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Assante R, Zampella E, D'Antonio A, Mannarino T, Gaudieri V, Nappi C, Arumugam P, Panico M, Buongiorno P, Petretta M, Cuocolo A, Acampa W. Impact on cardiovascular outcome of coronary revascularization-induced changes in ischemic perfusion defect and myocardial flow reserve. Eur J Nucl Med Mol Imaging 2024; 51:1612-1621. [PMID: 38191816 PMCID: PMC11043198 DOI: 10.1007/s00259-023-06588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE We evaluated the impact on cardiovascular outcome of coronary revascularization-induced changes in ischemic total perfusion defect (ITPD) and myocardial flow reserve (MFR) as assessed by 82Rb positron emission tomography (PET)/computed tomography (CT) imaging. METHODS The study included 102 patients referred to 82Rb PET/CT myocardial perfusion imaging before and after coronary revascularization. All patients were followed for the occurrence of cardiovascular events (cardiac death, nonfatal myocardial infarction, repeated revascularization, and heart failure) after the second imaging study. RESULTS During a median follow-up of 20 months, 21 events occurred. The clinical characteristics were comparable between patients with and without events. In the overall study population, after revascularization, there was a significant reduction (P < 0.001) of ITPD, while hyperemic myocardial blood flow (MBF) (P < 0.01) and MFR (P < 0.05) significantly improved. Event rate was higher in patients with ITPD (P < 0.005) or MFR (P < 0.001) worsening compared to those with unchanged or improved ITPD or MFR. At Cox univariable analysis, ITPD and MFR worsening resulted in predictors of events (both P < 0.05). Patients with worsening of both ITPD and MFR had the worst event-free survival (log-rank 32.9, P for trend < 0.001). CONCLUSIONS In patients with stable CAD, worsening of ITPD and MFR after revascularization procedures is associated with higher risk of cardiovascular events. Follow-up MPI with 82Rb PET/CT may improve risk stratification in patients submitted to coronary revascularization.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK
| | | | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
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Wechalekar K, Hutt D, Quigley AM, Whelan C, Chan PS, Hossen L, Armstrong I, Arumugam P, Moody W, Wechalekar AD. Recommendations for good clinical practice for DPD bone scintigraphy for cardiac amyloidosis. Nucl Med Commun 2024; 45:253-262. [PMID: 38275011 PMCID: PMC10916748 DOI: 10.1097/mnm.0000000000001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Affiliation(s)
- Kshama Wechalekar
- Department of Nuclear Medicine, Royal Brompton and Harefield Hospitals, London. Part of Guy’s and St. Thomas’ Foundation Trust
| | - David Hutt
- National Amyloidosis Centre, University College London
| | | | - Carol Whelan
- National Amyloidosis Centre, University College London
| | | | - Lucy Hossen
- Department of Nuclear Medicine, Royal Brompton and Harefield Hospitals, London. Part of Guy’s and St. Thomas’ Foundation Trust
| | - Ian Armstrong
- Nuclear Medicine Centre, Manchester University NHS Foundation Trust, Manchester and
| | - Parthiban Arumugam
- Nuclear Medicine Centre, Manchester University NHS Foundation Trust, Manchester and
| | - William Moody
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Kannan B, Pandi C, Pandi A, Jayaseelan VP, Murugan M S, Arumugam P. Altered expression of GLS2 indicates a poor prognosis and correlates with clinicopathological features of oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00029-8. [PMID: 38342749 DOI: 10.1016/j.ijom.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/13/2024]
Abstract
Glutamine metabolism, governed by enzymes including glutaminase (GLS1 and GLS2), has a pivotal role in cancer progression. The objective of this study was to determine whether GLS2 transcription levels are associated with oral squamous cell carcinoma (OSCC) when compared to matched adjacent normal tissues. Primary tumour and adjacent normal tissues were collected from 51 OSCC patients, and GLS2 mRNA expression analysis was conducted using real-time qPCR. Additionally, The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma (TCGA-HNSCC) dataset was utilized to examine GLS2 expression in relation to clinicopathological features, the prognosis, and tumour immune cell infiltration. A significantly reduced expression of GLS2 mRNA was found in the OSCC tissues when compared to the matched adjacent normal tissue samples (P < 0.001), which aligned with the results from the TCGA-HNSCC dataset and immunohistochemistry. Moreover, GLS2 mRNA expression was associated with clinicopathological features including tumour stage, grade, and human papillomavirus status (all P < 0.05), predicted a poorer prognosis (P = 0.024), and was correlated with tumour immune cell infiltration (all P < 0.05) in head and neck squamous cell carcinoma. Functional pathway analysis indicated its involvement in cell proliferation and metabolic cycles. GLS2 dysregulation is linked to oral cancer, suggesting its potential as a predictive prognostic marker for OSCC. Furthermore, targeting glutaminases via GLS2 may represent a promising therapeutic strategy for OSCC treatment.
