Nuclear Cardiology Headlines

Integration of coronary anatomy and myocardial perfusion imaging. - Advances in cardiovascular imaging have resulted in the development of multiple noninvasive techniques to evaluate myocardial perfusion and coronary anatomy, each of which has unique strengths and limitations. For example, CT angiography can directly visualize the presence of atherosclerosis, but the hemodynamic effect of many lesions identified by this technique is unknown. Alternatively, myocardial perfusion imaging enables a physiological assessment, but it may underestimate the extent of atherosclerosis in patients with multivessel disease.

Blunting of the Heart Rate Response to Adenosine and Regadenoson in Relation to Hyperglycemia and the Metabolic Syndrome. - Adenosine and regadenoson cause an increase in heart rate (HR) during myocardial perfusion imaging (MPI). It has been shown that patients with diabetes mellitus have a blunted HR response due to cardiac autonomic dysfunction. It is not known whether the HR response is related to hyperglycemia and the metabolic syndrome (MS).

Temporal trends in compliance with appropriateness criteria for stress single-photon emission computed tomography sestamibi studies in an academic medical center. - BACKGROUND: The purpose of this study was to apply published appropriateness criteria for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in a single academic medical center to determine if the percentage of inappropriate studies was changing over time. In a previous study, we applied the American College of Cardiology Foundation/American Society of Nuclear Cardiology (ASNC) appropriateness criteria for stress SPECT MPI and reported that 14% of stress SPECT studies were performed for inappropriate reasons. METHODS: Using similar methodology, we retrospectively examined 284 patients who underwent stress SPECT MPI in October 2006 and compared the findings to the previous cohort of 284 patients who underwent stress SPECT MPI in May 2005.

Eighth Annual Mario S. Verani, MD Memorial Lecture: Nuclear cardiology in the era of multimodality cardiac imaging: Can we survive? - Nuclear cardiology is the best noninvasive imaging method for measuring myocardial blood flow to diagnose coronary artery disease, assess the risk for adverse cardiac events, and identify long-term cardiac outcome. Our strengths include: reliance on physiology rather than anatomic definition; standardized and efficient techniques that can be performed in large hospitals and academic centers and in small hospitals and outpatient offices; a large body of evidence-based supporting clinical data; and profitability. We have defined training; committed to quality improvement through development of guidelines and appropriateness criteria; certified physicians and accredited laboratories; and implemented a strong payer advocacy program.

An open-source framework of neural networks for diagnosis of coronary artery disease from myocardial perfusion SPECT. - BACKGROUND: The purpose of this study is to develop and analyze an open-source artificial intelligence program built on artificial neural networks that can participate in and support the decision making of nuclear medicine physicians in detecting coronary artery disease from myocardial perfusion SPECT (MPS). METHODS AND RESULTS: Two hundred and forty-three patients, who had MPS and coronary angiography within three months, were selected to train neural networks. Six nuclear medicine residents, one experienced nuclear medicine physician, and neural networks evaluated images of 65 patients for presence of coronary artery stenosis.

Incidence and progression of aortic valve calcium in the Multi-ethnic Study of Atherosclerosis (MESA). - Aortic valve calcium (AVC) is common among older adults and shares epidemiologic and histopathologic similarities to atherosclerosis. However, prospective studies have failed to identify meaningful risk associations with incident ("new") AVC or its progression. In the present study, AVC was quantified from serial computed tomographic images from 5,880 participants (aged 45 to 84 years) in the Multi-Ethnic Study of Atherosclerosis, using the Agatston method.

Can carbonated lime drink intake prior to myocardial perfusion imaging with tc-99m MIBI reduce the extracardiac activity that degrades the image quality and leads to fallacies in interpretation? - BACKGROUND:: During myocardial perfusion imaging with Tc-99m sestamibi, intestinal and hepatic radiotracer activity commonly interfere with visualization of the inferior wall of the myocardium leading to difficulties in interpretation. This study was undertaken to assess if carbonated lime drink ingestion prior to imaging prevents the said interference and improves the quality of images. MATERIALS AND METHODS:: The study group comprised 33 consecutive patients including 26 males (age range: 30-80 years) and 7 females (42-62 years) who were referred for myocardial perfusion imaging.