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Wang P, Ren C, Wang L, Qian H, Li F, Su X, Shen Z, Hsu B, Huo L. Comparative evaluation of a novel [ 18F] F-Labeled PET tracer XTR004 against [ 13N] ammonia in myocardial perfusion imaging for coronary artery disease. Eur J Nucl Med Mol Imaging 2025; 52:1864-1877. [PMID: 39681776 DOI: 10.1007/s00259-024-07004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 11/24/2024] [Indexed: 12/18/2024]
Abstract
AIMS This study aimed to evaluate image quality, myocardial perfusion, and diagnostic performance of a novel [18F]F-labeled PET tracer, XTR004 PET, myocardial perfusion imaging (MPI) compared with [13N]Ammonia (NH3) PET MPI. METHODS AND RESULTS Forty-seven patients with suspected or known coronary artery disease (CAD) were prospectively enrolled to undergo one-day rest/ATP-stress XTR004 and NH3 electrocardiograph-gated PET imaging within 2 weeks. Among them, twenty-six patients underwent invasive coronary angiography (ICA), and nineteen were identified with flow-limited CAD (stenosis ≥ 70%). Image quality (excellent/good/average) and certainty of interpretation were evaluated by two independent, blinded readers. Despite a higher liver uptake, XTR004 achieved good to excellent image quality in 83% of cases, comparable to 95.7% of NH3(P = 0.091). Additionally, the diagnostic certainty, measured as the percentage of cases with definitely abnormal or normal interpretations, was similar between XTR004 and NH3, with results of 87.2% and 89.2%, respectively. The sensitivity and specificity levels of XTR004 and NH3 MPI were similar (79% vs. 79%, 86% vs. 71%, P = 1.00). Linear regression of rest/stress myocardial perfusion in 17 segments revealed the linear slope close to unity with excellent R2 value (rest: slope = 0.954-1.074, R2 = 0.990-0.997; stress: slope = 0.951-1.082, R2 = 0.971-0.996). XTR004 was tolerated well by all patients. No adverse events were reported. CONCLUSION XTR004 PET MPI demonstrated promising image quality, diagnostic certainty and myocardial perfusion characteristics comparable to NH3 PET MPI. Future research should concentrate on the quantitative analysis of myocardial blood flow to explore the clinical implications of XTR004 PET MPI.
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Affiliation(s)
- Peipei Wang
- Department of Nuclear Medicine, Peking Union Medical College Hospital. Chinese Academy of Medical Science & Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Ren
- Department of Nuclear Medicine, Peking Union Medical College Hospital. Chinese Academy of Medical Science & Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Liang Wang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Hao Qian
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Fang Li
- Department of Nuclear Medicine, Peking Union Medical College Hospital. Chinese Academy of Medical Science & Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Xinhui Su
- Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhujun Shen
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Bailing Hsu
- Nuclear Science and Engineering Institute, E2433 Lafferre Hall, University of Missouri-Columbia, University of Missouri-Columbia, Columbia, MO, 65211, USA.
| | - Li Huo
- Department of Nuclear Medicine, Peking Union Medical College Hospital. Chinese Academy of Medical Science & Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
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Perrin M, Claudin M, Djaballah K, Boursier C, Verger A, Imbert L, Roch V, Doyen M, Marie L, Karcher G, Popovic B, Lamiral Z, Camenzind E, Marie PY. Diagnostic accuracy of low-dose myocardial perfusion imaging in a real-world setting. J Nucl Cardiol 2025; 45:102140. [PMID: 39788413 DOI: 10.1016/j.nuclcard.2025.102140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 12/10/2024] [Accepted: 12/18/2024] [Indexed: 01/12/2025]
Abstract
BACKGROUND This large-scale study analyzes factors affecting the diagnostic accuracy of low-dose myocardial perfusion imaging and correlation with coronary angiography in a real-world practice. METHODS We compared data extracted from routine reports of (i) low-dose [99mTc]sestamibi stress-MPI performed with no attenuation correction and predominantly exercise stress testing and (ii) the corresponding coronary angiography. RESULTS We considered 1070 pairs of coronary angiography/stress-MPI results reported by 11 physicians. Mean MPI effective dose was 4.5 ± 2.1 mSv. The extent of MPI-ischemia was predictive of >70% but not 50%-70% coronary stenoses. A positive test was associated with a sensitivity of 74.7% (413/553) and a specificity of 53.2% (275/517) for >70% stenosis detection. Positive predictive values were lower in patients with left bundle branch block or pacemakers (LBBB/PM) (45.6% vs 64.7%, P = .006) and markedly higher for patients with MPI-ischemia ≥3 segments or associated with ST-segment depression (75.0% (165/220)) as compared to those with <3 segments MPI-ischemia, MPI-infarction or isolated ST-segment depression (57% (248.0/435), P < .001). Negative predictive values were lower for patients with previous coronary artery disease (CAD) history (58.3%), male (61.0%), and elderly patients (59.6%) (vs 72.1%, 79.2%, and 72.4%, respectively, all P < .05). CONCLUSIONS Routine results from low-dose stress-MPI, predominantly associated with exercise stress testing and uncorrected for attenuation, correlate with real-world coronary angiography results. However, this correlation is lower than that achieved with conventional study designs and affected by the definition of significant CAD and context variables (LBBB/PM, CAD history, sex, and age). Better consideration of these interacting factors could improve patient monitoring.
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Affiliation(s)
- Mathieu Perrin
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France
| | - Marine Claudin
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France
| | - Karim Djaballah
- Université de Lorraine, CHRU-Nancy, Department of Cardiology, Nancy, F-54000, France
| | - Caroline Boursier
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France
| | - Antoine Verger
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France; Université de Lorraine, INSERM U1254, IADI, Nancy, F-54000, France
| | - Laetitia Imbert
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France; Université de Lorraine, INSERM U1254, IADI, Nancy, F-54000, France
| | - Véronique Roch
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France
| | - Matthieu Doyen
- Université de Lorraine, INSERM U1254, IADI, Nancy, F-54000, France
| | | | - Gilles Karcher
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France
| | - Batric Popovic
- Université de Lorraine, CHRU-Nancy, Department of Cardiology, Nancy, F-54000, France; Université de Lorraine, INSERM, UMR-1116, DCAC, Nancy, F-54000, France
| | - Zohra Lamiral
- Université de Lorraine, CHRU-Nancy, INSERM, CIC 1433, Nancy, France
| | - Edoardo Camenzind
- Université de Lorraine, CHRU-Nancy, Department of Cardiology, Nancy, F-54000, France; Université de Lorraine, INSERM, UMR-1116, DCAC, Nancy, F-54000, France
| | - Pierre-Yves Marie
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France; Université de Lorraine, INSERM U1254, IADI, Nancy, F-54000, France.
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3
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Cheng Z, Chen P, Yan J. A review of state-of-the-art resolution improvement techniques in SPECT imaging. EJNMMI Phys 2025; 12:9. [PMID: 39883257 PMCID: PMC11782768 DOI: 10.1186/s40658-025-00724-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 01/21/2025] [Indexed: 01/31/2025] Open
Abstract
Single photon emission computed tomography (SPECT), a technique capable of capturing functional and molecular information, has been widely adopted in theranostics applications across various fields, including cardiology, neurology, and oncology. The spatial resolution of SPECT imaging is relatively poor, which poses a significant limitation, especially the visualization of small lesions. The main factors affecting the limited spatial resolution of SPECT include projection sampling techniques, hardware and software. Both hardware and software innovations have contributed substantially to improved SPECT imaging quality. The present review provides an overview of state-of-the-art methods for improving spatial resolution in clinical and pre-clinical SPECT systems. It delves into advancements in detector design and modifications, projection sampling techniques, traditional reconstruction algorithm development and optimization, and the emerging role of deep learning. Hardware enhancements can result in SPECT systems that are both lighter and more compact, while also improving spatial resolution. Software innovations can mitigate the costs of hardware modifications. This survey offers a thorough overview of the rapid advancements in resolution enhancement techniques within the field of SPECT, with the objective of identifying the most recent trends. This is anticipated to facilitate further optimization and improvement of clinical systems, enabling the visualization of small lesions in the early stages of tumor detection, thereby enhancing accurate localization and facilitating both diagnostic imaging and radionuclide therapy, ultimately benefiting both clinicians and patients.
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Affiliation(s)
- Zhibiao Cheng
- School of Information and Communication Engineering, North University of China, Taiyuan, 030051, China.
- Shanxi Key Laboratory of Intelligent Detection Technology and Equipment, North University of China, Taiyuan, 030051, China.
| | - Ping Chen
- School of Information and Communication Engineering, North University of China, Taiyuan, 030051, China.
- Shanxi Key Laboratory of Intelligent Detection Technology and Equipment, North University of China, Taiyuan, 030051, China.
| | - Jianhua Yan
- Department of Nuclear Medicine, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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4
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Nogueira SA, Luz FAB, Camargo TFO, Oliveira JCS, Campos Neto GC, Carvalhaes FBF, Reis MRC, Santos PV, Mendes GS, Loureiro RM, Tornieri D, Pacheco VMG, Coimbra AP, Calixto WP. Artificial intelligence applied in identifying left ventricular walls in myocardial perfusion scintigraphy images: Pilot study. PLoS One 2025; 20:e0312257. [PMID: 39823407 PMCID: PMC11741626 DOI: 10.1371/journal.pone.0312257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 10/03/2024] [Indexed: 01/19/2025] Open
Abstract
This paper proposes the use of artificial intelligence techniques, specifically the nnU-Net convolutional neural network, to improve the identification of left ventricular walls in images of myocardial perfusion scintigraphy, with the objective of improving the diagnosis and treatment of coronary artery disease. The methodology included data collection in a clinical environment, followed by data preparation and analysis using the 3D Slicer Platform for manual segmentation, and subsequently, the application of artificial intelligence models for automated segmentation, focusing on the efficiency of identifying the walls of the left ventricular. A total of 83 clinical routine exams were collected, each exam containing 50 slices, which is 4,150 images. The results demonstrate the efficiency of the proposed artificial intelligence model, with a Dice coefficient of 87% and an average Intersection over Union of 0.8, reflecting high agreement with the manual segmentations produced by experts and surpassing traditional interpretation methods. The internal and external validation of the model corroborates its future applicability in real clinical scenarios, offering a new perspective in the analysis of myocardial perfusion scintigraphy images. The integration of artificial intelligence into the process of analyzing myocardial perfusion scintigraphy images represents a significant advancement in diagnostic accuracy, promoting substantial improvements in the interpretation of medical images, and establishing a foundation for future research and clinical applications, such as artifact correction.
