Journal of Nuclear Cardiology最新文献

{"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":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":"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":"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":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":"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":"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":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":"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":"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":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":"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":"Head-to-head comparison of ¹⁸F-sodium fluoride coronary PET imaging between a silicon photomultiplier with digital photon counting and conventional scanners.","authors":"Hidenobu Hashimoto, Keiichiro Kuronuma, Mark C Hyun, Donghee Han, Valerie Builoff, Sebastian Cadet, Damini Dey, Daniel S Berman, Jacek Kwiecinski, Piotr J Slomka","doi":"10.1016/j.nuclcard.2024.102045","DOIUrl":"10.1016/j.nuclcard.2024.102045","url":null,"abstract":"<p><strong>Background: </strong>We compared silicone photomultipliers with digital photon counting (SiPM) and photomultiplier tubes (PMT) positron emission tomography (PET) in imaging coronary plaque activity with ¹⁸F-sodium fluoride (¹⁸F-NaF) and evaluated comprehensively SiPM PET reconstruction settings.</p><p><strong>Methods: </strong>In 25 cardiovascular disease patients (mean age 67 ± 12 years), we conducted ¹⁸F-NaF PET on a SiPM (Biograph Vision) and conventional PET (Discovery 710) on the same day as part of a prospective clinical trial (NCT03689946). Following administration of 250 MBq of ¹⁸F-NaF, patients underwent a contrast-enhanced CT angiography and a 30-min PET acquisition in list-mode on each PET consecutively. Image noise was defined as mean standard deviation of blood pool activity within the left atria. Target-to-background ratio (TBR) and signal-to-noise ratio (SNR) were measured within the whole-vessel tubular three-dimensional volumes of interest on the cardiac motion and attenuation-corrected ¹⁸F-NaF PET images using dedicated software.</p><p><strong>Results: </strong>There were significant differences in image noise and background activity between the two PETs (Image noise (%), PMT: 7.6 ± 3.7 vs SiPM: 4.0 ± 2.3, P < 0.001; background activity, PMT: 1.4 ± 0.4 vs SiPM: 1.0 ± 0.3, P < 0.001). Similarly, the SNR and TBR were significantly higher in vessels scanned with the SiPM PET (SNR, PMT: 16.3 ± 11.5 vs SiPM: 32.7 ± 29.8, P < 0.001; TBR, PMT: 0.8 ± 0.4 vs SiPM: 1.1 ± 0.6, P < 0.001). SiPM PET image reconstruction with a 256 matrix, 1.4 mm pixel, and 2 mm Gaussian filter provided best trade off in terms of maximal SNR, TBR, and clinically practical file size.</p><p><strong>Conclusions: </strong>In ¹⁸F-NaF coronary PET imaging, the SiPM PET showed superior image contrast and less image noise compared with PMT PET.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348377","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":"Detection of small vegetations in native bi-valvular (aortic + mitral) infective endocarditis with 4D ECG-gated cardiac [¹⁸F]FDG PET/CT.","authors":"Juan P Suarez, Maria L Dominguez, Carmen Vigil, Belen Fernandez, Sara Naranjo, Laura Rodriguez, Noelia Martin, Francisco M Gonzalez","doi":"10.1016/j.nuclcard.2024.102043","DOIUrl":"10.1016/j.nuclcard.2024.102043","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289443","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":"Transient ischemic dilatation in cardiac amyloidosis.","authors":"Bethlehem Mengesha,Gary Small,David Ian Paterson,Benjamin Chow","doi":"10.1016/j.nuclcard.2024.102042","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2024.102042","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267680","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":"How to differentiate obstructive from non-obstructive CAD with quantitative PET MPI using Coronary Flow Capacity.","authors":"Nils P Johnson,K Lance Gould","doi":"10.1016/j.nuclcard.2024.102039","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2024.102039","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267682","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":"Regional variation in technetium pyrophosphate (PYP) uptake in transthyretin cardiac amyloidosis (ATTR-CA) and concomitant myocardial infarction: A case series.","authors":"Simrat Kaur, Fatimah Chamseddine, Bryan Abadie, Vikas Sunder, Wael Jaber","doi":"10.1016/j.nuclcard.2024.102031","DOIUrl":"10.1016/j.nuclcard.2024.102031","url":null,"abstract":"<p><p>- Diffuse and patchy myocardial uptake of Tc-99m PYP is well established in cases of ATTR-CA. - Chronic myocardial infarction leads to regional myocardial thinning and lack of vascular supply can present as regional sparing 'cold spot' on Tc-99m PYP imaging. - The absence of Tc-99m PYP uptake in vascular regions should raise the possibility of underlying scar.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132960","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":"Cardiac positron emission tomography and other modalities for coronary artery disease assessment: A snapshot from the medicare data.","authors":"Mouaz Al-Mallah, Maria Alwan, Mahmoud Al Rifai, Ahmed Sayed","doi":"10.1016/j.nuclcard.2024.102030","DOIUrl":"10.1016/j.nuclcard.2024.102030","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-02","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}