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Affiliation(s)
- B Kannan
- Molecular Biology Laboratory, Centre for Cellular and Molecular Research, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - C Pandi
- Molecular Biology Laboratory, Centre for Cellular and Molecular Research, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - A Pandi
- Clinical Genetics Laboratory, Centre for Cellular and Molecular Research, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - V P Jayaseelan
- Clinical Genetics Laboratory, Centre for Cellular and Molecular Research, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - S Murugan M
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - P Arumugam
- Molecular Biology Laboratory, Centre for Cellular and Molecular Research, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
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4
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Arumugam P, Better N, Keng FY, Allam A, Gimelli A, Mut F, Grossman GB, Alexanderson-Rosas E, Páez D, Campisi R. Current state and challenges of implementing a cardiac positron emission tomography program outside North America. J Nucl Cardiol 2024; 31:101788. [PMID: 38215599 DOI: 10.1016/j.nuclcard.2023.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Affiliation(s)
- Parthiban Arumugam
- Manchester University FT, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Nathan Better
- Departments of Cardiology and Nuclear Medicine, Cabrini Health, Victoria, Australia and Monash University, Victoria, Australia
| | - Felix Yj Keng
- National Heart Centre, YLL School of Medicine, National University of Singapore, DUKE-NUS Medical School, LKC School of Medicine, Nanyang Technological University, Singapore
| | - Adel Allam
- Department of Cardiology, Al Azhar University and Department of Nuclear Cardiology, Alfa Medical, Egypt
| | - Alessia Gimelli
- Imaging Department, Fondazione Toscana Gabriele Monasterio, Italy
| | - Fernando Mut
- Department of Nuclear Medicine, Hospital Italiano, Montevideo, Uruguay
| | - Gabriel B Grossman
- Nuclear Medicine Department, Moinhos de Vento Hospital, Porto Alegre and Cardionuclear Clinic, Porto Alegre, Brazil
| | - Erick Alexanderson-Rosas
- Nuclear Cardiology Department, Instituto Nacional de Cardiología Ignacio Chávez, Department of Physiology, Medical School, UNAM, Mexico
| | - Diana Páez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Emery Agency, Vienna, Austria
| | - Roxana Campisi
- Department of Nuclear Medicine, Diagnóstico Maipú-DASA and Instituto Argentino de Diagnóstico y Tratamiento S.A., Buenos Aires, Argentina.
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5
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Sandoe JAT, Ahmed F, Arumugam P, Guleri A, Horner C, Howard P, Perry J, Prendergast BD, Schwiebert R, Steeds RP, Watkin R, Wendler O, Chambers JB. Expert consensus recommendations for the provision of infective endocarditis services: updated guidance from the Joint British Societies. Heart 2023; 109:e2. [PMID: 36898706 PMCID: PMC10423555 DOI: 10.1136/heartjnl-2022-321791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Infective endocarditis (IE) remains a difficult condition to diagnose and treat and is an infection of high consequence for patients, causing long hospital stays, life-changing complications and high mortality. A new multidisciplinary, multiprofessional, British Society for Antimicrobial Chemotherapy (BSAC)-ledWorking Party was convened to undertake a focused systematical review of the literature and to update the previous BSAC guidelines relating delivery of services for patients with IE. A scoping exercise identified new questions concerning optimal delivery of care, and the systematic review identified 16 231 papers of which 20 met the inclusion criteria. Recommendations relating to endocarditis teams, infrastructure and support, endocarditis referral processes, patient follow-up and patient information, and governance are made as well as research recommendations. This is a report of a joint Working Party of the BSAC, British Cardiovascular Society, British Heart Valve Society, British Society of Echocardiography, Society of Cardiothoracic Surgeons of Great Britain and Ireland, British Congenital Cardiac Association and British Infection Association.