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Affiliation(s)
- Solange Amorim Nogueira
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | - Fernanda Ambrogi B. Luz
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | - Thiago Fellipe O. Camargo
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | | | | | | | - Marcio Rodrigues C. Reis
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | - Paulo Victor Santos
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | | | | | | | - Viviane M. Gomes Pacheco
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
| | | | - Wesley Pacheco Calixto
- Electrical, Mechanical & Computer Engineering School, Federal University of Goias, Goiania, Brazil
- Systems and Robotics Institute, Coimbra University, Coimbra, Portugal
- Technology Research and Development Center (GCITE), Federal Institute of Goias, Goiania, Goias, Brazil
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5
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Verger A, Cecchin D, Guedj E, Albert NL, Brendel M, Fraioli F, Tolboom N, Traub-Weidinger T, Yakushev I, Van Weehaeghe D, Fernandez PA, Garibotto V, Imbert L. EANM perspectives for CZT SPECT in brain applications. Eur J Nucl Med Mol Imaging 2024; 51:3680-3684. [PMID: 38858281 DOI: 10.1007/s00259-024-06788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Affiliation(s)
- Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Allée du Morvan, Nancy, 54500, France.
| | - Diego Cecchin
- Department of Medicine, Unit of Nuclear Medicine, University Hospital of Padova, Padova, Italy
| | - Eric Guedj
- Département de Médecine Nucléaire, Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Hôpital de La Timone, CERIMED, Marseille, France
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tatjana Traub-Weidinger
- Department of Diagnostic and Therapeutic Nuclear Medicine, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts dr Isar, Technical University of Munich, Munich, Germany
| | - Donatienne Van Weehaeghe
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Pablo Aguiar Fernandez
- CIMUS, Universidade Santiago de Compostela & Nuclear Medicine Department, Univ. Hospital IDIS, Santiago de Compostela, Spain
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland
- NIMTLab, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Allée du Morvan, Nancy, 54500, France
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Ding X, Cui L, Li J, Cao J, Ding M, Wang H, Zhang F, Wang H. Assessing the diagnostic value of left ventricular synchrony indices derived from phase analysis by D-SPECT in identifying obstructive coronary artery disease. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:1919-1930. [PMID: 38960945 DOI: 10.1007/s10554-024-03182-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/28/2024] [Indexed: 07/05/2024]
Abstract
This study aimed to assess the diagnostic efficacy of left ventricular synchrony (LVS) for detecting coronary artery disease (CAD). We explored whether the LVS index derived from phase analysis of D-SPECT provides superior diagnostic value compared to conventional perfusion analysis in identifying obstructive CAD. Patients with suspected or confirmed CAD underwent drug-stress/rest gated D-SPECT myocardial perfusion imaging (MPI) and coronary angiography (CAG). A 50% stenosis was set as the threshold for obstructive CAD. 110 participants were enrolled in this analysis. There were significant differences in phase standard deviation (PSD), phase histogram bandwidth (PHB) and entropy among the four groups. Patients without cardiac disease and those with mild-moderate stenosis exhibited no noticeable contraction asynchrony. However, LVS indices demonstrated a gradual increase with the progression of coronary stenosis when compared to NC (P < 0.001). Obstructive CAD was identified in 43 out of 110 participants (39%). Optimal cutoff values for diagnosing obstructive CAD during stress were determined as 7.6° for PSD, 24° for PHB, and 37% for entropy, respectively. Notably, PSD, PHB, and entropy indices exhibited higher sensitivity compared to MPI. The integration of the stress-induced LVS indices into routine MPI analysis resulted in a significantly greater area under the curve (AUC), leading to improved diagnostic performance and enhanced differential capacity. Stress-induced LVS indices increase with the severity of coronary artery stenosis by D-SPECT phase analysis. Further, the indices-derived phase analysis exhibits superior sensitivity and discriminatory ability compared to MPI in detecting obstructive CAD.
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Affiliation(s)
- Xinhua Ding
- Department of Nuclear Medicine, Gansu Province, Gansu Provincial Hospital, 204 Donggang West Road, Chengguan District, Lanzhou, 730000, China
| | - Lanlan Cui
- PET/CT Center, Gansu Provincial Hospital, Lanzhou, China
| | - Jianfeng Li
- Department of Cardiology, Gansu Province, Gansu Provincial Hospital, 204 Donggang West Road, Chengguan District, Lanzhou, 730000, China
| | - Jiancang Cao
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Mingjia Ding
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Haiyong Wang
- Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, China
| | - Fu Zhang
- Department of Cardiology, Gansu Province, Gansu Provincial Hospital, 204 Donggang West Road, Chengguan District, Lanzhou, 730000, China.
| | - Haijun Wang
- Department of Nuclear Medicine, Gansu Province, Gansu Provincial Hospital, 204 Donggang West Road, Chengguan District, Lanzhou, 730000, China.
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7
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Bottardi A, Prado GFA, Lunardi M, Fezzi S, Pesarini G, Tavella D, Scarsini R, Ribichini F. Clinical Updates in Coronary Artery Disease: A Comprehensive Review. J Clin Med 2024; 13:4600. [PMID: 39200741 PMCID: PMC11354290 DOI: 10.3390/jcm13164600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/05/2024] [Accepted: 07/26/2024] [Indexed: 09/02/2024] Open
Abstract
Despite significant goals achieved in diagnosis and treatment in recent decades, coronary artery disease (CAD) remains a high mortality entity and continues to pose substantial challenges to healthcare systems globally. After the latest guidelines, novel data have emerged and have not been yet considered for routine practice. The scope of this review is to go beyond the guidelines, providing insights into the most recent clinical updates in CAD, focusing on non-invasive diagnostic techniques, risk stratification, medical management and interventional therapies in the acute and stable scenarios. Highlighting and synthesizing the latest developments in these areas, this review aims to contribute to the understanding and management of CAD helping healthcare providers worldwide.
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Affiliation(s)
- Andrea Bottardi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Guy F. A. Prado
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
- Department of Clinical and Molecular Medicine, Sapienza University, 00185 Rome, Italy
| | - Mattia Lunardi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Simone Fezzi
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Gabriele Pesarini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Domenico Tavella
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Roberto Scarsini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
| | - Flavio Ribichini
- Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy; (A.B.); (G.F.A.P.); (S.F.); (G.P.); (D.T.); (R.S.); (F.R.)
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8
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Tassetti L, Sfriso E, Torlone F, Baggiano A, Mushtaq S, Cannata F, Del Torto A, Fazzari F, Fusini L, Junod D, Maragna R, Volpe A, Carrabba N, Conte E, Guglielmo M, La Mura L, Pergola V, Pedrinelli R, Indolfi C, Sinagra G, Perrone Filardi P, Guaricci AI, Pontone G. The Role of Multimodality Imaging (CT & MR) as a Guide to the Management of Chronic Coronary Syndromes. J Clin Med 2024; 13:3450. [PMID: 38929984 PMCID: PMC11205051 DOI: 10.3390/jcm13123450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Chronic coronary syndrome (CCS) is one of the leading cardiovascular causes of morbidity, mortality, and use of medical resources. After the introduction by international guidelines of the same level of recommendation to non-invasive imaging techniques in CCS evaluation, a large debate arose about the dilemma of choosing anatomical (with coronary computed tomography angiography (CCTA)) or functional imaging (with stress echocardiography (SE), cardiovascular magnetic resonance (CMR), or nuclear imaging techniques) as a first diagnostic evaluation. The determinant role of the atherosclerotic burden in defining cardiovascular risk and prognosis more than myocardial inducible ischemia has progressively increased the use of a first anatomical evaluation with CCTA in a wide range of pre-test probability in CCS patients. Functional testing holds importance, both because the role of revascularization in symptomatic patients with proven ischemia is well defined and because functional imaging, particularly with stress cardiac magnetic resonance (s-CMR), gives further prognostic information regarding LV function, detection of myocardial viability, and tissue characterization. Emerging techniques such as stress computed tomography perfusion (s-CTP) and fractional flow reserve derived from CT (FFRCT), combining anatomical and functional evaluation, appear capable of addressing the need for a single non-invasive examination, especially in patients with high risk or previous revascularization. Furthermore, CCTA in peri-procedural planning is promising to acquire greater importance in the non-invasive planning and guiding of complex coronary revascularization procedures, both by defining the correct strategy of interventional procedure and by improving patient selection. This review explores the different roles of non-invasive imaging techniques in managing CCS patients, also providing insights into preoperative planning for percutaneous or surgical myocardial revascularization.
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Affiliation(s)
- Luigi Tassetti
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Enrico Sfriso
- Radiology Unit, Department of Medical, Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy;
| | | | - Andrea Baggiano
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Saima Mushtaq
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Francesco Cannata
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Alberico Del Torto
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Fabio Fazzari
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Laura Fusini
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Daniele Junod
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Riccardo Maragna
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Alessandra Volpe
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
| | - Nazario Carrabba
- Department of Cardiothoracovascular Medicine, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy;
| | - Edoardo Conte
- Department of Clinical Cardiology and Cardiovascular Imaging, Galeazzi-Sant’Ambrogio Hospital IRCCS, 20157 Milan, Italy;
| | - Marco Guglielmo
- Department of Cardiology, Division of Heart and Lungs, Medical Center Utrecht, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Lucia La Mura
- Department of Advanced Biomedical Sciences, University Federico II of Naples, 80131 Naples, Italy; (L.L.M.); (P.P.F.)
| | - Valeria Pergola
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | - Roberto Pedrinelli
- Cardiac, Thoracic and Vascular Department, University of Pisa, 56124 Pisa, Italy;
| | - Ciro Indolfi
- Istituto di Cardiologia, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Gianfranco Sinagra
- Cardiology Specialty School, University of Trieste, 34127 Trieste, Italy;
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), 34149 Trieste, Italy
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, University Federico II of Naples, 80131 Naples, Italy; (L.L.M.); (P.P.F.)
| | - Andrea Igoren Guaricci
- Cardiology Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70126 Bari, Italy;
| | - Gianluca Pontone
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (L.T.); (A.B.); (S.M.); (F.C.); (F.F.); (L.F.); (D.J.); (R.M.); (A.V.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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9
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Vauchot F, Dubois J, Bourdon A. Improving multi-pinhole CZT myocardial perfusion imaging specificity without changing sensibility by using adapted filter parameters. EJNMMI Res 2024; 14:27. [PMID: 38453724 PMCID: PMC10920588 DOI: 10.1186/s13550-024-01083-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Meta-analysis show the diagnostic performance of cardiac dedicated multi-pinhole cadmium-zinc-telluride myocardial perfusion imaging (MPI) with a sensibility around 0.9 and a specificity around 0.7. The aim of the present study is to explore a simple method to generate less artefact on MPI using single photon emission computed tomography (SPECT) and to enhance specificity without changing sensibility. RESULTS From October 2018 to March 2019, 200 patients who underwent SPECT with [99mTc]Tc-tetrofosmin were prospectively recruited: 100 patients with ischemia or necrosis diagnosis (first arm), and 100 patients with myocardial reversible SPECT artefact (second arm). Each SPECT was explored using two image process based on a Butterworth prefilter and post-filter: the original image processing (reconstruction A) with a cut-off frequency equals to 37% of the Nyquist frequency and order equals to 7, and a second image processing (reconstruction B) with a cut-off frequency equals to 25% of the Nyquist frequency and order equals to 5. For each patient, sum stress or rest score with and without septum (SSRS and SSRSws) were calculated with the two reconstructions. No significant statistical difference between SSRSa and SSRSb was identified for the first arm (P = 0.54) and the relative difference ∆r was - 0.5 ± 11.1% (95% CI - 2.7 to 1.7). We found a significant statistical difference between SSRSa and SSRSb for the second arm (p < 0.0001) and the relative difference ∆r was 69.7 ± 16.2% (95% CI 66.6-72.9). CONCLUSION In conclusion, using a Butterworth prefilter and post-filter cut-off frequency equal to 25% of the Nyquist frequency before iterative reconstruction generates less artefact and improves myocardial SPECT specificity without affecting sensibility compared with the original reconstruction.
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Affiliation(s)
- Fabien Vauchot
- Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France.
| | - Julien Dubois
- Department of Radiopharmacy, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Aurélie Bourdon
- Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France
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10
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Sweet C, Shmuel N, Shoaf JN, Stoecklein M, Muthukrishnan A, Stern E, Nguyen NC. A Pictorial Review of I-123 MIBG Imaging of Neuroblastoma Utilizing a State-of-the-Art CZT SPECT/CT System. Nucl Med Mol Imaging 2024; 58:1-8. [PMID: 38250182 PMCID: PMC10796310 DOI: 10.1007/s13139-023-00825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 01/23/2024] Open
Abstract
The field of nuclear medicine is entering a new era of gamma-camera technology. Solid-state SPECT/CT systems will gradually replace the thallium-activated sodium-iodide NaI(Tl) systems. This digital technology allows drastic improvements in image quality, radiotracer dose reduction, and procedure efficiency. This pictorial review presents our initial experience on an NM/CT 870 CZT system (GE Healthcare), equipped with dual-head cadmium zinc telluride (CZT) detectors, for I-123 metaiodobenzylguanidine (MIBG) imaging in pediatric neuroblastoma. On planar imaging, CZT shows greater image quality than at conventional gamma-camera using the Infinia Hawkeye (GE Healthcare). Physiologic structures such as salivary glands and myocardium show sharper borders with a more notable signal-to-noise ratio at CZT than conventional gamma camera. On SPECT imaging, the CZT scanner, combined with resolution recovery, demonstrates either comparable or greater image quality at 80% of the conventional gamma camera’s acquisition time. Due to the 2.46-mm detector pixel with fully registered collimator holes matching each pixel and direct conversion of photons into electrical signals, the CZT gamma camera system provides significant advantages in photon localization and energy resolution.
