Journal of Nuclear Cardiology最新文献

{"title":"Parametric imaging of myocardial blood flow with 82Rb PET: An accuracy and image quality analysis","authors":"Chad R.R.N. Hunter PhD ,&nbsp;Eric Moulton PhD ,&nbsp;Rob S.B. Beanlands MD, MASNC ,&nbsp;Robert A. deKemp PhD, MASNC","doi":"10.1016/j.nuclcard.2024.102020","DOIUrl":"10.1016/j.nuclcard.2024.102020","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to develop a framework for generating three-dimensional (3D) myocardial blood flow (MBF) images, computing their accuracy against clinically validated two-dimensional (2D) polar MBF maps of the left ventricle, and evaluating their improvements in image quality over relative myocardial perfusion imaging (MPI).</div></div><div><h3>Methods</h3><div>N = 40 patients with a wide range of defect severities and uptake dynamics were retrospectively studied. The FlowQuant™ software was used to generate reference MPI and polar MBF maps and was adapted for voxel-wise MBF mapping. We evaluated agreement between parametric vs polar values for MBF at rest and stress and for reserve (stress/rest MBF). We also assessed improvements in image quality, assessed by signal-to-noise ratio, contrast-to-noise ratio, tissue-to-blood ratio, and defect severity, from relative MPI to MBF.</div></div><div><h3>Results</h3><div>There was excellent agreement between 3D parametric and 2D polar maps for all flow parameters (interclass correlation coefficient &gt;0.96), albeit with minimal bias (&lt;8%) for rest and stress MBF at the patient level. Image quality substantially improved from MPI to MBF in every patient for all image-quality metrics (<em>P</em> &lt; 0.0001)</div></div><div><h3>Conclusions</h3><div>We developed a robust methodology for producing highly accurate 3D MBF images exhibiting considerably improved image quality compared to relative MPI commonly used in clinical practice.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102020"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Become a Fellow of the American Society of Nuclear Cardiology and commit to excellence","authors":"Lawrence M. Phillips MD, MASNC","doi":"10.1016/j.nuclcard.2024.102036","DOIUrl":"10.1016/j.nuclcard.2024.102036","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102036"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142536956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the prognostic effectiveness of stress single photon emission computed tomography vs positron emission tomography myocardial perfusion imaging","authors":"Alan Rozanski MD ,&nbsp;Daniel Berman MD","doi":"10.1016/j.nuclcard.2024.102038","DOIUrl":"10.1016/j.nuclcard.2024.102038","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102038"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-imagining risk stratification in high-risk patients: PET and SPECT myocardial perfusion imaging in focus","authors":"Marcelo F. Di Carli MD, MASNC","doi":"10.1016/j.nuclcard.2024.102057","DOIUrl":"10.1016/j.nuclcard.2024.102057","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102057"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142536955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking beyond the valve: Myocardial ischemia, left ventricular remodeling, and adverse outcomes in aortic stenosis","authors":"Wunan Zhou MD, MPH","doi":"10.1016/j.nuclcard.2024.102037","DOIUrl":"10.1016/j.nuclcard.2024.102037","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102037"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of positron emission tomography and single-photon emission computed tomography myocardial perfusion imaging for predicting risk in patients with cardiometabolic disease","authors":"","doi":"10.1016/j.nuclcard.2024.101908","DOIUrl":"10.1016/j.nuclcard.2024.101908","url":null,"abstract":"<div><h3>Background</h3><div>The epidemiology of coronary artery disease (CAD) has shifted, with increasing prevalence of cardiometabolic disease and decreasing findings of obstructive CAD on myocardial perfusion imaging (MPI). Coronary microvascular dysfunction (CMD), defined as impaired myocardial flow reserve (MFR) by positron emission tomography (PET), has emerged as a key mediator of risk. We aimed to assess whether PET MFR provides additive value for risk stratification of cardiometabolic disease patients compared with single-photon emission computed tomography (SPECT) MPI.