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Affiliation(s)
- Jonathan A T Sandoe
- Microbiology department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Fozia Ahmed
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK
- The University of Manchester, Manchester, UK
| | - Parthiban Arumugam
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Achyut Guleri
- Microbiology department, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Carolyne Horner
- Formerly British Society of Antimicrobial Chemotherapy, Birmingham, UK
| | - Philip Howard
- NHS England North East & Yorkshire, Leeds, UK
- University of Leeds, Leeds, UK
| | - John Perry
- Microbiology department, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Bernard D Prendergast
- Cardiology department, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Cleveland Clinic, London, UK
| | - Ralph Schwiebert
- Microbiology department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- School of Medicine, University of Leeds, Leeds, UK
| | - Richard Paul Steeds
- Cardiology department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Richard Watkin
- Cardiology department, University Hospitals Birmingham NHS Foundation Trust, Sutton Coldfield, UK
| | - Olaf Wendler
- Cardiothoracic Surgery, King's College Hospital, King's Health Partners, London, UK
| | - John B Chambers
- Cardiology department, Guy's and St Thomas' NHS Foundation Trust, London, UK
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6
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Moss A, Daghem M, Tzolos E, Meah MN, Wang KL, Bularga A, Adamson PD, Kwiecinski J, Fletcher A, Dawson D, Arumugam P, Sabharwal N, Greenwood JP, Townend JN, Calvert PA, Rudd JHF, Berman D, Verjans J, Slomka P, Dey D, Forsyth L, Murdoch L, Lee RJ, Lewis S, Mills NL, van Beek EJR, Williams MC, Dweck MR, Newby DE. Coronary Atherosclerotic Plaque Activity and Future Coronary Events. JAMA Cardiol 2023; 8:755-764. [PMID: 37379010 PMCID: PMC10308296 DOI: 10.1001/jamacardio.2023.1729] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/03/2023] [Indexed: 06/29/2023]
Abstract
Importance Recurrent coronary events in patients with recent myocardial infarction remain a major clinical problem. Noninvasive measures of coronary atherosclerotic disease activity have the potential to identify individuals at greatest risk. Objective To assess whether coronary atherosclerotic plaque activity as assessed by noninvasive imaging is associated with recurrent coronary events in patients with myocardial infarction. Design, Setting, and Participants This prospective, longitudinal, international multicenter cohort study recruited participants aged 50 years or older with multivessel coronary artery disease and recent (within 21 days) myocardial infarction between September 2015 and February 2020, with a minimum 2 years' follow-up. Intervention Coronary 18F-sodium fluoride positron emission tomography and coronary computed tomography angiography. Main Outcomes and Measures Total coronary atherosclerotic plaque activity was assessed by 18F-sodium fluoride uptake. The primary end point was cardiac death or nonfatal myocardial infarction but was expanded during study conduct to include unscheduled coronary revascularization due to lower than anticipated primary event rates. Results Among 2684 patients screened, 995 were eligible, 712 attended for imaging, and 704 completed an interpretable scan and comprised the study population. The mean (SD) age of participants was 63.8 (8.2) years, and most were male (601 [85%]). Total coronary atherosclerotic plaque activity was identified in 421 participants (60%). After a median follow-up of 4 years (IQR, 3-5 years), 141 participants (20%) experienced the primary end point: 9 had cardiac death, 49 had nonfatal myocardial infarction, and 83 had unscheduled coronary revascularizations. Increased coronary plaque activity was not associated with the primary end point (hazard ratio [HR], 1.25; 95% CI, 0.89-1.76; P = .20) or unscheduled revascularization (HR, 0.98; 95% CI, 0.64-1.49; P = .91) but was associated with the secondary end point of cardiac death or nonfatal myocardial infarction (47 of 421 patients with high plaque activity [11.2%] vs 19 of 283 with low plaque activity [6.7%]; HR, 1.82; 95% CI, 1.07-3.10; P = .03) and all-cause mortality (30 of 421 patients with high plaque activity [7.1%] vs 9 of 283 with low plaque activity [3.2%]; HR, 2.43; 