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Affiliation(s)
- Cassidy Sweet
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | | | - Jennifer N. Shoaf
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | - Marcy Stoecklein
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | | | | | - Nghi C. Nguyen
- Department of Radiology, University of Texas, Southwestern Medical Center, Dallas, TX USA
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11
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Li J, Yang G, Zhang L. Artificial Intelligence Empowered Nuclear Medicine and Molecular Imaging in Cardiology: A State-of-the-Art Review. PHENOMICS (CHAM, SWITZERLAND) 2023; 3:586-596. [PMID: 38223683 PMCID: PMC10781930 DOI: 10.1007/s43657-023-00137-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 01/16/2024]
Abstract
Nuclear medicine and molecular imaging plays a significant role in the detection and management of cardiovascular disease (CVD). With recent advancements in computer power and the availability of digital archives, artificial intelligence (AI) is rapidly gaining traction in the field of medical imaging, including nuclear medicine and molecular imaging. However, the complex and time-consuming workflow and interpretation involved in nuclear medicine and molecular imaging, limit their extensive utilization in clinical practice. To address this challenge, AI has emerged as a fundamental tool for enhancing the role of nuclear medicine and molecular imaging. It has shown promising applications in various crucial aspects of nuclear cardiology, such as optimizing imaging protocols, facilitating data processing, aiding in CVD diagnosis, risk classification and prognosis. In this review paper, we will introduce the key concepts of AI and provide an overview of its current progress in the field of nuclear cardiology. In addition, we will discuss future perspectives for AI in this domain.
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Affiliation(s)
- Junhao Li
- Department of Nuclear Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002 Jiangsu China
| | - Guifen Yang
- Department of Nuclear Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002 Jiangsu China
| | - Longjiang Zhang
- Department of Radiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002 Jiangsu China
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12
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He M, Han W, Shi C, Wang M, Li J, He W, Xu X, Gan Q, Guan S, Zhang L, Chen Y, Chang X, Li T, Qu X. A Comparison of Dynamic SPECT Coronary Flow Reserve with TIMI Frame Count in the Treatment of Non-Obstructive Epicardial Coronary Patients. Clin Interv Aging 2023; 18:1831-1839. [PMID: 37937265 PMCID: PMC10627069 DOI: 10.2147/cia.s429450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Background Microvascular dysfunction in patients with non-obstructive epicardial coronary may aggravate patient's symptoms or lead to various clinical events. Objective To investigate the correlation between dynamic single photon emission computed tomography (D-SPECT) derived coronary flow reserve (CFR) and TIMI frame count (TFC) in patients with non-obstructive epicardial coronary patients. Methods Patients with suspected or known stable CAD who were recommended to undergo invasive coronary angiography were prospectively enrolled in this study. Those who had non-obstructive coronary received TIMI frame count (TFC) and D-SPECT. A cut-off value of >40 was defined as slow flow referred to TFC. Results A total of 47 patients diagnosed with non-obstructive coronary were enrolled. The mean age of patients was 66.09 ± 8.36 years, and 46.8% were male. Dynamic SPECT derived coronary flow reserve (CFR) was significantly correlated with TIMI frame count in 3 epicardial coronary (LAD: r=-0.506, P = 0.0003; LCX: r= -0.532, P = 0.0001; RCA: r= -0.657, P < 0.0001). The sensitivity and specificity of CFR in identifying abnormal TIMI frame count < 40 was 100.0% and 57.6% in LAD, 62.5% and 87.0% in LCX, 83.9% and 75.0% in RCA, respectively. The optimal CFR cut-off values were 2.02, 2.47, and 1.96 among the three vessels. Conclusion In patients with non-obstructive coronary, CFR derived from D-SPECT was strongly correlated with TFC. This study demonstrates that that CFR may be an alternative non-invasive method for identifying slow flow in non-obstructive coronary.
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Affiliation(s)
- Mingping He
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Wenzheng Han
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Chuan Shi
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Ming Wang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Junheng Li
- Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Wei He
- Department of Nuclear Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xinxin Xu
- Clinical Research Center for Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Qian Gan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Shaofeng Guan
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Liang Zhang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Yang Chen
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xifeng Chang
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Tianqi Li
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
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13
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Yamashita S, Nakajima K, Okuda K, Yamamoto H, Shibutani T, Yoneyama T, Tsuji S, Yokoyama K. Phantom-Based Standardization Method for 123I-metaiodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera. ANNALS OF NUCLEAR CARDIOLOGY 2023; 9:85-90. [PMID: 38058581 PMCID: PMC10696155 DOI: 10.17996/anc.23-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 12/08/2023]
Abstract
Background: The 123I-metaiodobenzylguanidine heart-to-mediastinum ratios (HMRs) have been standardized between D-SPECT and Anger cameras in a small patient cohort using a phantom-based conversion method. This study aimed to determine the validity of this method and compare the diagnostic performance of the two cameras in a larger patient cohort. Methods: We retrospectively calculated HMRs from early and late anterior-planar equivalent and planar images acquired from 173 patients in 177 studies using D-SPECT and Anger cameras, respectively. The D-SPECT HMRs were cross-calibrated to an Anger camera using conversion coefficients based on previous phantom findings, then standardized to medium-energy general-purpose collimator conditions. Relationships between HMRs before and after corrections were investigated. Late HMRs were classified into four cardiac mortality risk groups and divided into two groups using a threshold of 2.2 to verify diagnostic performance concordance. Results: Correction improved linear regression lines and differences in HMRs among the groups. The overall ratios of perfect concordance were (134 [75.7%] of 177), and higher in groups with very low (49 [80.3%] of 61) and high (51 [86.4%] of 59) HMRs when the standardized HMR was classified according to cardiac mortality risk. That between the systems was the highest (164 [92.7%] of 177) when the HMR was divided by a threshold value of 2.2. Conclusions: Phantom-based conversion can standardize HMRs between D-SPECT and Anger cameras because the standardized HMR provided comparable diagnostic performance. Our findings indicated that this conversion could be applied to multicenter studies that include both D-SPECT and Anger cameras.
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Affiliation(s)
- Shozo Yamashita
- Division of Radiology, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Ishikawa, Japan
| | - Koichi Okuda
- Department of Radiation Science, Hirosaki University Graduate School of Health Sciences, Aomori, Japan
| | - Haruki Yamamoto
- Division of Radiology, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Tatsuya Yoneyama
- Division of Thyroid, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Shiro Tsuji
- PET Imaging Center, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Kunihiko Yokoyama
- PET Imaging Center, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
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14
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Assante R, Zampella E, Cantoni V, Green R, D'Antonio A, Mannarino T, Gaudieri V, Nappi C, Buongiorno P, Panico M, Petretta M, Cuocolo A, Acampa W. Prognostic value of myocardial perfusion imaging by cadmium zinc telluride single-photon emission computed tomography in patients with suspected or known coronary artery disease: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2023; 50:3647-3658. [PMID: 37480369 PMCID: PMC10547640 DOI: 10.1007/s00259-023-06344-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Aim of this study was to define the prognostic value of stress myocardial perfusion imaging by cadmium zinc telluride (CZT) single-photon emission computed tomography (SPECT) for prediction of adverse cardiovascular events in patients with known or suspected coronary artery disease (CAD). METHODS AND RESULTS Studies published until November 2022 were identified by database search. We included studies using stress myocardial perfusion imaging by CZT-SPECT to evaluate subjects with known or suspected CAD and providing primary data of adverse cardiovascular events. Total of 12 studies were finally included recruiting 36,415 patients. Pooled hazard ratio (HR) for the occurrence of adverse events was 2.17 (95% confidence interval, CI, 1.78-2.65) and heterogeneity was 66.1% (P = 0.001). Five studies reported data on adjusted HR for the occurrence of adverse events. Pooled HR was 1.69 (95% CI, 1.44-1.98) and heterogeneity was 44.9% (P = 0.123). Seven studies reported data on unadjusted HR for the occurrence of adverse events. Pooled HR was 2.72 (95% CI, 2.00-3.70). Nine studies reported data useful to calculate separately the incidence rate of adverse events in patients with abnormal and normal myocardial perfusion. Pooled incidence rate ratio was 2.38 (95% CI, 1.39-4.06) and heterogeneity was 84.6% (P < 0.001). The funnel plot showed no evidence of asymmetry (P = 0.517). At meta-regression analysis, we found an association between HR for adverse events and presence of angina symptoms and family history of CAD. CONCLUSIONS Stress myocardial perfusion imaging by CZT-SPECT is a valuable noninvasive prognostic indicator for adverse cardiovascular events in patients with known or suspected CAD.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Mariarosaria Panico
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
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15
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Saraste A, Knuuti J, Bengel F. Phenotyping heart failure by nuclear imaging of myocardial perfusion, metabolism, and molecular targets. Eur Heart J Cardiovasc Imaging 2023; 24:1318-1328. [PMID: 37294318 PMCID: PMC10531130 DOI: 10.1093/ehjci/jead128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023] Open
Abstract
Nuclear imaging techniques can detect and quantify pathophysiological processes underlying heart failure, complementing evaluation of cardiac structure and function with other imaging modalities. Combined imaging of myocardial perfusion and metabolism can identify left ventricle dysfunction caused by myocardial ischaemia that may be reversible after revascularization in the presence of viable myocardium. High sensitivity of nuclear imaging to detect targeted tracers has enabled assessment of various cellular and subcellular mechanisms of heart failure. Nuclear imaging of active inflammation and amyloid deposition is incorporated into clinical management algorithms of cardiac sarcoidosis and amyloidosis. Innervation imaging has well-documented prognostic value with respect to heart failure progression and arrhythmias. Emerging tracers specific for inflammation and myocardial fibrotic activity are in earlier stages of development but have demonstrated potential value in early characterization of the response to myocardial injury and prediction of adverse left ventricular remodelling. Early detection of disease activity is a key for transition from broad medical treatment of clinically overt heart failure towards a personalized approach aimed at supporting repair and preventing progressive failure. This review outlines the current status of nuclear imaging in phenotyping heart failure and combines it with discussion on novel developments.
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Affiliation(s)
- Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4–8, 20520 Turku, Finland
- Heart Center, Turku University Hospital and University of Turku, Hämeentie 11, 20520 Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4–8, 20520 Turku, Finland
| | - Frank Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
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16
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Kalantari F, Mohseninia N, Wetsch A, Harsini S, Hehenwarter L, Schweighofer-Zwink G, Zamani-Siahkali N, Rendl G, Beheshti M, Pirich C. Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance. Life (Basel) 2023; 13:1879. [PMID: 37763283 PMCID: PMC10532584 DOI: 10.3390/life13091879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Myocardial perfusion imaging (MPI) plays a crucial role in diagnosing coronary artery disease (CAD), with single-photon emission computed tomography (SPECT) being a widely accepted method. The accuracy of MPI relies on image quality and the expertise of physicians. While CZT-SPECT cameras offer advantages, they can be susceptible to attenuation artifacts. Therefore, our objective was to evaluate the diagnostic accuracy of CZT-SPECT and SPECT/CT in a clinical setting. METHOD We conducted a prospective single-center study involving patients with known or suspected stable ischemic heart disease who underwent SPECT-MPI using CZT-SPECT and SPECT/CT scanners, and the latter was equipped with cardiofocal collimation. Experienced physicians performed analysis and reporting based on automated quantification and visual image interpretation. RESULTS A total of 77 patients (32 women (41.6%) and 45 men (58.4%) with an average age of 71.9 ± 8.9 years) were included. The agreement between readers regarding the final conclusion based on imaging reporting using both devices was very high (Kappa 0.87-0.93). Per-vessel analysis revealed a trend suggesting that CZT-SPECT was superior to conventional SPECT/CT in terms of sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, although the difference did not reach statistical significance. CONCLUSION Our study demonstrated that CZT-SPECT imaging offers comparable diagnostic accuracy, improved patient comfort, and eliminates CT-induced radiation compared to SPECT/CT. These findings suggest that cardiac CZT-SPECT imaging has the potential to become a valuable imaging modality in clinical practice.
