Journal of Nuclear Cardiology最新文献

{"title":"Correlation between technetium-99m pyrophosphate myocardial uptake and extracellular volume on cardiac magnetic resonance imaging in patients with transthyretin cardiac amyloidosis","authors":"Chun-Yuan Khoo MBBS , Jennifer Maning DO , Richard Weinberg MD, PhD , Ryan Avery MD , Vinesh Appadurai MD , Sanjiv Shah MD , Korosh Sharain MD , Scott M. Leonard BSc , Logan Robert Linscheid BSc , Chen Chen MD , Anahita Iyer BSc , Susan Lehrer BSc , Ike S. Okwuosa MD , Paul C. Cremer MD, MS","doi":"10.1016/j.nuclcard.2024.102083","DOIUrl":"10.1016/j.nuclcard.2024.102083","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"44 ","pages":"Article 102083"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686961","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":"Post-walking exercise skeletal muscle perfusion and energetics in patients with symptomatic lower extremity peripheral artery disease.","authors":"Sanjay Divakaran, Hendrik J Harms, Matthew Robertson, Sai K Merugumala, Mi-Ae Park, Marie F Kijewski, Laurel B Martell, Victoria Morgan, Leanne Barrett, Anna Perillo, David Yang, Petr Jarolim, Mark W Feinberg, Marie D Gerhard-Herman, Michael Belkin, Alexander P Lin, Mark A Creager, Marc P Bonaca, Marcelo F Di Carli","doi":"10.1016/j.nuclcard.2025.102143","DOIUrl":"10.1016/j.nuclcard.2025.102143","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of symptoms and reduced exercise capacity from peripheral artery disease (PAD) remains unclear. Additionally, there is limited information on blood flow and skeletal muscle energetics after walking exercise in patients with claudication in comparison to healthy individuals.</p><p><strong>Methods: </strong>We prospectively enrolled 19 patients with claudication from PAD and 12 healthy subjects. All participants underwent rest and post-exercise perfusion imaging of the lower leg muscles via PET/CT. Participants exercised on a treadmill following the Gardner-Skinner protocol. Skeletal muscle blood flow (SMBF) was quantified in each leg at rest and immediately after exercise. Phosphocreatine (PCr) recovery and NAD⁺/NADH concentrations were measured pre- and post-exercise by ³¹P magnetic resonance spectroscopy (MRS) in a subset of participants. Comparisons were made between the legs of healthy subjects and the asymptomatic and symptomatic legs of patients with PAD.</p><p><strong>Results: </strong>SMBF increased post-exercise in all participants. Among patients with PAD, the post-exercise/rest SMBF ratio, was higher in the symptomatic (n = 25) than asymptomatic (n = 13) legs (8.03 ± 2.84 vs 6.03 ± 2.81, P = 0.046) and higher than the post-exercise/rest SMBF ratio measured in the legs of healthy subjects (4.40 ± 1.47, P < 0.001). The post-exercise/rest PCr and NAD⁺/NADH ratios were lower in the legs of patients with PAD (n = 3) when compared with the legs of healthy subjects (n = 6) (0.79 ± 0.06 vs 1.00 ± 0.07 (P = 0.004) and 1.15 ± 0.43 vs 2.08 ± 0.30 (P = 0.007), respectively).</p><p><strong>Conclusions: </strong>SMBF increased post-exercise to the greatest degree in the symptomatic legs of patients with PAD and post-exercise skeletal muscle mitochondrial function was abnormal in patients with PAD. These data suggest that the causes of symptoms and reduced exercise capacity from PAD are not limited to abnormal perfusion pressure in the legs.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102143"},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074873","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":"AHL amyloidosis mimicking transthyretin amyloidosis on cardiac Tc-99 m pyrophosphate scan: A diagnostic challenge.","authors":"Ting-Jui Hsu, Chin-Te Tseng, Ling Kuo, Chih-Yu Yang, Yao-Ping Lin, Wen-Chung Yu, Der-Cherng Tarng","doi":"10.1016/j.nuclcard.2025.102147","DOIUrl":"10.1016/j.nuclcard.2025.102147","url":null,"abstract":"<p><strong>Background: </strong>Amyloidosis is a multisystem disease characterized by the deposition of amyloid fibrils, leading to organ dysfunction. When cardiac amyloidosis is suspected, it is essential to screen for light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR), the two most common subtypes.</p><p><strong>Case presentation: </strong>We report a patient with advanced heart failure and mild kidney dysfunction as initial symptoms. Preliminary testing revealed a slightly abnormal light chain ratio and a strong positive Tc-99 m pyrophosphate (PYP) scan. Biopsies of the heart, bone marrow, and kidney confirmed amyloidosis. Further immunofluorescence and mass spectrometry analysis identified immunoglobulin G and lambda light chain deposits. The patient was diagnosed with multiple myeloma and heavy and light chain amyloidosis (AHL) and initiated treatment with cyclophosphamide, bortezomib, and dexamethasone, rather than tafamidis, an oral transthyretin kinetic stabilizer used for ATTR.</p><p><strong>Conclusions: </strong>AHL amyloidosis is a rare subtype. This case demonstrates that a positive PYP scan, even with intense uptake, is not entirely specific for ATTR. Tissue confirmation is essential for a definitive diagnosis, particularly when light chain disease or other rare forms are suspected, because AL/AHL and ATTR have distinct treatments and prognoses and may coexist.