Journal of Nuclear Cardiology最新文献

{"title":"Cardiac positron emission tomography and other modalities for coronary artery disease assessment: A snapshot from the medicare data","authors":"Mouaz Al-Mallah MD, MSc ,&nbsp;Maria Alwan MD ,&nbsp;Mahmoud Al Rifai MD, MPH ,&nbsp;Ahmed Sayed MBBS","doi":"10.1016/j.nuclcard.2024.102030","DOIUrl":"10.1016/j.nuclcard.2024.102030","url":null,"abstract":"<div><h3>Background</h3><div>Positron emission tomography (PET) is an important tool for assessing coronary artery disease (CAD), but its widespread utilization is limited due to various factors, including limited local champion availability. This study aims to compare the frequency of PET procedures and their interpreters with other common CAD assessment modalities.</div></div><div><h3>Methods</h3><div>Using Medicare data, we examined the number of cardiac PET procedures billed and compared them with single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA), stress magnetic resonance imaging (MRI), and stress echocardiography. Healthcare Common Procedure Coding System codes were used to identify procedures. We calculated the total number of PET myocardial perfusion imaging (MPI) procedures, the proportion of PET/CT and myocardial blood flow (MBF) assessments, and the median number of studies read per physician. We also analyzed the trends in the use of different CAD assessment modalities between 2018 and 2022. Descriptive statistics summarized the data.</div></div><div><h3>Results</h3><div>In 2022, Medicare billed for 212,106 PET MPI scans. SPECT was six times more frequent (1,343,519), whereas stress echocardiography (201,676) and CCTA (118,734) had similar or lower use. Stress MRI (3,932) was least used. Of the PET MPI scans, 46% were PET/CT, and 39% included MBF measurements. Cardiologists interpreted 86% of PET scans, with a median of 58 studies per reader; 23% interpreted ≤25 studies annually. SPECT had a median of 63 studies per reader, and CCTA, stress MRI, and stress echocardiography had medians of 27, 20, and 24, respectively. PET, CT, and MRI use increased from 2018 to 2022, whereas SPECT and stress echocardiography declined.</div></div><div><h3>Conclusion</h3><div>In the Medicare population, radionuclide perfusion imaging (SPECT and PET) remained the preferred method for assessment of CAD, with SPECT being the most frequently used modality and PET being the second most frequently used modality for this application. However, PET/CT and MBF are underutilized, limiting diagnostic and prognostic capabilities. Efforts to enhance education and awareness of PET's advantages and to address barriers to its wider adoption are essential to maximize its clinical benefits and improve patient outcomes.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"41 ","pages":"Article 102030"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132959","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":"Fast vs slow rubidium-82 infusion profiles and test-retest precision of myocardial perfusion using contemporary 3D cardiac analog positron emission tomography-computed tomography imaging","authors":"Robert M. Bober MD ,&nbsp;Richard V. Milani MD ,&nbsp;Nadia I. Abelhad MD ,&nbsp;Cruz Velasco-Gonzalez PhD ,&nbsp;Merrill H. Stewart MD ,&nbsp;Daniel P. Morin MD, MPH","doi":"10.1016/j.nuclcard.2024.102059","DOIUrl":"10.1016/j.nuclcard.2024.102059","url":null,"abstract":"<div><h3>Background</h3><div>On legacy 2D positron emission tomography (PET) systems utilizing a 50 mL/min Rb-82 profile, test-retest precision of quantitative perfusion is ∼10%. It is unclear whether Rb-82 infusion rate significantly impacts quantitative perfusion and/or image quality on modern analog 3D PET-CT systems. We aimed to determine whether the Rb-82 infusion profile significantly impacts test-retest precision of quantitative perfusion, perfusion metrics, and/or image quality on a modern analog 3D PET-CT scanner.</div></div><div><h3>Methods</h3><div>Ninety-eight volunteers from 3 distinct groups: healthy volunteers (Normals), patients with risk factors, and/or coronary disease (Clinicals) and patients with prior transmural myocardial infarctions (Infarcts), underwent cardiac stress testing on an analog 3D PET-CT. Participants received 3 consecutive resting scans and 2 consecutive stress scans, minutes apart, with two randomly assigned Rb-82 infusion profiles: 50 mL/min (fast [F]) and 20 mL/min (slow [S]). Perfusion metrics (resting (rMBF) and stress myocardial blood flow (sMBF)) were calculated using HeartSee software. Coefficients of variance (COV), repeatability (RC), MBF, and image quality metrics were compared.</div></div><div><h3>Results</h3><div>rMBF correlated well between F and S profiles, with intraclass correlation coefficients (ICC) ranging .91-.93. sMBF was highly correlated between F and S profiles (ICC = .97). Fast and slow profiles were associated with similar same-day test-retest precision (COV 11.5% vs 11.3% (<em>P</em> = .77); RC 21.5% vs 22.6%, for F–F vs S–S). There were no clinically significant differences in MBF values between F and S profiles. Image quality metrics were similar between the 2 profiles.