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Affiliation(s)
- Forough Kalantari
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Nasibeh Mohseninia
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Andreas Wetsch
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Sara Harsini
- BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
| | - Lukas Hehenwarter
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Gregor Schweighofer-Zwink
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Nazanin Zamani-Siahkali
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
- Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - Gundula Rendl
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
| | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, Austria (N.Z.-S.)
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17
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Zampella E, Assante R, Acampa W. Myocardial perfusion reserve by CZT cameras: A journey inside coronary microvascular circulation. Is it time to leave yet? J Nucl Cardiol 2023; 30:1668-1670. [PMID: 37311913 DOI: 10.1007/s12350-023-03313-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023]
Affiliation(s)
- Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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18
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D'Antonio A, Assante R, Zampella E, Mannarino T, Buongiorno P, Cuocolo A, Acampa W. Myocardial blood flow evaluation with dynamic cadmium-zinc-telluride single-photon emission computed tomography: Bright and dark sides. Diagn Interv Imaging 2023; 104:323-329. [PMID: 36797156 DOI: 10.1016/j.diii.2023.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) assessment with non-invasive techniques represent an important tool to evaluate both coronary artery disease severity and extent. Currently, cardiac positron emission tomography-computed tomography (PET-CT) is the "gold standard" for the assessment of coronary function and provides accurate estimations of baseline and hyperemic MBF and MFR. Nevertheless, due to the high cost and complexity, PET-CT is not widely used in clinical practice. The introduction of cardiac-dedicated cadmium-zinc-telluride (CZT) cameras has renewed researchers' interest on MBF quantitation by single-photon emission computed tomography (SPECT). Indeed, many studies evaluated MPR and MBF measurements by dynamic CZT-SPECT in different cohorts of patients with suspected or overt coronary artery disease. As well, many others have compared the values obtained by CZT-SPECT to the ones by PET-CT, showing good correlations in detecting significant stenosis, although with different and non-standardized cut-off values. Nevertheless, the lack of standardized protocol for acquisition, reconstruction and elaboration makes more difficult to compare different studies and to further assess the real advantages of MBF quantitation by dynamic CZT-SPECT in clinical routine. Many are the issues involved in the bright and dark sides of dynamic CZT-SPECT. They include different type of CZT cameras, different execution protocols, different tracers with different myocardial extraction fraction and distribution, different software packages with different tools and algorithms, often requiring manual post-processing elaboration. This review article provides a clear summary of the state of the art on MBF and MPR evaluation by dynamic CZT-SPECT and outlines the major issues to solve to optimize this technique.
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Affiliation(s)
- Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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19
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Hyafil F. Quantification of myocardial blood flow with cadmium-zinc-telluride SPECT: Is it worth the effort? Diagn Interv Imaging 2023; 104:309-310. [PMID: 37085422 DOI: 10.1016/j.diii.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015, Paris, France; Université Paris Cité, Faculté de Médecine, INSERM U970, 75006 Paris, France.
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20
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Bergamaschi L, Pavon AG, Angeli F, Tuttolomondo D, Belmonte M, Armillotta M, Sansonetti A, Foà A, Paolisso P, Baggiano A, Mushtaq S, De Zan G, Carriero S, Cramer MJ, Teske AJ, Broekhuizen L, van der Bilt I, Muscogiuri G, Sironi S, Leo LA, Gaibazzi N, Lovato L, Pontone G, Pizzi C, Guglielmo M. The Role of Non-Invasive Multimodality Imaging in Chronic Coronary Syndrome: Anatomical and Functional Pathways. Diagnostics (Basel) 2023; 13:2083. [PMID: 37370978 PMCID: PMC10297526 DOI: 10.3390/diagnostics13122083] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Coronary artery disease (CAD) is one of the major causes of mortality and morbidity worldwide, with a high socioeconomic impact. Currently, various guidelines and recommendations have been published about chronic coronary syndromes (CCS). According to the recent European Society of Cardiology guidelines on chronic coronary syndrome, a multimodal imaging approach is strongly recommended in the evaluation of patients with suspected CAD. Today, in the current practice, non-invasive imaging methods can assess coronary anatomy through coronary computed tomography angiography (CCTA) and/or inducible myocardial ischemia through functional stress testing (stress echocardiography, cardiac magnetic resonance imaging, single photon emission computed tomography-SPECT, or positron emission tomography-PET). However, recent trials (ISCHEMIA and REVIVED) have cast doubt on the previous conception of the management of patients with CCS, and nowadays it is essential to understand the limitations and strengths of each imaging method and, specifically, when to choose a functional approach focused on the ischemia versus a coronary anatomy-based one. Finally, the concept of a pathophysiology-driven treatment of these patients emerged as an important goal of multimodal imaging, integrating 'anatomical' and 'functional' information. The present review aims to provide an overview of non-invasive imaging modalities for the comprehensive management of CCS patients.
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Affiliation(s)
- Luca Bergamaschi
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland (A.G.P.); (L.A.L.)
| | - Anna Giulia Pavon
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland (A.G.P.); (L.A.L.)
| | - Francesco Angeli
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.A.); (M.A.); (A.S.); (A.F.); (C.P.)
- Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Domenico Tuttolomondo
- Department of Cardiology, Parma University Hospital, Viale Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (N.G.)
| | - Marta Belmonte
- Cardiovascular Center Aalst, OLV-Clinic, 9300 Aalst, Belgium;
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy;
| | - Matteo Armillotta
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.A.); (M.A.); (A.S.); (A.F.); (C.P.)
- Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Angelo Sansonetti
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.A.); (M.A.); (A.S.); (A.F.); (C.P.)
- Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Alberto Foà
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.A.); (M.A.); (A.S.); (A.F.); (C.P.)
- Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Pasquale Paolisso
- Department of Advanced Biomedical Sciences, University Federico II, 80138 Naples, Italy;
| | - Andrea Baggiano
- Perioperative and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (A.B.); (S.M.); (G.P.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Saima Mushtaq
- Perioperative and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (A.B.); (S.M.); (G.P.)
| | - Giulia De Zan
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
- Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, 28100 Novara, Italy
| | - Serena Carriero
- Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy;
| | - Maarten-Jan Cramer
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
| | - Arco J. Teske
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
| | - Lysette Broekhuizen
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
| | - Ivo van der Bilt
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
- Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
| | - Giuseppe Muscogiuri
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (G.M.); (S.S.)
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, 20149 Milan, Italy
| | - Sandro Sironi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy; (G.M.); (S.S.)
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
| | - Laura Anna Leo
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland (A.G.P.); (L.A.L.)
| | - Nicola Gaibazzi
- Department of Cardiology, Parma University Hospital, Viale Antonio Gramsci 14, 43126 Parma, Italy; (D.T.); (N.G.)
| | - Luigi Lovato
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy;
| | - Gianluca Pontone
- Perioperative and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (A.B.); (S.M.); (G.P.)
| | - Carmine Pizzi
- Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy; (F.A.); (M.A.); (A.S.); (A.F.); (C.P.)
- Department of Medical and Surgical Sciences—DIMEC—Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Marco Guglielmo
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands; (G.D.Z.); (M.-J.C.); (A.J.T.); (L.B.); (I.v.d.B.)
- Department of Cardiology, Haga Teaching Hospital, 2545 GM The Hague, The Netherlands
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21
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Liu L, Dai N, Yin G, Zhang W, Mohammed AQ, Xu S, Lv X, Shi T, Feng C, Mohammed AA, Mareai RM, Xu Y, Yu X, Abdu FA, Yu F, Che W. Prognostic value of combined coronary angiography-derived IMR and myocardial perfusion imaging by CZT SPECT in INOCA. J Nucl Cardiol 2023; 30:684-701. [PMID: 35918592 DOI: 10.1007/s12350-022-03038-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/26/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND A significant proportion of ischemia with non-obstructive coronary artery disease (INOCA) demonstrate coronary microvascular dysfunction (CMD), a condition associated with abnormal myocardial perfusion imaging (MPI) and adverse outcomes. Coronary angiography-derived index of microvascular resistance (caIMR) is a novel non-invasive technique to assess CMD. We aimed to investigate the prognostic value of combined caIMR and MPI by CZT SPECT in INOCA patients. METHODS Consecutive 151 patients with chest pain and < 50% coronary stenosis who underwent coronary angiography and MPI within 3 months were enrolled. caIMR was calculated by computational pressure-flow dynamics. CMD was defined as caIMR ≥ 25. The endpoint was major adverse cardiac events (MACE: cardiovascular death, nonfatal myocardial infarction, revascularization, angina-related rehospitalization, heart failure, and stroke). RESULTS Of all INOCA patients, CMD was present in 93 (61.6%) patients. The prevalence of abnormal MPI was significantly higher in CMD compared with non-CMD patients (40.9% vs 13.8%, P < .001). CMD showed a higher risk of MACE than non-CMD patients. Patients with both CMD and abnormal MPI had the worst prognosis, followed by patients with CMD and normal MPI (log-rank P < .001). Cox regression analysis identified CMD (HR 3.121, 95%CI 1.221-7.974, P = .017) and MPI (HR 2.704, 95%CI 1.030-7.099, P = .043) as predictive of MACE. The prognostic value of INOCA patients enhanced significantly by adding CMD and MPI to the model with clinical risk factors (AUC = 0.777 vs 0.686, P = .030). CONCLUSION caIMR-derived CMD is associated with increased risk of MACE among INOCA patients. Patients with abnormalities on both caIMR and MPI had the worse outcomes.
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Affiliation(s)
- Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Neng Dai
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Wen Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Siling Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Xian Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Tingting Shi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Cailin Feng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Ayman A Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Redhwan M Mareai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Xuejing Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
- Department of Cardiology, Shanghai Tenth People's Hospital Chongming Branch, Tongji University School of Medicine, Shanghai, China.
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22
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Thiele F, Schau F, Rogasch JMM, Wetz C, Bluemel S, Brenner W, Amthauer H, Lange C, Schatka I. Same same but different: dopamine transporter SPECT on scanners with CZT vs. NaI detectors. EJNMMI Res 2023; 13:24. [PMID: 36949290 PMCID: PMC10033816 DOI: 10.1186/s13550-023-00973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/12/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The aims of this study were to establish a normal database (NDB) for semiquantification of dopamine transporter (DAT) single-photon emission computed tomography (SPECT) with [123I]FP-CIT on a cadmium zinc telluride (CZT) camera, test the preexisting NaI-derived NDB for use in CZT scans, and compare the diagnostic findings in subjects imaged with a CZT scanner with either the preexisting NaI-based NDB or our newly defined CZT NDB. METHODS The sample comprised 73 subjects with clinically uncertain parkinsonian syndrome (PS) who prospectively underwent [123I]FP-CIT SPECT on a CZT camera according to standard guidelines with identical acquisition and reconstruction protocols (DaTQUANT). Two experienced readers visually assessed the images and binarized the subjects into "non-neurodegenerative PS" and "neurodegenerative PS". Twenty-five subjects from the "non-neurodegenerative PS" subgroup were randomly selected to establish a CZT NDB. The remaining 48 subjects were defined as "test group". DaTQUANT was used to determine the specific binding ratio (SBR). For the test group, SBR values were transformed to z-scores for the putamen utilizing both the CZT NDB and the manufacturer-provided NaI-based NDB (GE NDB). A predefined fixed cut-off of -2 was used for dichotomization of z-scores to classify neurodegenerative and non-neurodegenerative PS. Performance of semiquantification using the two NDB to identify subjects with neurodegenerative PS was assessed in comparison with the visual rating. Furthermore, a randomized head-to-head comparison of both detector systems was performed semiquantitatively in a subset of 32 out of all 73 subjects. RESULTS Compared to the visual rating as reference, semiquantification based on the dedicated CZT NDB led to fewer discordant ratings than the GE NDB in CZT scans (3 vs. 8 out of 48 subjects). This can be attributed to the putaminal z-scores being consistently higher with the GE NDB on a CZT camera (median absolute difference of 1.68), suggesting an optimal cut-off of -0.5 for the GE NDB instead of -2.0. Average binding ratios and z-scores were significantly lower in CZT compared to NaI data. CONCLUSIONS Use of a dedicated, CZT-derived NDB is recommended in [123I]FP-CIT SPECT with a CZT camera since it improves agreement between semiquantification and visual assessment.
