Journal of Nuclear Cardiology最新文献

{"title":"Incremental prognostic value of ¹⁸F-fluorodeoxyglucose myocardial ischemic memory imaging for major adverse cardiovascular events in patients with suspected unstable angina.","authors":"Feifei Zhang, Xiaoyu Yang, Yongjun Chen, Xiaoliang Shao, Jianfeng Wang, Sheng Zhang, Guiliang Shi, Minfu Yang, Zhifang Wu, Sijin Li, Yuetao Wang","doi":"10.1016/j.nuclcard.2024.102051","DOIUrl":"10.1016/j.nuclcard.2024.102051","url":null,"abstract":"<p><strong>Background: </strong>The additional prognostic value of ^{18F-flurodeoxyglucose} positron emission tomography (¹⁸F-FDG PET) myocardial ischemic memory imaging for patients with suspected unstable angina (UA) is not well established. This study aimed to determine whether ¹⁸F-FDG PET imaging provides incremental prognostic information for predicting major adverse cardiac events (MACEs) compared to clinical risk factors, Global Registry of Acute Coronary Events (GRACE) score, and coronary artery calcium score (CACS) in patients with suspected UA.</p><p><strong>Methods: </strong>In this post hoc analysis of a prospective study, 265 patients suspected with UA (62.3% male, mean age: 65.0±9.4 years) were enrolled. ¹⁸F-FDG positivity was defined as focal or focal on diffuse uptake patterns. MACEs included cardiovascular death, acute myocardial infarction, heart failure, rehospitalization for UA, and stroke. Multivariable Cox regression was used to identify predictors of MACEs, and the incremental prognostic value of ¹⁸F-FDG PET imaging was assessed using the Concordance Index (C-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>Over a median follow-up of 25 months, 51 patients (19.2%) experienced MACEs. ¹⁸F-FDG positivity (hazard ratio [HR]=3.220, 95% confidence interval [CI]: 1.630-6.360, P<.001), as well as ¹⁸F-FDG standardized uptake ratio (HR=1.330, 95% CI: 1.131-1.564, P=.0006) and Extent (HR=1.045, 95% CI: 1.028-1.062, P<.0001), were independent predictors of MACE. The addition of ¹⁸F-FDG PET imaging significantly improved risk stratification beyond clinical factors, the GRACE score, and CACS, with improved C-index (.769 vs .688, P=.045), NRI (.324, P=.020), and IDI (.055, P=.027).</p><p><strong>Conclusion: </strong>¹⁸F-FDG PET myocardial ischemic memory imaging significantly improves prognostic assessment for patients with suspected UA, providing valuable additional risk stratification beyond clinical risk factors, GRACE score, and CACS.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377972","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":"The prognostic utility of heart rate and blood pressure response to regadenoson stress.","authors":"Andrea Torres, Alex Yerkan, Ayesha Abbasi, Rami Doukky","doi":"10.1016/j.nuclcard.2024.102050","DOIUrl":"10.1016/j.nuclcard.2024.102050","url":null,"abstract":"<p><strong>Background: </strong>Although heart rate response (HRR) to regadenoson stress has been shown to be a strong predictor of outcome, it has not been investigated in a large all-comers cohort. The prognostic utility of systolic blood pressure response (SBPR) has not been investigated in comparison with HRR.</p><p><strong>Methods and results: </strong>In a retrospective cohort of 10,227 patients undergoing regadenoson stress single-photon emission computed tomography myocardial perfusion imaging (MPI), HRR, and SBPR were calculated as 100×(peak hyperemia value-baseline value)/baseline value. During 35±21 months follow-up, 921 (8.8%) deaths were observed. The median HRR was 35% (interquartile range [IQR], 21% to 51%). The median SBPR was -9% (IQR, -17% to -2%). HRR and SBPR were independently associated with all-cause mortality with adjusted hazard ratio [HR] of .980 per 1% increment in HRR (CI, .977-.984) and .994 per 1% increment in SBPR (CI, .988-.999). Mortality rates increased with decreasing HRR quartile and SBPR tertile. HRR provided incremental prognostic value for all-cause mortality beyond clinical and imaging parameters (area under the curve [AUC] increase, .03; P<.001) and SBPR data (AUC increase, .11; P<0001). SBPR did not provide significant incremental prognostic value beyond clinical and imaging parameters or HRR data. We derived and validated HRR of <20% as a cut-off that can improve risk stratification beyond clinical and MPI findings.</p><p><strong>Conclusion: </strong>Among patients undergoing stress MPI, impaired HRR to regadenoson provided independent and incremental prognostic value for all-cause mortality beyond clinical, imaging, and SBPR data. SBPR positively correlates with HRR, but it does not provide incremental prognostic utility. HRR, but not SBPR, should be routinely reported and considered in assessing patients' overall risk. An abnormal HRR threshold of <20% can improve risk stratification.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377973","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":"Automated deep learning segmentation of cardiac inflammatory FDG PET.","authors":"Alexis Poitrasson-Rivière, Michael D Vanderver, Tomoe Hagio, Liliana Arida-Moody, Jonathan B Moody, Jennifer M Renaud, Edward P Ficaro, Venkatesh L Murthy","doi":"10.1016/j.nuclcard.2024.102052","DOIUrl":"10.1016/j.nuclcard.2024.102052","url":null,"abstract":"<p><strong>Background: </strong>Fluorodeoxyglucose positron emission tomography (FDG PET) with suppression of myocardial glucose utilization plays a pivotal role in diagnosing cardiac sarcoidosis. Reorientation of images to match perfusion datasets and myocardial segmentation enables consistent image scaling and quantification. However, such manual tasks are cumbersome. We developed a 3D U-Net deep-learning (DL) algorithm for automated myocardial segmentation in cardiac sarcoidosis FDG PET.</p><p><strong>Methods: </strong>The DL model was trained on FDG PET scans from 316 patients with left ventricular contours derived from paired perfusion datasets. Qualitative analysis of clinical readability was performed to compare DL segmentation with the current automated method on a 50-patient test subset. Additionally, left ventricle displacement and angulation, as well as SUVmax sampling were compared with inter-user reproducibility results. A hybrid workflow was also investigated to accelerate study processing time.</p><p><strong>Results: </strong>DL segmentation enhanced readability scores in over 90% of cases compared with the standard segmentation currently used in the software. DL segmentation performed similar to a trained technologist, surpassing standard segmentation for left ventricle displacement and angulation, as well as correlation of SUVmax. Using the DL segmentation as initial placement for manual segmentation significantly decreased the processing time.</p><p><strong>Conclusion: </strong>A novel DL-based automated segmentation tool markedly improves processing of cardiac sarcoidosis FDG PET. This tool yields optimized splash display of sarcoidosis FDG PET datasets with no user input and offers significant processing time improvement for manual segmentation of such datasets.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377971","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":"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}