</div></div><div><h3>Methods</h3><div>We retrospectively followed patients referred for PET, exercise SPECT, or pharmacologic SPECT MPI with cardiometabolic disease (obesity, diabetes, or chronic kidney disease) and without known CAD. We compared rates and hazards of composite major adverse cardiovascular events (MACEs) (annualized cardiac mortality or acute myocardial infarction) among propensity-matched PET and SPECT patients using Poisson and Cox regression. Normal SPECT was defined as a total perfusion deficit (TPD) of &lt;5%, reflecting the absence of obstructive CAD. Normal PET was defined as a TPD of &lt;5% plus an MFR of ≥2.0.</div></div><div><h3>Results</h3><div>Among 21,544 patients referred from 2006 to 2020, cardiometabolic disease was highly prevalent (PET: 2308 [67%], SPECT: 9984 [55%]) and higher among patients referred to PET (<em>P</em> &lt; 0.001). Obstructive CAD findings (TPD &gt; 5%) were uncommon (PET: 21% and SPECT: 11%). Conversely, impaired MFR on PET (&lt;2.0) was common (62%). In a propensity-matched analysis over a median 6.4-year follow-up, normal PET identified low-risk (0.9%/year MACE) patients, and abnormal PET identified high-risk (4.2%/year MACE) patients with cardiometabolic disease; conversely, those with normal pharmacologic SPECT remained moderate-risk (1.6%/year, <em>P</em> &lt; 0.001 compared to normal PET).</div></div><div><h3>Conclusions</h3><div>Cardiometabolic disease is common among patients referred for MPI and is associated with a heterogenous level of risk. Compared with pharmacologic SPECT, PET with MFR can detect nonobstructive CAD including CMD and can more accurately discriminate low-risk from higher-risk individuals.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 101908"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141600208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Society of Nuclear Cardiology quality metrics for cardiac amyloid radionuclide imaging","authors":"Fadi G. Hage MD, MASNC ,&nbsp;Jamieson M. Bourque ,&nbsp;Shivda Pandey ,&nbsp;Nishant R. Shah ,&nbsp;Prem Soman ,&nbsp;Brian G. Abbott ,&nbsp;Aiden Abidov ,&nbsp;Niti R. Aggarwal ,&nbsp;Wael AlJaroudi ,&nbsp;Pradeep G. Bhambhvani ,&nbsp;Sabahat Bokhari ,&nbsp;Sharmila Dorbala ,&nbsp;Rami Doukky ,&nbsp;Jessica M. Duran ,&nbsp;Andrew J. Einstein ,&nbsp;Dennis Gallagher ,&nbsp;Robert C. Hendel ,&nbsp;Wael Jaber ,&nbsp;Cesia Gallegos Kattan ,&nbsp;Saurabh Malhotra ,&nbsp;Brett W. Sperry","doi":"10.1016/j.nuclcard.2024.102041","DOIUrl":"10.1016/j.nuclcard.2024.102041","url":null,"abstract":"<div><div>This document from the American Society of Nuclear Cardiology develops metrics for the assessment of quality for laboratories that perform cardiac amyloid radionuclide imaging. These metrics are based on clinical guidelines, appropriate use criteria, information and position statements, and expert opinion. The document introduces 15 quality metrics that address current gaps in care organized around 4 axes: A) Appropriate indications; B) Patient experience and workflow; C) Instrumentation and protocols; and D) Interpretation and reporting. With the increasing use of imaging for cardiac amyloid, it is imperative that our laboratories maintain a high level of quality to preserve the value that imaging provides to patients. Laboratories should perform imaging in appropriately selected patients avoiding low-value imaging. Proper education should be provided to patients prior to performing testing, timely access to testing must be available, and periodic assessment of patient experience and satisfaction should be the norm. Strict adherence to established protocols with periodic assessment of laboratory quality control is essential. Laboratory studies to rule out plasma cell dyscrasia should be performed in all patients suspected of having cardiac amyloidosis. Crucially, interpretation should be based on SPECT rather than planar imaging in all patients. The study report should include sufficient technical details to allow for proper interpretation of study findings and its conclusion should be clear and unambiguous to guide clinical management. Laboratories can use data derived from these metrics to identify areas of deficiency and introduce quality improvement initiatives, which will ultimately improve patient outcomes.