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102147"},"PeriodicalIF":3.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047122","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":"Quantification of metabolic activity in the evaluation of cardiac sarcoidosis","authors":"Christiane Wiefels MD ,&nbsp;Kevin Boczar MD ,&nbsp;David Birnie MBChB ,&nbsp;Rob Beanlands MD ,&nbsp;Panithaya Chareonthaitawee MD","doi":"10.1016/j.nuclcard.2024.102088","DOIUrl":"10.1016/j.nuclcard.2024.102088","url":null,"abstract":"<div><div>Sarcoidosis is a systemic disorder characterized by non-necrotizing granulomatous inflammation and fibrosis affecting multiple organs, notably the lungs and lymph nodes. Cardiac sarcoidosis (CS), a subset of the disease predominantly involving the heart, significantly heightens the associated morbidity and mortality of sarcoidosis. Early detection of CS is crucial for optimal management. Positron emission tomography/computed tomography (PET/CT) using 18F-fluorodeoxyglucose (18F-FDG) has emerged as an important diagnostic, prognostic, and monitoring tool for CS. Guidelines emphasize a combined approach of visual interpretation and adjunctive quantitative metrics to enhance diagnostic accuracy and treatment monitoring. Various quantitative parameters including maximum standardized uptake value (SUVmax), coefficient of variation, and texture analysis show promise as auxiliary tools diagnosing and prognosticating CS. However, standardization and validation of these quantitative methods remain challenging due to inter-center variability and technological differences. Further validation through large-scale, multi-center studies is needed to optimize their use and better delineate their role in CS diagnosis, prognostication, and therapy monitoring.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102088"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716343","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":"Heart rate and blood pressure response to vasodilator stress: A trip back to the future","authors":"Ahmed Aljizeeri MBBS ,&nbsp;Mouaz H. Al-Mallah MD, MSc","doi":"10.1016/j.nuclcard.2024.102085","DOIUrl":"10.1016/j.nuclcard.2024.102085","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102085"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006924","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":"Incidentally detected diaphragmatic eventration as para-cardiac thoracic activity on myocardial perfusion imaging","authors":"Hardik Veerwal MD,&nbsp;Komal Preet MBBS,&nbsp;Ashwani Sood DNB,&nbsp;Harpreet Singh MD,&nbsp;Madan Parmar MSc,&nbsp;Bhagwant R. Mittal MD, DNB","doi":"10.1016/j.nuclcard.2024.101817","DOIUrl":"10.1016/j.nuclcard.2024.101817","url":null,"abstract":"<div><div>Diaphragmatic eventration<span><span> is the elevation of hemi-diaphragm without any disruption to diaphragmatic continuity which can be congenital or acquired. The most common acquired cause is phrenic nerve paralysis<span> due to traumatic causes and is usually incidentally diagnosed on chest radiograph or </span></span>computed tomography<span><span>. We hereby report a case of a patient who had road traffic accident with fracture of the left proximal femur<span>. Stress Myocardial Perfusion Imaging (MPI) done for pre-operative clearance showed an incidental </span></span>tracer<span><span> avidity adjoining to left myocardium in the </span>thorax. It was confirmed on anatomical imaging to be gastric cavity uptake due to diaphragm eventration.</span></span></span></div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 101817"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672026","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":"I can see clearly now the blur has gone: Deep learning efficiencies in single-photon emission computed tomography myocardial perfusion imaging","authors":"Manish Motwani MB ChB, PhD","doi":"10.1016/j.nuclcard.2024.102091","DOIUrl":"10.1016/j.nuclcard.2024.102091","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102091"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769759","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 motion correction with a deep learning network for perfusion defect assessment in single-photon emission computed tomography myocardial perfusion imaging","authors":"Xirang Zhang MS ,&nbsp;Yongyi Yang PhD ,&nbsp;P. Hendrik Pretorius PhD ,&nbsp;Piotr J. Slomka PhD ,&nbsp;Michael A. King PhD","doi":"10.1016/j.nuclcard.2024.102071","DOIUrl":"10.1016/j.nuclcard.2024.102071","url":null,"abstract":"<div><h3>Background</h3><div>In myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT), ungated studies are used for evaluation of perfusion defects despite motion blur. We investigate the potential benefit of motion correction using a deep-learning (DL) network for evaluating perfusion defects.