95% CI, 1.15-5.12; P = .02). After adjustment for differences in baseline clinical characteristics, coronary angiography findings, and Global Registry of Acute Coronary Events score, high coronary plaque activity was associated with cardiac death or nonfatal myocardial infarction (HR, 1.76; 95% CI, 1.00-3.10; P = .05) but not with all-cause mortality (HR, 2.01; 95% CI, 0.90-4.49; P = .09). Conclusions and Relevance In this cohort study of patients with recent myocardial infarction, coronary atherosclerotic plaque activity was not associated with the primary composite end point. The findings suggest that risk of cardiovascular death or myocardial infarction in patients with elevated plaque activity warrants further research to explore its incremental prognostic implications.
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Affiliation(s)
- Alastair Moss
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
- National Institute for Health and Care Research, Leicester Biomedical Research Centre, University of Leicester, Leicester, England
| | - Marwa Daghem
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Evangelos Tzolos
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Mohammed N. Meah
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Kang-Ling Wang
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Anda Bularga
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Philip D. Adamson
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - Jacek Kwiecinski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland
| | - Alison Fletcher
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Dana Dawson
- Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, Aberdeen, Scotland
| | | | - Nikant Sabharwal
- Oxford University Hospitals, NHS Foundation Trust, Oxford, England
| | - John P. Greenwood
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, England
| | - Jon N. Townend
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, England
| | | | - James H. F. Rudd
- Department of Medicine, University of Cambridge, Cambridge, England
| | - Dan Berman
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Johan Verjans
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Piotr Slomka
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Damini Dey
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Laura Forsyth
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Lauren Murdoch
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Robert J. Lee
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Nicholas L. Mills
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
- Usher Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Edwin J. R. van Beek
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Michelle C. Williams
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - Marc R. Dweck
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
| | - David E. Newby
- Edinburgh Imaging, The University of Edinburgh, Edinburgh, Scotland
- British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, Scotland
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Orsborne C, Anton-Rodrigez JM, Sherratt N, Watkins A, Lohezic M, Clark D, Lloyd W, Naish JH, Woolfson P, Reid AB, Schmitt M, Muthu S, Arumugam P, Jovanovic A, Miller CA. Inflammatory Fabry Cardiomyopathy Demonstrated Using Simultaneous [ 18F]-FDG PET-CMR. JACC Case Rep 2023; 15:101863. [PMID: 37283843 PMCID: PMC10240277 DOI: 10.1016/j.jaccas.2023.101863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/15/2023] [Accepted: 04/07/2023] [Indexed: 06/08/2023]
Abstract
Using hybridized [18F]-fluorodeoxyglucose positron emission tomography with cardiac magnetic resonance, we identify active myocardial inflammation and demonstrate its relationship with late gadolinium enhancement, in Fabry disease. We demonstrate that late gadolinium enhancement represents, at least in part, active myocardial inflammation and identify an early inflammatory phenotype that may represent a therapeutic window before irreversible tissue injury and adaptation occur. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Christopher Orsborne
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Jose M. Anton-Rodrigez
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Neal Sherratt
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Amy Watkins
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | | | - David Clark
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - William Lloyd