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102041"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of cardiac amyloidosis imaging with bone-avid tracers: From qualification to quantification","authors":"Saurabh Malhotra MD, MPH, FASNC ,&nbsp;Albert J. Sinusas MD, MASNC","doi":"10.1016/j.nuclcard.2024.102032","DOIUrl":"10.1016/j.nuclcard.2024.102032","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"39 ","pages":"Article 102032"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative 99mTc-pyrophosphate myocardial uptake: Changes on transthyretin stabilization therapy","authors":"Shilpa Vijayakumar MD, MPH ,&nbsp;Ardel Romero Pabon MD ,&nbsp;Olivier F. Clerc MD, MPH ,&nbsp;Sarah A.M. Cuddy MD ,&nbsp;Yuezhi Gu ,&nbsp;Caelan Watts ,&nbsp;Kyle Sullivan ,&nbsp;Benjamin Auer PhD ,&nbsp;Marie Foley Kijewski PhD ,&nbsp;Marcelo F. DiCarli MD ,&nbsp;Rodney H. Falk MD ,&nbsp;Sharmila Dorbala MD, MPH","doi":"10.1016/j.nuclcard.2024.102019","DOIUrl":"10.1016/j.nuclcard.2024.102019","url":null,"abstract":"<div><h3>Background</h3><div>Quantitative technetium-99m-pyrophosphate cardiac single-photon emission computed tomography (^99mTc-PYP SPECT/CT) is an emerging method for estimating myocardial burden of transthyretin cardiac amyloidosis (ATTR-CA), but its efficacy in monitoring longitudinal changes remains uncertain. We aimed to investigate longitudinal changes in cardiac ATTR amyloid burden following transthyretin stabilization therapy using visual and quantitative ^99mTc-PYP SPECT/CT and to relate these with changes in cardiac biomarkers and function.</div></div><div><h3>Methods</h3><div>This prospective longitudinal cohort study investigated changes in ^99mTc-PYP SPECT/CT in 23 participants with ATTR-CA on transthyretin stabilization therapy (median: 2.6 years). Quantitative analysis included left ventricular (LV) standardized uptake values (SUVs) (SUV_max, SUV_mean), cardiac amyloid activity (CAA; SUV_mean∗LV activity volume), and percent injected dose (%ID) (mean activity concentration∗LV activity volume/injected activity), calculated using a threshold of &gt;1.5 times left atrial blood pool activity concentration on SPECT/CT. Longitudinal changes of paired continuous and ordinal variables were analyzed using Wilcoxon signed-rank test.</div></div><div><h3>Results</h3><div>Following therapy, visual grade decreased significantly (<em>P</em> = 0.003). Several quantitative ^99mTc-PYP metrics also decreased significantly: SUV_max (median −0.75, <em>P</em> = 0.011), CAA (median: −406.6, <em>P</em> &lt; 0.001), and %ID (median: −0.45, <em>P</em> &lt; 0.001). Serum transthyretin levels improved (median: +6.5 mg/dL, <em>P</em> = 0.008). Echocardiographic parameters (global longitudinal strain, LV mass index, and LV wall thickness), N-terminal pro-B-type natriuretic peptide, and estimated glomerular filtration rate remained stable.</div></div><div><h3>Conclusions</h3><div>Favorable changes in ^99mTc-PYP myocardial uptake were observed in participants on transthyretin stabilization therapy, whereas echocardiographic parameters and biomarkers remained stable. These results likely signify myocardial ATTR amyloid stabilization rather than amyloid burden regression. Further investigation is needed to understand the implications of these findings.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"39 ","pages":"Article 102019"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication of unexpected nuclear medicine and PET findings is a two-way street","authors":"Joseph C. Lee MBBS, FRACP, FAANMS ,&nbsp;Jia Wen Chong B Med Sci, MBBS, Grad Dip Clin Ed ,&nbsp;Bradley M. Hector B Med Rad Sci","doi":"10.1016/j.nuclcard.2024.102018","DOIUrl":"10.1016/j.nuclcard.2024.102018","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"39 ","pages":"Article 102018"},"PeriodicalIF":3.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}