</div></div><div><h3>Methods</h3><div>We employed a DL network for cardiac motion correction in ECG-gated SPECT-MPI images, wherein the image data from different cardiac phases are combined with respect to a reference gate to reduce motion blur. For training the DL network, 197 cases were used. Given the variability of gated images during the cardiac cycle, we investigated the detectability of perfusion defects in two distinct reference gates. To assess perfusion defect detection, we performed receiver-operating characteristic (ROC) analyses on the motion-corrected images using a separate test dataset of clinical 194 subjects, in which studies were created from actual patient data with inserted simulated-lesions as ground truth. The reconstructed images were assessed by the quantitative-perfusion SPECT (QPS) software. We also evaluated the performance on reduced-count studies (by two and four folds).</div></div><div><h3>Results</h3><div>The quantitative results, measured by area-under-the-ROC curve (AUC), demonstrated that DL motion correction improves the detectability of perfusion defects significantly on both standard- and reduced-count studies, and that the detectability can vary with reference cardiac phases. A joint assessment from two reference phases achieved AUC = 0.841 on the quarter-count data, higher than with ungated full-count data (AUC = 0.795, <em>P</em>-value = 0.0054).</div></div><div><h3>Conclusions</h3><div>DL motion correction can benefit assessment of perfusion defects in standard- and reduced-count SPECT-MPI studies. It can also be beneficial to evaluate perfusion images over multiple cardiac phases.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102071"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566921","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":"Expanding best practices in nuclear cardiology: A blueprint for growth","authors":"Marcelo F. Di Carli MD, MASNC","doi":"10.1016/j.nuclcard.2025.102127","DOIUrl":"10.1016/j.nuclcard.2025.102127","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102127"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006880","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":"Assessing the effect of repeat positron emission tomography imaging on treatment response and cardiovascular outcomes among a homogenously treated cohort of patients with suspected cardiac sarcoidosis","authors":"Chaitanya Rojulpote MD ,&nbsp;Abhijit Bhattaru BA ,&nbsp;Shivaraj Patil MD ,&nbsp;Sarah L. Adams DO ,&nbsp;Jonathan A. Salas BS ,&nbsp;Mahesh K. Vidula MD ,&nbsp;Raul Porto Perez MD ,&nbsp;Wumesh Kc MD, PhD ,&nbsp;Karen Patterson MD ,&nbsp;Caitlin B. Clancy MD ,&nbsp;Milton Rossman MD ,&nbsp;Lee Goldberg MD ,&nbsp;Paco E. Bravo MD","doi":"10.1016/j.nuclcard.2024.102082","DOIUrl":"10.1016/j.nuclcard.2024.102082","url":null,"abstract":"<div><h3>Background</h3><div>Serial positron emission tomography (PET) imaging is routinely used to monitor treatment response in patients with suspected cardiac sarcoidosis (CS). Corticosteroids remain the mainstay of therapy in CS. However, there are no data available on the cardiovascular outcomes and optimal timing interval to obtain repeat PET while factoring in the influence of corticosteroid taper in relation to surveillance imaging.</div></div><div><h3>Methods</h3><div>We identified 81 patients with suspected CS (age: 56.3 ± 1.9, 67% male, left ventricle ejection fraction: 46.5 ± 3) who were not on immunosuppression treatment and demonstrated inflammation on baseline PET, subsequently started on moderate-dose prednisone monotherapy (i.e., 30-40 mg/day), and had a diagnostic follow-up PET. Treatment response was graded as complete treatment response (CTR) or partial treatment response (PTR) vs no response. Patients were divided into tertiles based on follow-up time between PET scans; tertile-1 (&lt;3.2 months; median: 3.1 months), tertile-2 (3.2-6.8 months; median: 5.9 months), and tertile-3 (&gt;6.8 months; median: 9.8 months). Corticosteroid taper was captured by measuring weekly changes in prednisone from the start of treatment to up to one-year follow-up. Major adverse cardiovascular events (MACEs), defined as sustained ventricular arrhythmias, were documented during the first year post baseline PET.</div></div><div><h3>Results</h3><div>Treatment response CTR/PTR rates were similar across tertiles: (tertile-1 [92%] vs tertile-2 [86.2%] vs tertile-3 [85.2%]; <em>P</em> = .76). Taper rates and one-year cumulative prednisone dose were similar between the three groups (<em>P</em> = .9). No significant difference was found in short-term MACEs between the tertile groups (<em>P</em> = .89). Similarly, MACEs did not differ significantly according to treatment response status (<em>P</em> = .39).</div></div><div><h3>Conclusions</h3><div>Surveillance time and taper rates do not seem to influence treatment response on PET scans among patients initiated on moderate-dose prednisone only. Similar MACE rates were observed despite variations in follow-up time and treatment response status.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"43 ","pages":"Article 102082"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695405","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}