Significance of Coronary Stenoses Using Dynamic. Values Of Myocardial Blood Flow And Coronary Flow Reserve
The 2nd International Symposium on Physics, Engineering and Technologies for Biomedicine Volume 2018 Conference Paper Detection Of Functional Significance of Coronary Stenoses Using Dynamic 13 N-Ammonia
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 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 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 informationNuclear Medicine is the Best Approach for Detecting Coronary Artery Disease: From JSNC 2016 Evening Seminar
Annals of Nuclear Cardiology Vol. 3 No. 1 150-154 DEBATE ARTICLES: WHICH IMAGING IS THE BEST FOR DETECTING CAD? REVIEW ARTICLE Nuclear Medicine is the Best Approach for Detecting Coronary Artery Disease:
More informationASNC 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,
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
PET Scanning: Cardiac Applications Page 1 of 31 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Positron Emission Tomography (PET) Scanning: Cardiac Applications
More informationMyocardial 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,
More informationJournal of the American College of Cardiology Vol. 42, No. 5, by the American College of Cardiology Foundation ISSN /03/$30.
Journal of the American College of Cardiology Vol. 42, No. 5, 2003 2003 by the American College of Cardiology Foundation ISSN 0735-1097/03/$30.00 Published by Elsevier Inc. doi:10.1016/s0735-1097(03)00837-4
More informationNon-invasive images of the myocardium
Heart 2000;83:355 360 IMAGING TECHNIQUES Myocardial perfusion imaging Raymond J Gibbons Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota,
More informationPreview of Presentation
Preview of Presentation Discuss Healthcare Environment Clinical Implementation of Technical Innovations SNMMI/ASNC Joint Statement on Rb-82 Cardiac PET Imaging Protocol Principles of Rb-82 Cardiac Imaging
More informationLong-Term Prognostic Value of 13 N-Ammonia Myocardial Perfusion Positron Emission Tomography
Journal of the American College of Cardiology Vol. 54, No. 2, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.02.069
More informationNuclear 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
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 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 informationEvaluation of myocardial ischaemia
l2 TOPIC Evaluation of myocardial ischaemia Topic Contents Markers of myocardial injury and infarction 6 Myocardial territories supplied by coronary arteries 8 The 17 segment model 9 Regional assessment
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 informationProper risk stratification is critical for the management of
Prediction of Death and Nonfatal Myocardial Infarction in High-Risk Patients: A Comparison Between the Duke Treadmill Score, Peak Exercise Radionuclide Angiography, and SPECT Perfusion Imaging Lawrence
More informationExercise Test: Practice and Interpretation. Jidong Sung Division of Cardiology Samsung Medical Center Sungkyunkwan University School of Medicine
Exercise Test: Practice and Interpretation Jidong Sung Division of Cardiology Samsung Medical Center Sungkyunkwan University School of Medicine 2 Aerobic capacity and survival Circulation 117:614, 2008
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 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 informationStress 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
More informationPHARMACOLOGICAL 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,
More informationEffect of intravenous atropine on treadmill stress test results in patients with poor exercise capacity or chronotropic incompetence ABSTRACT
Effect of intravenous atropine on treadmill stress test results in patients with poor exercise capacity or chronotropic incompetence Samad Ghaffari, MD, Bahram Sohrabi, MD. ABSTRACT Objective: Exercise
More informationOriginal Policy Date
MP 6.01.11 Cardiac Applications of PET Scanning Medical Policy Section Radiology Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature search/12:2013 Return to Medical
More informationIAEA International Conference on Integrated Medical Imaging in CV Disease 2013
IAEA International Conference on Integrated Medical Imaging in CV Disease 2013 How to Stress My Patient Choosing the Proper Stress Test Consultant and Advisory Board for Astellas John J. Mahmarian, MD,
More informationMedical Policy. MP Cardiac Applications of Positron Emission Tomography Scanning
Medical Policy BCBSA Ref. Policy: 6.01.20 Last Review: 09/19/2018 Effective Date: 09/19/2018 Section: Radiology Related Policies 6.01.51 Interim Positron Emission Tomography Scanning in Oncology to Detect
More informationNew Insight about FFR and IVUS MLA
New Insight about FFR and IVUS MLA Can IVUS MLA Predict FFR
More informationThere are 3 principle types of stress tests which do not involve the measurement of radiolabelled distribution within the body.
National Imaging Associates, Inc. Clinical guidelines MYOCARDIAL PERFUSION IMAGING HEART (CARDIAC) PET SCAN STRESS ECHOCARDIOGRAM (Non-emergent outpatient testing) CPT4 Codes: Refer to pages 11-12 LCD
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 informationViability Testing Using Dynamic Echocardiography
Viability Testing Using Dynamic Echocardiography Theodora A Zaglavara, MD, PhD Director of Echocardiography EUROMEDICA KYANOUS STAVROS HOSPITAL Thessaloniki GREECE Goals of Cardiac Imaging in Coronary
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 information