</div></div><div><h3>Conclusions</h3><div>There are no clinically significant differences in precision, perfusion metrics, or image quality between Rb-82 fast and slow infusions using a contemporary analog 3D PET-CT.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"41 ","pages":"Article 102059"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467876","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":"PET myocardial perfusion imaging: Trends, challenges, and opportunities","authors":"Jorge Dahdal MD ,&nbsp;Ruurt A. Jukema MD ,&nbsp;Hendrik J. Harms PhD ,&nbsp;Maarten J. Cramer MD, PhD ,&nbsp;Pieter G. Raijmakers MD, PhD ,&nbsp;Paul Knaapen MD, PhD ,&nbsp;Ibrahim Danad MD, PhD","doi":"10.1016/j.nuclcard.2024.102011","DOIUrl":"10.1016/j.nuclcard.2024.102011","url":null,"abstract":"<div><div>Various non-invasive images are used in clinical practice for the diagnosis and prognostication of chronic coronary syndromes. Notably, quantitative myocardial perfusion imaging (MPI) through positron emission tomography (PET) has seen significant technical advancements and a substantial increase in its use over the past two decades. This progress has generated an unprecedented wealth of clinical information, which, when properly applied, can diagnose and fine-tune the management of patients with different types of ischemic syndromes. This state-of-art review focuses on quantitative PET MPI, its integration into clinical practice, and how it holds up at the eyes of modern cardiac imaging and revascularization clinical trials, along with future perspectives.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102011"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788402","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":"18F-FDG PET-CT for diagnosing cutaneous fistulas secondary to retained lead fragments: A rare and challenging complication after pacemaker extraction","authors":"","doi":"10.1016/j.nuclcard.2024.101794","DOIUrl":"10.1016/j.nuclcard.2024.101794","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 101794"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391947","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":"Myocardial ischemia in patients with mild-to-moderate aortic stenosis: Interaction with cardiac remodeling and adverse events","authors":"Riccardo Liga MD, PhD, FESC ,&nbsp;Assuero Giorgetti MD ,&nbsp;Michelangelo Bertasi RT ,&nbsp;Elena Filidei MD ,&nbsp;Alessia Gimelli MD","doi":"10.1016/j.nuclcard.2024.102017","DOIUrl":"10.1016/j.nuclcard.2024.102017","url":null,"abstract":"<div><h3>Background</h3><div>The association between aortic valve stenosis (AVS) and myocardial perfusion abnormalities has been incompletely characterized. We sought to assess the predictors of myocardial ischemia in patients with mild-to-moderate AVS, and its relationship with long-term prognosis.</div></div><div><h3>Methods</h3><div>Eighty-nine patients with mild-to-moderate AVS (peak velocity between 2.6 and 4.0 m/second and aortic valve area &gt; .6 cm²/m²), preserved left ventricular (LV) function, and either normal coronary arteries (28 patients) or non-obstructive coronary artery disease (&lt;50% stenosis; 61 patients) were individuated. Myocardial perfusion imaging was performed using a cadmium–zinc–telluride camera, and the summed difference score (SDS) was computed. The presence of either LV hypertrophy (LVH) (LV mass index [LVMI] &gt; 115 g/m² [males] or 95 g/m² [females]) or concentric LV remodeling (relative wall thickness: &gt;.42) was determined at two-dimensional echocardiography.</div></div><div><h3>Results</h3><div>Forty (45%) and 49 (55%) patients had mild and moderate AVS, respectively. Fifty (56%), 17 (19%), and 22 (25%) patients had normal LV geometry, concentric LV remodeling, and LVH, respectively. An interaction between LV remodeling and inducible ischemia was revealed with progressively higher values of SDS in patients with normal LV geometry (3 ± 3), concentric remodeling (4 ± 2), and LVH (7 ± 2) (<em>P</em> &lt; .001).</div><div>Accordingly, a moderate correlation existed between LVMI and SDS values (R: .67; <em>P</em> &lt; .001). After a median follow-up of 84 ± 47 months, 27 adverse events were recorded, including 19 AV replacements and 8 deaths. On multivariable analysis, the presence of LVH (hazard ratio [HR]: 6.46; 95% confidence interval [CI]: 2.09–20.00; <em>P</em> = .001) and a higher SDS (HR: 1.41; 95% CI: 1.15–1.75; <em>P</em> = .001) were the two independent predictors of AE.</div></div><div><h3>Conclusions</h3><div>In patients with mild-to-moderate AVS, myocardial ischemia correlates with the severity of adverse LV remodeling. Patients with LVH and ischemia are at increased risk of AE.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102017"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000166","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":"Parametric 82Rb-chloride positron emission tomography imaging of myocardial blood flow: Ready for clinical prime time?","authors":"Benjamin Auer PhD","doi":"10.1016/j.nuclcard.2024.102040","DOIUrl":"10.1016/j.nuclcard.2024.102040","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"40 ","pages":"Article 102040"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289445","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":"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}