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Affiliation(s)
- Felix Thiele
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
| | - Franziska Schau
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Julian M M Rogasch
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Wetz
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Stephanie Bluemel
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Catharina Lange
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Imke Schatka
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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23
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Ko CL, Lin SS, Huang CW, Chang YH, Ko KY, Cheng MF, Wang SY, Chen CM, Wu YW. Polar map-free 3D deep learning algorithm to predict obstructive coronary artery disease with myocardial perfusion CZT-SPECT. Eur J Nucl Med Mol Imaging 2023; 50:376-386. [PMID: 36102963 DOI: 10.1007/s00259-022-05953-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/23/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Deep learning (DL) models have been shown to outperform total perfusion deficit (TPD) quantification in predicting obstructive coronary artery disease (CAD) from myocardial perfusion imaging (MPI). However, previously published methods have depended on polar maps, required manual correction, and normal database. In this study, we propose a polar map-free 3D DL algorithm to predict obstructive disease. METHODS We included 1861 subjects who underwent MPI using cadmium-zinc-telluride camera and subsequent coronary angiography. The subjects were divided into parameterization and external validation groups. We implemented a fully automatic algorithm to segment myocardium, perform registration, and apply normalization. We further flattened the image based on spherical coordinate system transformation. The proposed model consisted of a component to predict patent arteries and a component to predict disease in each vessel. The model was cross-validated in the parameterization group, and then further tested using the external validation group. The performance was assessed by area under receiver operating characteristic curves (AUCs) and compared with TPD. RESULTS Our algorithm preprocessed all images accurately as confirmed by visual inspection. In patient-based analysis, the AUC of the proposed model was significantly higher than that for stress-TPD (0.84 vs 0.76, p < 0.01). In vessel-based analysis, the proposed model also outperformed regional stress-TPD (AUC = 0.80 vs 0.72, p < 0.01). The addition of quantitative images did not improve the performance. CONCLUSIONS Our proposed polar map-free 3D DL algorithm to predict obstructive CAD from MPI outperformed TPD and did not require manual correction or a normal database.
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Affiliation(s)
- Chi-Lun Ko
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shau-Syuan Lin
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Cheng-Wen Huang
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yu-Hui Chang
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Kuan-Yin Ko
- Department of Nuclear Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Mei-Fang Cheng
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shan-Ying Wang
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chung-Ming Chen
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Yen-Wen Wu
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan.
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24
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Hammel J, Birnbacher L, Makowski MR, Pfeiffer F, Pfeiffer D. Absolute iodine concentration for dynamic perfusion imaging of the myocardium: improved detection of poststenotic ischaemic in a 3D-printed dynamic heart phantom. Eur Radiol Exp 2022; 6:51. [PMID: 36310190 PMCID: PMC9618471 DOI: 10.1186/s41747-022-00304-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the detection capabilities of myocardial perfusion defects of dual-energy computed tomography (CT) technology using time-resolved iodine-based maps for functional assessment of coronary stenosis in a dynamic heart phantom. Methods An anatomical heart model was designed using a three-dimensional (3D) printing technique. The lumen of the right coronary artery was reduced to 25% of the original areal cross-section. Scans were acquired with a 64-slice dual-layer CT equipment using a perfusion protocol with 36 time points. For distinguishing haemodynamically affected from unaffected myocardial regions, conventional and spectral mean transit time (MTT) parameter maps were compared. A dose reduction technique was simulated by using a subset of time points of the time attenuation curves (TACs). Results The tracer kinetic modeling showed decreased errors on fit parameters from conventional to spectral TACs (42% reduction for A and 40% for λ). Three characteristic regions (highly, moderately, and not affected by the simulated stenosis) can be distinguished in all spectral perfusion maps. The best distinction was observed on MTT maps. An area under the curve (AUC) value of 1.00 for the voxel-wise differentiation of haemodynamically affected tissue was achieved versus a 0.89 AUC for conventional MTT maps. By temporal under-sampling, a dose reduction of approximately 78% from 19 to 4.3 mSv was achieved with a 0.96 AUC. Conclusion Dual-energy CT can provide time-resolved iodine density data, which enables the calculation of absolute quantitative perfusion maps with decreased fitting errors, improving the accuracy for poststenotic myocardial ischaemic detection in a 3D-printed heart phantom.
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25
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Morrone D, Gentile F, Aimo A, Cameli M, Barison A, Picoi ME, Guglielmo M, Villano A, DeVita A, Mandoli GE, Pastore MC, Barillà F, Mancone M, Pedrinelli R, Indolfi C, Filardi PP, Muscoli S, Tritto I, Pizzi C, Camici PG, Marzilli M, Crea F, Caterina RD, Pontone G, Neglia D, Lanza G. Perspectives in noninvasive imaging for chronic coronary syndromes. Int J Cardiol 2022; 365:19-29. [PMID: 35901907 DOI: 10.1016/j.ijcard.2022.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022]
Abstract
Both the latest European guidelines on chronic coronary syndromes and the American guidelines on chest pain have underlined the importance of noninvasive imaging to select patients to be referred to invasive angiography. Nevertheless, although coronary stenosis has long been considered the main determinant of inducible ischemia and symptoms, growing evidence has demonstrated the importance of other underlying mechanisms (e.g., vasospasm, microvascular disease, energetic inefficiency). The search for a pathophysiology-driven treatment of these patients has therefore emerged as an important objective of multimodality imaging, integrating "anatomical" and "functional" information. We here provide an up-to-date guide for the choice and the interpretation of the currently available noninvasive anatomical and/or functional tests, focusing on emerging techniques (e.g., coronary flow velocity reserve, stress-cardiac magnetic resonance, hybrid imaging, functional-coronary computed tomography angiography, etc.), which could provide deeper pathophysiological insights to refine diagnostic and therapeutic pathways in the next future.
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Affiliation(s)
- Doralisa Morrone
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University Hospital of Pisa, Italy.
| | - Francesco Gentile
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University Hospital of Pisa, Italy
| | - Alberto Aimo
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | | | - Maria Elena Picoi
- Azienda Tutela Salute Sardegna, Ospedale Giovanni Paolo II, Unità di terapia intensiva Cardiologica, Olbia, Sardegna, Italy
| | - Marco Guglielmo
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan 20138, Italy
| | - Angelo Villano
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio DeVita
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesco Barillà
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Università di Roma, Policlinico Umberto I, Roma, Italy
| | - Massimo Mancone
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Università di Roma, Policlinico Umberto I, Roma, Italy
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University Hospital of Pisa, Italy
| | - Ciro Indolfi
- Istituto di Cardiologia, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi "Magna Graecia", Catanzaro - Mediterranea Cardiocentro, Napoli, Italy
| | - Pasquale Perrone Filardi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy, Mediterranea Cardiocentro, Naples, Italy
| | - Saverio Muscoli
- U.O.C. Cardiologia, Fondazione Policlinico "Tor Vergata", Roma, Italy
| | - Isabella Tritto
- Università di Perugia, Dipartimento di Medicina, Sezione di Cardiologia e Fisiopatologia Cardiovascolare, Perugia, Italy
| | - Carmine Pizzi
- Università di Bologna, Alma Mater Studiorum, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Bologna, Italy
| | - Paolo G Camici
- Vita-Salute University and IRCCS San Raffaele Hospital, Milan, Italy
| | - Mario Marzilli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University Hospital of Pisa, Italy
| | - Filippo Crea
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan 20138, Italy
| | - Raffaele De Caterina
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University Hospital of Pisa, Italy
| | - Gianluca Pontone
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino, IRCCS, Milan 20138, Italy
| | | | - Gaetano Lanza
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Henzlova MJ, Duvall L. Is the CZT technology the future of nuclear cardiology? J Nucl Cardiol 2022; 29:737-740. [PMID: 33128127 DOI: 10.1007/s12350-020-02399-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
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Zhang H, Shi K, Fei M, Fan X, Liu L, Xu C, Qin S, Zhang J, Wang J, Zhang Y, Lv Z, Che W, Yu F. A Left Ventricular Mechanical Dyssynchrony-Based Nomogram for Predicting Major Adverse Cardiac Events Risk in Patients With Ischemia and No Obstructive Coronary Artery Disease. Front Cardiovasc Med 2022; 9:827231. [PMID: 35369339 PMCID: PMC8971375 DOI: 10.3389/fcvm.2022.827231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe risk stratification of patients with ischemia and no obstructive coronary artery disease (INOCA) remains suboptimal. This study aims to establish a left ventricular mechanical dyssynchrony (LVMD)-based nomogram to improve the present situation.MethodsPatients with suspected coronary artery disease (CAD) were retrospectively enrolled and divided into three groups: normal (stenosis <50%, without myocardial ischemia), INOCA (stenosis <50%, summed stress score >4, summed difference score ≥2), and obstructive CAD (stenosis ≥50%). LVMD was defined by ROC analysis. INOCA group were followed up for the occurrence of major adverse cardiac events (MACEs: cardiovascular death, non-fatal myocardial infarction, revascularization, stroke, heart failure, and hospitalization for unstable angina). Nomogram was established using multivariate Cox regression analysis.ResultsAmong 334 patients (118 [35.3%] INOCA), LVMD parameters were significantly higher in INOCA group versus normal group but they did not differ between obstructive CAD groups. In INOCA group, 27 (22.9%) MACEs occurred during a 26-month median follow-up. Proportion of LVMD was significantly higher with MACEs under both stress (63.0% vs. 22.0%, P < 0.001) and rest (51.9% vs. 20.9%, P = 0.002). Kaplan–Meier analysis revealed significantly higher rate of MACEs (stress log-rank: P = 0.002; rest log-rank: P < 0.001) in LVMD patients. Multivariate Cox regression analysis showed that stress LVMD (HR: 3.82; 95% CI: 1.30–11.20; P = 0.015) was an independent predictor of MACEs. The internal bootstrap resampling approach indicates that the C-index of nomogram was 0.80 (95% CI: 0.71–0.89) and the AUC values for 1 and 3 years of risk prediction were 0.68 (95% CI: 0.46–0.89) and 0.84 (95% CI: 0.72–0.95), respectively.ConclusionLVMD-based nomogram might provide incremental prognostic value and improve the risk stratification in INOCA patients.
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Affiliation(s)
- Han Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Kuangyu Shi
- Department of Nuclear Medicine, University of Bern, Bern, Switzerland
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Mengyu Fei
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xin Fan
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Lu Liu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chong Xu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shanshan Qin
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Jiajia Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Junpeng Wang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Yu Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Zhongwei Lv,
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Wenliang Che,
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
- Fei Yu,
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Karam M, Fahs D, Maatouk B, Safi B, Jaffa AA, Mhanna R. Polymeric nanoparticles in the diagnosis and treatment of myocardial infarction: Challenges and future prospects. Mater Today Bio 2022; 14:100249. [PMID: 35434594 PMCID: PMC9006854 DOI: 10.1016/j.mtbio.2022.100249] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
Myocardial infarction (MI) is the leading cause of morbidity and mortality worldwide. Despite extensive efforts to provide early diagnosis and adequate treatment regimens, detection of MI still faces major limitations and pathological MI complications continue to threaten the recovery of survivors. Polymeric nanoparticles (NPs) represent novel noninvasive drug delivery systems for the diagnosis and treatment of MI and subsequent prevention of fatal heart failure. In this review, we cover the recent advances in polymeric NP-based diagnostic and therapeutic approaches for MI and their application as multifunctional theranostic tools. We also discuss the in vivo behavior and toxicity profile of polymeric NPs, their application in noninvasive imaging, passive, and active drug delivery, and use in cardiac regenerative therapy. We conclude with the challenges faced with polymeric nanosystems and suggest future efforts needed for clinical translation.