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Josephine H. Naish
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Peter Woolfson
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Anna B. Reid
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Matthias Schmitt
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Sivakumar Muthu
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Ana Jovanovic
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Christopher A. Miller
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Division of Cell-Matrix Biology & Regenerative Medicine, Wellcome Centre for Cell-Matrix Research, School of Biology, Faculty of Biology, Medicine & Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
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8
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Zampella E, Mannarino T, D'Antonio A, Assante R, Gaudieri V, Buongiorno P, Panico M, Cantoni V, Green R, Nappi C, Arumugam P, Petretta M, Cuocolo A, Acampa W. Prediction of outcome by 82Rb PET/CT in patients with ischemia and nonobstructive coronary arteries. J Nucl Cardiol 2023; 30:1110-1117. [PMID: 36352083 DOI: 10.1007/s12350-022-03144-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The purpose of this study was to assess the prognostic value of cardiac 82Rb positron emission tomography (PET)/computed tomography (CT) imaging in patients with myocardial ischemia of nonobstructive coronary arteries (INOCA). METHODS We retrospectively evaluated 311 INOCA patients who underwent rest stress 82Rb PET/CT. Cardiac end points were cardiac death, myocardial infarction, or late coronary revascularization. A parametric survival model was also used to identify how the variables influenced time to event. RESULTS During a median follow-up of 37 months (range 6-108), 23 (7%) cardiac events occurred. In patients with events total perfusion defect (TPD) was higher and myocardial flow reserve (MFR) lower compared to those without events (both P < .001). At multivariable Cox analysis, increased TPD (i.e., ≥ 5%) and reduced MFR (i.e., < 2) were predictors of events (both P < .001). At Weibull survival analysis, the highest probability of cardiac events and risk acceleration were observed in patients with both increased TPD and reduced MFR. Annualized event rate was higher in patients with reduced MFR compared to those with preserved MFR (P < .001). CONCLUSION In patients with INOCA, the combined evaluation of myocardial perfusion and coronary vascular function by 82Rb PET/CT is able to identify those at higher risk of cardiac events.
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Affiliation(s)
- Emilia Zampella
- 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
| | - Adriana D'Antonio
- 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
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | | | - 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
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK
| | | | - Alberto Cuocolo
- 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.
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9
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Ananthasubramaniam K, Arumugam P. Can we "REFINE" the art of predicting ischemia on SPECT myocardial perfusion imaging? J Nucl Cardiol 2022; 29:3233-3235. [PMID: 34873645 DOI: 10.1007/s12350-021-02867-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/07/2021] [Indexed: 01/18/2023]
Affiliation(s)
- Karthik Ananthasubramaniam
- Heart and Vascular Institute, Henry Ford West Bloomfield Hospital, 6777 W Maple, West Bloomfield, MI, 48322, USA.
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Manchester University, Manchester, United Kingdom
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Shoemark A, Griffin H, Wheway G, Hogg C, Lucas JS, Camps C, Taylor J, Carroll M, Loebinger MR, Chalmers JD, Morris-Rosendahl D, Mitchison HM, De Soyza A, Brown D, Ambrose JC, Arumugam P, Bevers R, Bleda M, Boardman-Pretty F, Boustred CR, Brittain H, Caulfield MJ, Chan GC, Fowler T, Giess A, Hamblin A, Henderson S, Hubbard TJP, Jackson R, Jones LJ, Kasperaviciute D, Kayikci M, Kousathanas A, Lahnstein L, Leigh SEA, Leong IUS, Lopez FJ, Maleady-Crowe F, McEntagart M, Minneci F, Moutsianas L, Mueller M, Murugaesu N, Need AC, O'Donovan P, Odhams CA, Patch C, Perez-Gil D, Pereira MB, Pullinger J, Rahim T, Rendon A, Rogers T, Savage K, Sawant K, Scott RH, Siddiq A, Sieghart A, Smith SC, Sosinsky A, Stuckey A, Tanguy M, Taylor Tavares AL, Thomas ERA, Thompson SR, Tucci A, Welland MJ, Williams E, Witkowska K, Wood SM. Genome sequencing reveals underdiagnosis of primary ciliary dyskinesia in bronchiectasis. Eur Respir J 2022; 60:13993003.00176-2022. [PMID: 35728977 DOI: 10.1183/13993003.00176-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/12/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Bronchiectasis can result from infectious, genetic, immunological and allergic causes. 60-80% of cases are idiopathic, but a well-recognised genetic cause is the motile ciliopathy, primary ciliary dyskinesia (PCD). Diagnosis of PCD has management implications including addressing comorbidities, implementing genetic and fertility counselling and future access to PCD-specific treatments. Diagnostic testing can be complex; however, PCD genetic testing is moving rapidly from research into clinical diagnostics and would confirm the cause of bronchiectasis. METHODS This observational study used genetic data from severe bronchiectasis patients recruited to the UK 100,000 Genomes Project and patients referred for gene panel testing within a tertiary respiratory hospital. Patients referred for genetic testing due to clinical suspicion of PCD were excluded from both analyses. Data were accessed from the British Thoracic Society audit, to investigate whether motile ciliopathies are underdiagnosed in people with bronchiectasis in the UK. RESULTS Pathogenic or likely pathogenic variants were identified in motile ciliopathy genes in 17 (12%) out of 142 individuals by whole-genome sequencing. Similarly, in a single centre with access to pathological diagnostic facilities, 5-10% of patients received a PCD diagnosis by gene panel, often linked to normal/inconclusive nasal nitric oxide and cilia functional test results. In 4898 audited patients with bronchiectasis, <2% were tested for PCD and <1% received genetic testing. CONCLUSIONS PCD is underdiagnosed as a cause of bronchiectasis. Increased uptake of genetic testing may help to identify bronchiectasis due to motile ciliopathies and ensure appropriate management.
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Affiliation(s)
- Amelia Shoemark
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Helen Griffin
- Primary Immunodeficiency Group, Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, UK
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
| | - Gabrielle Wheway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Hogg
- Royal Brompton Hospital and NHLI, Imperial College London, London, UK
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK
| | | | - Carme Camps
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Jenny Taylor
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office, John Radcliffe Hospital, Oxford, UK
| | - Mary Carroll
- Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - James D Chalmers
- Respiratory Research Group, Molecular and Cellular Medicine, University of Dundee, Dundee, UK
| | - Deborah Morris-Rosendahl
- Clinical Genetics and Genomics, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust and NHLI, Imperial College London, London, UK
| | - Hannah M Mitchison
- Genetics and Genomic Medicine Department, University College London, UCL Great Ormond Street Institute of Child Health, London, UK
- These authors contributed equally to this manuscript
| | - Anthony De Soyza
- Newcastle University and NIHR Biomedical Research Centre for Ageing, Freeman Hospital, Newcastle upon Tyne, UK
- These authors contributed equally to this manuscript
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Ngo L, Lee W, Elwashahy M, Arumugam P, Ranasinghe I. Very long-term outcomes of patients undergoing catheter ablation of atrial fibrillation: a systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The efficacy of catheter ablation of atrial fibrillation (AF) is reported to stabilise at 5-year, but most studies report up to 3-year-outcomes only.
Objective
To perform a systematic review and meta-analysis of outcomes at 5-years following AF ablation.
Methods
We searched PubMed and Embase for studies reporting on ≥5-year outcomes following AF ablation, including freedom from atrial arrhythmia, all-cause death, stroke, and major bleeding. All meta-analyses were performed using the “meta” package in R with pooled incidence calculated using log transformation.