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Affiliation(s)
- Mia Karam
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Lebanon
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Duaa Fahs
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Lebanon
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Batoul Maatouk
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Lebanon
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Brouna Safi
- Department of Chemical Engineering, Maroun Semaan Faculty of Engineering and Architecture, Lebanon
| | - Ayad A. Jaffa
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Rami Mhanna
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, Lebanon
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Muscogiuri G, Guglielmo M, Serra A, Gatti M, Volpato V, Schoepf UJ, Saba L, Cau R, Faletti R, McGill LJ, De Cecco CN, Pontone G, Dell’Aversana S, Sironi S. Multimodality Imaging in Ischemic Chronic Cardiomyopathy. J Imaging 2022; 8:jimaging8020035. [PMID: 35200737 PMCID: PMC8877428 DOI: 10.3390/jimaging8020035] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 02/01/2023] Open
Abstract
Ischemic chronic cardiomyopathy (ICC) is still one of the most common cardiac diseases leading to the development of myocardial ischemia, infarction, or heart failure. The application of several imaging modalities can provide information regarding coronary anatomy, coronary artery disease, myocardial ischemia and tissue characterization. In particular, coronary computed tomography angiography (CCTA) can provide information regarding coronary plaque stenosis, its composition, and the possible evaluation of myocardial ischemia using fractional flow reserve CT or CT perfusion. Cardiac magnetic resonance (CMR) can be used to evaluate cardiac function as well as the presence of ischemia. In addition, CMR can be used to characterize the myocardial tissue of hibernated or infarcted myocardium. Echocardiography is the most widely used technique to achieve information regarding function and myocardial wall motion abnormalities during myocardial ischemia. Nuclear medicine can be used to evaluate perfusion in both qualitative and quantitative assessment. In this review we aim to provide an overview regarding the different noninvasive imaging techniques for the evaluation of ICC, providing information ranging from the anatomical assessment of coronary artery arteries to the assessment of ischemic myocardium and myocardial infarction. In particular this review is going to show the different noninvasive approaches based on the specific clinical history of patients with ICC.
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Affiliation(s)
- Giuseppe Muscogiuri
- Department of Radiology, Istituto Auxologico Italiano IRCCS, San Luca Hospital, University Milano Bicocca, 20149 Milan, Italy
- Correspondence: ; Tel.: +39-329-404-9840
| | - Marco Guglielmo
- Department of Cardiology, Division of Heart and Lungs, Utrecht University, Utrecht University Medical Center, 3584 Utrecht, The Netherlands;
| | - Alessandra Serra
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, 09042 Cagliari, Italy; (A.S.); (L.S.); (R.C.)
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy; (M.G.); (R.F.)
| | - Valentina Volpato
- Department of Cardiac, Neurological and Metabolic Sciences, Istituto Auxologico Italiano IRCCS, San Luca Hospital, University Milano Bicocca, 20149 Milan, Italy;
| | - Uwe Joseph Schoepf
- Department of Radiology and Radiological Science, MUSC Ashley River Tower, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, USA; (U.J.S.); (L.J.M.)
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, 09042 Cagliari, Italy; (A.S.); (L.S.); (R.C.)
| | - Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato, 09042 Cagliari, Italy; (A.S.); (L.S.); (R.C.)
| | - Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, 10124 Turin, Italy; (M.G.); (R.F.)
| | - Liam J. McGill
- Department of Radiology and Radiological Science, MUSC Ashley River Tower, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, USA; (U.J.S.); (L.J.M.)
| | - Carlo Nicola De Cecco
- Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA;
| | | | - Serena Dell’Aversana
- Department of Radiology, Ospedale S. Maria Delle Grazie—ASL Napoli 2 Nord, 80078 Pozzuoli, Italy;
| | - Sandro Sironi
- School of Medicine and Post Graduate School of Diagnostic Radiology, University of Milano-Bicocca, 20126 Milan, Italy;
- Department of Radiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
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30
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Imbert L, Marie PY. Dedicated CZT gamma cameras for nuclear cardiology. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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31
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Mendoza-Ibañez OI, Martínez-Lucio TS, Alexanderson-Rosas E, Slart RH. SPECT in Ischemic Heart Diseases. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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32
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Imbert L, Bahloul A, Verger A, Marie PY. 360° CZT gamma cameras for nuclear medicine and molecular imaging. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00087-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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33
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Liu L, Abdu FA, Yin G, Xu B, Mohammed AQ, Xu S, Lv X, Luo Y, Zu L, Yang C, Zhang Z, Zhou Y, Cai H, Lv Z, Xu Y, Che W. Prognostic value of myocardial perfusion imaging with D-SPECT camera in patients with ischemia and no obstructive coronary artery disease (INOCA). J Nucl Cardiol 2021; 28:3025-3037. [PMID: 33000403 DOI: 10.1007/s12350-020-02252-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/01/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Myocardial perfusion imaging (MPI) with a novel D-SPECT camera maintains excellent prognostic value compared to conventional SPECT. However, information about the relationship between D-SPECT MPI and the prognosis in patients with ischemia and no obstructive coronary artery disease (INOCA) is limited. The objective of this study was to evaluate the prognostic value of MPI with D-SPECT in INOCA and obstructive coronary artery disease (CAD) patients. METHODS All consecutive patients with suspected CAD and without prior CAD who underwent D-SPECT MPI and invasive coronary angiography within 3 months were considered. INOCA and obstructive CAD were defined as < 50% and ≥ 50% coronary stenosis, respectively. Patients were followed-up for the occurrence of major adverse cardiac events (MACE: cardiovascular death, nonfatal myocardial infarction, revascularization, stroke, heart failure and angina-related rehospitalization). RESULTS Among 506 patients, 232 (45.8%) were INOCA patients. A total of 33.2% of the INOCA patients had abnormal D-SPECT MPI, whereas 77.7% of the obstructive CAD patients had abnormal D-SPECT MPI. In both groups, patients with abnormal D-SPECT MPI demonstrated higher MACE rates and lower survival free of MACE. In addition, patients with INOCA and abnormal D-SPECT MPI had a poor prognosis similar to that of the obstructive CAD patients. Cox regression analysis showed that the risk-adjusted hazard ratios for abnormal D-SPECT MPI were 2.55 [1.11-5.87] and 2.06 [1.03-4.10] in the INOCA and obstructive CAD patients, respectively. CONCLUSIONS D-SPECT MPI provides excellent prognostic information, with a more severe prognosis in patients with abnormal D-SPECT MPI. INOCA patients with abnormal D-SPECT MPI experience a poor prognosis similar to that of patients with obstructive CAD.
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Affiliation(s)
- Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
- Department of Cardiology, Clinical Medical College of Shanghai Tenth People's Hospital, Nanjing Medical University, Shanghai, China
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
- Department of Cardiology, Clinical Medical College of Shanghai Tenth People's Hospital, Nanjing Medical University, Shanghai, China
| | - Bin Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Siling Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Xian Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Yanru Luo
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Lu Zu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Changrui Yang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Ziyi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Yuxiao Zhou
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Haidong Cai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
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Grossman GB, Baptista IS. Quantitative analysis: Specific normal database for the best practice. J Nucl Cardiol 2021; 28:1294-1297. [PMID: 31646468 DOI: 10.1007/s12350-019-01902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Gabriel Blacher Grossman
- Nuclear Medicine Department, Hospital Moinhos de Vento, Porto Alegre, Brazil.
- Cardionuclear, Instituto de Cardiologia, Porto Alegre, Brazil.
| | - Ilo S Baptista
- Nuclear Medicine Department, Hospital Moinhos de Vento, Porto Alegre, Brazil
- Cardionuclear, Instituto de Cardiologia, Porto Alegre, Brazil
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35
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Gimelli A, Liga R, Bertasi M, Kusch A, Marzullo P. Head-to-head comparison of a CZT-based all-purpose SPECT camera and a dedicated CZT cardiac device for myocardial perfusion and functional analysis. J Nucl Cardiol 2021; 28:1323-1330. [PMID: 31385223 DOI: 10.1007/s12350-019-01835-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/21/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare the outputs of a novel all-purpose SPECT camera equipped with CZT detectors (Discovery NM/CT 670) with the state-of-the-art represented by a dedicated CZT (Alcyone, Discovery 530c) cardiac camera in patients submitted to myocardial perfusion imaging (MPI). METHODS We included 19 patients that underwent sequential low-dose 99mTc-tetrofosmin (148-185 MBq during stress and 296-370 MBq at rest) MPI with Alcyone and Discovery 670 cameras. Quantitative (% tracer's uptake) and semi-quantitative analyses of perfusion data were performed for each scan. Moreover, major left ventricular (LV) functional and structural parameters were derived from each camera and compared. RESULTS The two cameras showed excellent correlation for segmental myocardial % uptake at stress (R = 0.90; P < 0.001) and at rest (R = 0.88; P < 0.001) with narrow Bland-Altman limits of agreement. The level of diagnostic agreement of Discovery 670 and Alcyone cameras regarding perfusion analysis was excellent (Cohen's κ 0.85). Similarly, the two cameras showed excellent correlation in the evaluation of LV ejection fraction (R = 0.95), peak filling rate (R = 0.97), and mass (R = 0.98). CONCLUSIONS Our preliminary results suggest that MPI with an all-purpose Discovery 670 CZT-SPECT camera is feasible, comparing well with the current state-of-the-art technology.
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Affiliation(s)
- Alessia Gimelli
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy.
| | | | | | - Annette Kusch
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Paolo Marzullo
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
- CNR, Institute of Clinical Physiology, Pisa, Italy
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36
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Xu B, Liu L, Abdu FA, Yin G, Mohammed AQ, Xu S, Lv X, Fan R, Feng C, Shi T, Zhang W, Xu Y, Cai H, Yu F, Che W. Prognostic Value of Diastolic Dysfunction Derived From D-SPECT in Coronary Artery Disease Patients With Normal Ejection Fraction. Front Cardiovasc Med 2021; 8:700027. [PMID: 34336957 PMCID: PMC8319539 DOI: 10.3389/fcvm.2021.700027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/07/2021] [Indexed: 12/31/2022] Open
Abstract
Diastolic dysfunction (DD) with normal systolic function has been elucidated to be associated with heart failure and worse prognosis. The recently introduced single photon emission computed tomography (SPECT) with dedicated cardiac cadmium-zinc-telluride (CZT) cameras (D-SPECT) is a novel method to quantitate left ventricular functional parameters. We aimed to evaluate the prognostic value of DD derived from D-SPECT in coronary artery disease (CAD) patients with normal ejection fraction. All CAD patients who underwent D-SPECT and invasive coronary angiography within 3 months were considered. DD was defined as peak filling rate (PFR) <2.1 end diastolic volume (EDV, ml)/s according to the D-SPECT results. Patients were divided into three groups: group 1 (n = 226)-normal PFR; group 2 (n = 67)-ischemia-related DD (abnormal stress PFR and normal rest PFR); and group 3 (n = 106)-rest DD (abnormal rest PFR). The primary clinical endpoint of the present study was a composite of heart failure events (HFE). A total of 399 consecutive CAD patients with normal systolic function undergoing stress D-SPECT were analyzed. The incidence rates of HFE among the three groups were 4.0, 7.5, and 11.3%, respectively. Cox regression analysis showed that the multivariate predictors of HFE were rest PFR, diabetes mellitus, obesity, and old age. DD derived from D-SPECT in CAD patients with normal ejection fraction is predictive of HFE.
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Affiliation(s)
- Bin Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Medical College of Soochow University, Soochow University, Suzhou, China
| | - Lu Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fuad A Abdu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guoqing Yin
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Abdul-Quddus Mohammed
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Siling Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xian Lv
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Rui Fan
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Cailin Feng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tingting Shi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haidong Cai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Cardiology, Shanghai Tenth People' s Hospital Chongming Branch, Shanghai, China
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Cantoni V, Green R, Acampa W, Zampella E, Assante R, Nappi C, Gaudieri V, Mannarino T, Cuocolo R, Di Vaia E, Petretta M, Cuocolo A. Diagnostic performance of myocardial perfusion imaging with conventional and CZT single-photon emission computed tomography in detecting coronary artery disease: A meta-analysis. J Nucl Cardiol 2021; 28:698-715. [PMID: 31089962 DOI: 10.1007/s12350-019-01747-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND We performed a meta-analysis to compare the diagnostic performance of conventional SPECT (C-SPECT) and cadmium-zinc-telluride (CZT)-SPECT systems in detecting angiographically proven coronary artery disease (CAD). METHODS Studies published between January 2000 and February 2018 were identified by database search. We included studies assessing C-SPECT or CZT-SPECT as a diagnostic test to evaluate patients for the presence of CAD, defined as at least 50% diameter stenosis on invasive coronary angiography. A study was eligible regardless of whether patients were referred for suspected or known CAD. RESULTS We identified 40 eligible articles (25 C-SPECT and 15 CZT-SPECT studies) including 7334 patients (4997 in C-SPECT and 2337 in CZT-SPECT studies). The pooled sensitivity and specificity were 85% and 66% for C-SPECT and 89% and 69% for CZT-SPECT imaging studies. The area under the curve was slightly higher for CZT-SPECT (0.89) compared to C-SPECT (0.83); accordingly, the summary diagnostic OR was 17 for CZT-SPECT and 11 for C-SPECT. The accuracy of the two tests slightly differs between C-SPECT and CZT-SPECT (chi-square 11.28, P < .05). At meta-regression analysis, no significant association between both sensitivity and specificity and demographical and clinical variables considered was found for C-SPECT and CZT-SPECT studies. CONCLUSIONS C-SPECT and CZT-SPECT have good diagnostic performance in detecting angiographic proven CAD, with a slightly higher accuracy for CZT-SPECT. This result supports the use of the novel gamma cameras in clinical routine practices also considering the improvements in acquisition time and radiation exposure reduction.
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Affiliation(s)
- Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Renato Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Eugenio Di Vaia
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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Ansheles AA, Sergienko IV, Prus YA, Sergienko VB. Nuclear imaging of chemotherapy-induced cardiotoxicity. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The high efficiency of modern chemotherapy has made it possible to achieve great success in the treatment of cancer. Cardiovascular adverse effects are a major disadvantage of anticancer therapy, often requiring low and less effective doses or even drug withdrawal. Nuclear imaging techniques are the most sensitive in early detection of left ventricular damage and dysfunction during chemotherapy. This review presents modern data on the potential of nuclear imaging of cardiotoxicity.
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Affiliation(s)
| | | | - Yu. A. Prus
- National Medical Research Center of Cardiology
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39
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Chen X, Zhang Y, Zhang H, Zhang L, Liu L, Cao Y, Ran H, Tian J. A non-invasive nanoparticles for multimodal imaging of ischemic myocardium in rats. J Nanobiotechnology 2021; 19:82. [PMID: 33752679 PMCID: PMC7986298 DOI: 10.1186/s12951-021-00822-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Ischemic heart disease (IHD) is the leading cause of morbidity and mortality worldwide, and imposes a serious economic load. Thus, it is crucial to perform a timely and accurate diagnosis and monitoring in the early stage of myocardial ischemia. Currently, nanoparticles (NPs) have emerged as promising tools for multimodal imaging, because of their advantages of non-invasion, high-safety, and real-time dynamic imaging, providing valuable information for the diagnosis of heart diseases. RESULTS In this study, we prepared a targeted nanoprobe (termed IMTP-Fe3O4-PFH NPs) with enhanced ultrasound (US), photoacoustic (PA), and magnetic resonance (MR) performance for direct and non-invasive visual imaging of ischemic myocardium in a rat model. This successfully designed nanoprobe had excellent properties such as nanoscale size, good stability, phase transformation by acoustic droplet vaporization (ADV), and favorable safety profile. Besides, it realized obvious targeting performance toward hypoxia-injured cells as well as model rat hearts. After injection of NPs through the tail vein of model rats, in vivo imaging results showed a significantly enhanced US/PA/MR signal, well indicating the remarkable feasibility of nanoprobe to distinguish the ischemic myocardium. CONCLUSIONS IMTP-Fe3O4-PFH NPs may be a promising nanoplatform for early detection of ischemic myocardium and targeted treatment under visualization for the future.
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Affiliation(s)
- Xiajing Chen
- Department of Cardiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Yanan Zhang
- Department of Cardiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Hui Zhang
- Department of Cardiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Liang Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Lingjuan Liu
- Department of Cardiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Yang Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Haitao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China
| | - Jie Tian
- Department of Cardiology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China.
- Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China.
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Guberman D, Paoletti R, Rugliancich A, Wunderlich C, Passeri A. Large-Area SiPM Pixels (LASiPs): A cost-effective solution towards compact large SPECT cameras. Phys Med 2021; 82:171-184. [PMID: 33640837 DOI: 10.1016/j.ejmp.2021.01.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/11/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Abstract
Single Photon Emission Computed Tomography (SPECT) scanners based on photomultiplier tubes (PMTs) are still largely employed in the clinical environment. A standard camera for full-body SPECT employs ~50-100 PMTs of 4-8 cm diameter and is shielded by a thick layer of lead, becoming a heavy and bulky system that can weight a few hundred kilograms. The volume, weight and cost of a camera can be significantly reduced if the PMTs are replaced by silicon photomultipliers (SiPMs). The main obstacle to use SiPMs in full-body SPECT is the limited size of their sensitive area. A few thousand channels would be needed to fill a camera if using the largest commercially-available SiPMs of 6 × 6 mm2. As a solution, we propose to use Large-Area SiPM Pixels (LASiPs), built by summing individual currents of several SiPMs into a single output. We developed a LASiP prototype that has a sensitive area 8 times larger than a 6 × 6 mm2 SiPM. We built a proof-of-concept micro-camera consisting of a 40 × 40 × 8 mm3 NaI(Tl) crystal coupled to 4 LASiPs. We evaluated its performance in a central region of 15×15 mm2, where we were able to reconstruct images of a 99mTc capillary with an intrinsic spatial resolution of ~2 mm and an energy resolution of ~11.6% at 140 keV. We used these measurements to validate Geant4 simulations of the system. This can be extended to simulate a larger camera with more and larger pixels, which could be used to optimize the implementation of LASiPs in large SPECT cameras. We provide some guidelines towards this implementation.
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Affiliation(s)
- D Guberman
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Pisa, I-56126 Pisa, Italy; Dipartimento di Scienze Fisiche, della Terra e dell'Ambiente, Universitá di Siena, I-53100 Siena, Italy.
| | - R Paoletti
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Pisa, I-56126 Pisa, Italy; Dipartimento di Scienze Fisiche, della Terra e dell'Ambiente, Universitá di Siena, I-53100 Siena, Italy
| | - A Rugliancich
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Pisa, I-56126 Pisa, Italy
| | - C Wunderlich
- Istituto Nazionale di Fisica Nucleare (INFN), Sezione di Pisa, I-56126 Pisa, Italy; Dipartimento di Scienze Fisiche, della Terra e dell'Ambiente, Universitá di Siena, I-53100 Siena, Italy
| | - A Passeri
- Dipartimento di Scienze Biomediche Sperimentali e Cliniche (SBSC), Universitá di Firenze, I-50134 Florence, Italy
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41
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Yamada Y, Nakano S, Gatate Y, Okano N, Muramatsu T, Nishimura S, Kuji I, Fukushima K, Matsunari I. Feasibility of simultaneous 99mTc-tetrofosmin and 123I-BMIPP dual-tracer imaging with cadmium-zinc-telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction. J Nucl Cardiol 2021; 28:187-195. [PMID: 30603890 DOI: 10.1007/s12350-018-01585-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/17/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simultaneous dual-tracer imaging using isotopes with close photo-peaks may benefit from improved properties of cadmium-zinc-telluride (CZT)-based scanners. METHODS Thirty patients having undergone primary percutaneous coronary intervention for acute myocardial infarction underwent single-(99mTc-tetrofosmin (TF) or 123I-BMIPP first) followed by simultaneous 99mTc-TF /123I-BMIPP dual-tracer imaging using a Discovery NM/CT 670 CZT. The values for the quantitative gated-SPECT (QGS) and the quantitative perfusion SPECT (QPS) were assessed. RESULTS The intra-class correlation (ICC) coefficients between the single- and dual-tracer imaging were high in all the QGS and QPS data (Summed motion score: 0.95, summed thickening score: 0.94, ejection fraction: 0.98, SRS for 99mTc-TF: 0.97/ for 123I-BMIPP: 0.95). Wall motion, wall thickening and rest scores per coronary-territory-based regions were also comparable between the single- and dual imaging (ICC coefficient > 0.91). The interrater concordance in the visual analysis for the infarction and perfusion-metabolism mismatch was significant for the global and regional left ventricle (P < 0.001). CONCLUSION The quantitative/semi-quantitative values for global and regional left-ventricular function, perfusion, and fatty acid metabolism were closely comparable between the dual-tracer imaging and the single-tracer mode. These data suggests the feasibility of the novel CZT-based scanner for the simultaneous 99mTc-TF /123I-BMIPP dual-tracer acquisitions in clinical settings.
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Affiliation(s)
- Yoshihiro Yamada
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shintaro Nakano
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan.
| | - Youdou Gatate
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Nanami Okano
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
| | - Toshihiro Muramatsu
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shigeyuki Nishimura
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
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Baessato F, Guglielmo M, Muscogiuri G, Baggiano A, Fusini L, Scafuri S, Babbaro M, Mollace R, Collevecchio A, Guaricci AI, Pontone G. Stress CMR in Known or Suspected CAD: Diagnostic and Prognostic Role. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6678029. [PMID: 33511208 PMCID: PMC7822671 DOI: 10.1155/2021/6678029] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022]
Abstract
The recently published 2019 guidelines on chronic coronary syndromes (CCS) focus on the need for noninvasive imaging modalities to accurately establish the diagnosis of coronary artery disease (CAD) and assess the risk of clinical scenario occurrence. Appropriate patient management should rely on controlling symptoms, improving prognosis, and guiding each therapeutic strategy as well as monitoring disease progress. Among the noninvasive imaging modalities, cardiovascular magnetic resonance (CMR) has gained broad acceptance in past years due to its unique features in providing a complete assessment of CAD through data on cardiac anatomy and function and myocardial viability, with high spatial and temporal resolution and without ionizing radiation. In detail, evaluation of the presence and extent of myocardial ischemia through stress CMR (S-CMR) has shown a high rule-in power in detecting functionally significant coronary artery stenosis in patients suspected of CCS. Moreover, S-CMR technique may add significant prognostic value, as demonstrated by different studies which have progressively evidenced the valuable power of this multiparametric imaging modality in predicting adverse cardiac events. The latest scientific progress supports a greater expansion of S-CMR with improvement of quantitative myocardial perfusion analysis, myocardial strain, and native mapping within the same examination. Although further study is warranted, these techniques, which are currently mostly restricted to the research field, are likely to become increasingly prevalent in the clinical setting with the scope of increasing accuracy in the selection of patients to be sent to invasive revascularization. This review investigates the diagnostic and prognostic role of S-CMR in the context of CAD, by analysing a strong, long-standing, scientific evidence together with an appraisal of new advanced techniques which may potentially enrich CAD management in the next future.
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Affiliation(s)
- Francesca Baessato
- Department of Cardiology, San Maurizio Regional Hospital, Bolzano, Italy
| | - Marco Guglielmo
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Giuseppe Muscogiuri
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Andrea Baggiano
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Laura Fusini
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Stefano Scafuri
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Mario Babbaro
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Rocco Mollace
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Ada Collevecchio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Andrea I. Guaricci
- Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, Bari, Italy
| | - Gianluca Pontone
- Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
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Johnson RD, Bath NK, Rinker J, Fong S, St James S, Pampaloni MH, Hope TA. Introduction to the D-SPECT for Technologists: Workflow Using a Dedicated Digital Cardiac Camera. J Nucl Med Technol 2020; 48:297-303. [PMID: 33020236 DOI: 10.2967/jnmt.120.254870] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022] Open
Abstract
The D-SPECT is a dedicated cardiac camera that incorporates a solid-state semiconductor detector. This camera differs greatly from conventional SPECT/CT systems, resulting in significant differences in patient imaging. This continuing education article focuses on the specifications of both SPECT/CT and D-SPECT systems, radiopharmaceutical dosing requirements, imaging workflows, and some disadvantages of using each camera system. When used properly, the D-SPECT system can provide high-quality cardiac images with lower doses and faster exam times than conventional SPECT/CT systems.
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Affiliation(s)
- Robert D Johnson
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California
| | - Navkanwal Kaur Bath
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California
| | - Jeffrey Rinker
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California
| | - Stephen Fong
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California
| | - Sara St James
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, California; and
| | - Miguel Hernandez Pampaloni
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Thomas A Hope
- Department of Radiology, San Francisco VA Medical Center, San Francisco, California .,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
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Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology. Eur J Hybrid Imaging 2020; 4:11. [PMID: 34191150 PMCID: PMC8218053 DOI: 10.1186/s41824-020-00080-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
The use of hybrid systems is increasingly growing in Europe and this is progressively important for the final result of diagnostic tests. As an integral part of the hybrid imaging system, computed tomography (CT) plays a crucial role in myocardial perfusion imaging diagnostics. Throughout Europe, a variety of equipment is available and also different university curricula of the nuclear medicine technologist are observed. Hence, the Technologist Committee of the European Association of Nuclear Medicine proposes to identify, through a bibliographic review, the recommendations for best practice in computed tomography applied to attenuation correction and calcium score in myocardial perfusion imaging, which courses in the set of knowledge, skills, and competencies for nuclear medicine technologists. This document aims at providing recommendations for CT acquisition protocols and CT image optimization in nuclear cardiology.
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Songy B, Guernou M, Lussato D, Queneau M, Bonardel G, Grellier JF, Flahaut L, Nguyen D. Feasibility of simultaneous dual isotope acquisition for myocardial perfusion imaging with a cadmium zinc telluride camera. J Nucl Cardiol 2020; 27:737-747. [PMID: 30478657 DOI: 10.1007/s12350-018-1452-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/10/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND We studied the impact of technetium-99m (99mTc) in the thallium-201 (201Tl) energy window (70 keV) to determine if CZT cardiac cameras allow us to perform simultaneous dual-isotope acquisition for myocardial perfusion imaging. METHODS We included 117 consecutive patients. We injected 0.7 MBq/kg of 201Tl at stress, performed the first scan (image T1), then injected at rest 2 MBq/kg of 99mTc-tetrofosmin and immediately acquired a second scan with reconstruction in the energy window of thallium (image T2). A corrected thallium image was created by the subtraction of 99mTc downscattered photons (image TS). We compared spectra, image quality, and semiquantitative scores on T1, T2, and TS images. RESULTS Though T2 images were of worse quality, TS images were of equal quality compared to T1 images in most cases. Scores show an underestimation of abnormalities in 20% of patients on T2 images and in 10% on TS images. CONCLUSIONS Despite the improved energy resolution of CZT cameras, downscatter of technetium in the 201Tl window leads to an underestimation of the pathological territory in 10% to 20% of cases. It does not allow us to use simultaneous dual-isotope acquisition in clinical practice without additional tools for scatter correction.
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Affiliation(s)
- Bernard Songy
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France.
| | - Mohamed Guernou
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - David Lussato
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Mathieu Queneau
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Gerald Bonardel
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | | | - Ludovic Flahaut
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Duc Nguyen
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
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Hyafil F, Chequer R, Sorbets E, Estellat C, Ducrocq G, Rouzet F, Alfaiate T, Regaieg H, Abtan J, Leygnac S, Milliner M, Imbert L, Burg S, Ben Azzouna R, Potier L, Laouénan C, Quintin C, Roussel R, Hartemann A, Montalescot G, Marie PY, Steg G, Le Guludec D. Head-to-head comparison of the diagnostic performances of Rubidium-PET and SPECT with CZT camera for the detection of myocardial ischemia in a population of women and overweight individuals. J Nucl Cardiol 2020; 27:755-768. [PMID: 30574676 DOI: 10.1007/s12350-018-01557-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/11/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-Rb-PET-MPS and 99m-Tc-SPECT-MPS in overweight individuals and women. METHODS AND RESULTS Men with BMI ≥ 25 and women referred for MPS were considered for inclusion. All individuals underwent 99m-Tc-SPECT-MPS with CZT cameras and 82-Rb-PET-MPS in 3D-mode. Individuals with at least one positive MPS were referred for coronary angiography (CA) with FFR measurements. A criterion for positivity was a composite endpoint including significant stenosis on CA or, in the absence of CA, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean BMI of 31.8 ± 6.5 were included. Sensitivity for the detection of myocardial ischemia was higher with 82-Rb-PET-MPS compared with 99m-Tc-SPECT-MPS (85% vs. 57%, P < .05); specificity was equally high with both imaging techniques (93% vs. 94%, P > .05). 82-Rb-PET allowed for a more accurate detection of patients with a high-risk coronary artery disease (HR-CAD) than 99m-Tc-SPECT-MPS (AUC = 0.86 vs. 0.75, respectively; P = .04). CONCLUSIONS In women and overweight individuals, 82-Rb-PET-MPS provides higher sensitivity for the detection of myocardial ischemia than 99m-Tc-SPECT-MPS thanks to a better image quality and an improved detection of HR-CAD.
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Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France.
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France.
| | - Renata Chequer
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Emmanuel Sorbets
- Department of Cardiology, Avicenne University Hospital, AP-HP, University Paris 13, 9300, Bobigny, France
| | - Candice Estellat
- Département de Biostatistiques, Hôpital Pitié-Salpêtrière, AP-HP, Santé Publique et Informatique Médicale, 75013, Paris, France
- INSERM, CIC-EC 1425, ECEVE UMR 1123, 75018, Paris, France
| | - Gregory Ducrocq
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - François Rouzet
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Toni Alfaiate
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Hamza Regaieg
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Jérémie Abtan
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - Sébastien Leygnac
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Milan Milliner
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Laetitia Imbert
- Department of Nuclear Medicine, Brambois University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Samuel Burg
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Rana Ben Azzouna
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Louis Potier
- Department of Diabetology, DHU FIRE, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Cédric Laouénan
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Caroline Quintin
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Ronan Roussel
- Department of Diabetology, DHU FIRE, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Agnès Hartemann
- Department of Diabetology, Pitié-Salpétriêre University Hospital, AP-HP, Sorbonne University Paris 6, 75006, Paris, France
| | - Gilles Montalescot
- ACTION Study Group, Department of Cardiology, Pitié-Salpétriêre, Sorbonne Université-Paris 6, 75006, Paris, France
| | - Pierre-Yves Marie
- Department of Nuclear Medicine, Brambois University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Gabriel Steg
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - Dominique Le Guludec
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
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47
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Grossman GB. Myocardial perfusion imaging in overweight patients and women: Is it CZT good enough? J Nucl Cardiol 2020; 27:769-773. [PMID: 30963418 DOI: 10.1007/s12350-019-01656-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Gabriel Blacher Grossman
- Nuclear Medicine Department, Hospital Moinhos de Vento, Porto Alegre, Brazil.
- Cardionuclear, Instituto de Cardiologia, Porto Alegre, Brazil.
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48
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Grigoratos C, Aimo A, Rapezzi C, Genovesi D, Barison A, Aquaro GD, Vergaro G, Pucci A, Passino C, Marzullo P, Gimelli A, Emdin M. Diphosphonate single-photon emission computed tomography in cardiac transthyretin amyloidosis. Int J Cardiol 2020; 307:187-192. [PMID: 32081469 DOI: 10.1016/j.ijcard.2020.02.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/26/2020] [Accepted: 02/10/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Planar diphosphonate scintigraphy is an established diagnostic tool for amyloid transthyretin (ATTR) cardiomyopathy. Characterization of the amyloid burden up to the segmental level by single photon emission computed tomography (SPECT) has not been evaluated so far. METHODS Data from consecutive patients undergoing cardiac 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) SPECT and diagnosed with ATTR cardiomyopathy at a tertiary referral center from June 2016 to April 2019 were collected. RESULTS Thirty-eight patients were included (median age 81 years, 79% men, 92% with wild-type ATTR). In patients with Perugini score 1, the most intense diphosphonate regional uptake was found in septal segments, particularly in infero-septal segments. Among patients scoring 2, the amyloid burden in the septum became more significant, and extended to inferior and apical segments. Finally, patients scoring 3 displayed an intense and widespread tracer uptake. All patients with Perugini score 1 had LGE in at least one antero-septal, one infero-septal, and one infero-lateral segment. All patients with score 2 displayed LGE in infero-septal, inferior, and infero-lateral segments. LGE became extensive in patients scoring 3, with all patients having at least one LGE-positive segment in each region. CONCLUSIONS When assimilating different Perugini grades to evolutive stages of the disease, amyloid deposition seem to progress from the septum to the inferior wall and then to the other regions and from the basis to the apex. The potential of segmental analysis might be particularly relevant in patients with very limited cardiac uptake at planar scintigraphy (Perugini score 1).
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Affiliation(s)
- Chrysanthos Grigoratos
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Claudio Rapezzi
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Andrea Barison
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Giuseppe Vergaro
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Angela Pucci
- Histopathology Department, University Hospital of Pisa, Italy
| | - Claudio Passino
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | - Michele Emdin
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy; Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
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49
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Zavadovsky KV, Maltseva AN, Grakova EV, Kopeva KV, Gulya MO, Saushkin VV, Mochula AV, Liga R, Gimelli A. Relationships between myocardial perfusion abnormalities and integrated indices of atherosclerotic burden: clinical impact of combined anatomic-functional evaluation. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aim to evaluate the relationships between functional and anatomical information obtained by myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) in a series of consecutive patients at intermediate probability of coronary artery disease (CAD). Material and Methods — The study group comprised 139 patients (83 men, age of 61.6±7.5 years) who underwent CCTA and single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI). Based on CCTA results patients were divided into three groups: 1) with the absence of coronary atherosclerosis on CCTA; 2) with non-obstructive CAD (<50%); 3) with obstructive (≥50%) CAD. The Segment Involvement Score, Segment Stenosis Score (SSS) and CTA Risk Score were calculated as measures of global atherosclerosis burden. MPI studies were considered abnormal in the presence of SSS≥4. Results — Abnormal myocardial perfusion was detected in 60% of cases in group 1 and 2; in 75% of cases in group 3. The overall frequencies of normal and abnormal MPI studies differed significantly only in obstructive CAD patients and did not differ in group 1 and 2. There were no significant correlations between calcium score, atherosclerotic lesion length, positive remodelling index and MPI results in patients with non-obstructive as well as in patients with obstructive CAD. In group of patients with obstructive CAD Segment Stenosis Score correlated wekly with SSS (r=0.39, p=0.001) and SDS (r=0.28; p=0.012); the CTA Risk Score showed correlationes with SSS (r=0.38, p=0.002) and SDS (r=0.30, p=0.020). Conclusion — Myocardial perfusion abnormalities may develop even in the absence of critical coronary artery lesions. The extent of myocardial ischemia correlates with measures of global CAD burden only in patients with obstructive CAD.
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50
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Piekarski E, Manrique A, Rouzet F, Le Guludec D. Current Status of Myocardial Perfusion Imaging With New SPECT/CT Cameras. Semin Nucl Med 2020; 50:219-226. [PMID: 32284108 DOI: 10.1053/j.semnuclmed.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Myocardial perfusion imaging (MPI) with Single-Photon Emission Computed Tomography (SPECT) has a major role in the management of coronary artery disease. Recent technological advances regarding SPECT detectors with the use of solid-state detectors has allowed for improved imaging quality since a decade with dramatic dose and/or time reduction of imaging protocols due to improved sensitivity and spatial resolution, and is now performed as a routine exam. Interestingly, this new technology has modified our everyday practice, from acquisition protocols (low dose and ultra-fast protocols) to image semiology. Numerous studies have shown how these technical advances have allowed for improved patient management, with similar or improved diagnostic and prognostic information derived from MPI. These improvements have also led to the straightforward implementation of myocardial blood flow measurement. This article reviews the current status of MPI using new SPECT and SPECT/CT cameras.
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Affiliation(s)
- Eve Piekarski
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France
| | - Alain Manrique
- Normandie Univ, UNICAEN, Caen, France; Médecine Nucléaire, CHU de Caen, Caen, France; GIP Cyceron, Campus Jules Horowitz, Caen, France
| | - François Rouzet
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France
| | - Dominique Le Guludec
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France.
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