Results
Among 5,764 studies screened, 58 (n=41,344 patients) were included for analysis. The pooled mean age was 60.3y, 68.7% male, 78.4% paroxysmal AF, and radiofrequency was the most common ablation energy (72.4%). Most (51.5%) patients had hypertension, but the pooled rates of other comorbidities were low (heart failure: 9.0%, coronary artery disease: 12.8%, diabetes: 11.0%, and previous stroke: 8.5%). Pooled incidence of freedom from atrial arrhythmia at 5-years was 47.6% (95% CI 43.8%-51.6%, I2=98.4%) after a single procedure and increased to 64.3% (95% CI 59.6%-69.3%, I2=98.3%) after multiple procedures (Figure 1). The incidence was higher among patients with paroxysmal compared with non paroxysmal AF (55.9% vs. 28.7% and 82.2% vs. 47.6% after single and multiple procedures respectively). Retrospective studies reported slightly higher incidence of arrhythmia freedom (single procedure: 51.2% vs. 46.7%; multiple procedures: 66.9% vs. 61.9%) than did prospective studies. Few studies reported outcomes other than atrial arrhythmia free survival at 5-years (n=14) and incidences of these outcomes could only be pooled for multiple procedures. Pooled incidences of death, stroke, and major bleeding at 5-years were 8.0% (95% CI 4.2%-15.2%, I2=95.8%), 2.3% (95% CI 1.4%-3.6%, I2=72.9%), and 1.1% (95% CI 0.6%-1.8%, I2=32.5%), respectively (Figure 2).
Conclusion
At five-years, only up to 65% of patients undergoing AF ablations remained free from atrial arrhythmia although there was significant heterogeneity among individual studies. Encouragingly, these patients had low risk of dying, experiencing a stroke or major bleeding (all incidences<10%).
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- L Ngo
- University of Queensland , Brisbane , Australia
| | - W Lee
- The Prince Charles Hospital , Brisbane , Australia
| | - M Elwashahy
- Wollongong Hospital , Wollongong , Australia
| | - P Arumugam
- University of Queensland , Brisbane , Australia
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12
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Arumugam P, Jayaseelan V, Senthil Murugan M. 60P ALKBH1 alterations predict poor prognosis in oral squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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13
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Armstrong IS, Memmott MJ, Hayden C, Arumugam P. The prevalence of image degradation due to motion in rest-stress rubidium-82 imaging on a SiPM PET-CT system. J Nucl Cardiol 2022; 29:1596-1606. [PMID: 33608851 DOI: 10.1007/s12350-021-02531-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/07/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Motion of the heart is known to affect image quality in cardiac PET. The prevalence of motion blurring in routine cardiac PET is not fully appreciated due to challenges identifying subtle motion artefacts. This study utilizes a recent prototype Data-Driven Motion Correction (DDMC) algorithm to generate corrected images that are compared with non-corrected images to identify visual differences in relative rubidium-82 perfusion images due to motion. METHODS 300 stress and 300 rest static images were reconstructed with DDMC and without correction (NMC). The 600 DDMC/NMC image pairs were assigned Visual Difference Score (VDS). The number of non-diagnostic images were noted. A "Dwell Fraction" (DF) was derived from the data to quantify motion and predict image degradation. RESULTS Motion degradation (VDS = 1 or 2) was evident in 58% of stress images and 33% of rest images. Seven NMC images were non-diagnostic-these originated from six studies giving a 2% rate of non-diagnostic studies due to motion. The DF metric was able to effectively predict image degradation. The DDMC heart identification and tracking was successful in all images. CONCLUSION Motion degradation is present in almost half of all relative perfusion images. The DDMC algorithm is a robust tool for predicting, assessing and correcting image degradation.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, TN, USA
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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Parmar V, Das H, Kumar A, Kumar A, Sharma M, Arumugam P, Patra S. Pasta properties of the neutron star within effective relativistic mean-field model. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.023031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Grimley M, Kent M, Asnani M, Shrestha A, Felker S, Lutzko C, Arumugam P, Witting S, Knight-Madden J, Niss O, Quinn C, Lo C, Little C, Dong A, Malik P. P1453: STABLE TRANSDUCTION OF FETAL HEMOGLOBIN IN PATIENTS WITH SICKLE CELL DISEASE IN THE PHASE 1/2 MOMENTUM STUDY OF ARU-1801 GENE THERAPY AND REDUCED INTENSITY CONDITIONING. Hemasphere 2022. [PMCID: PMC9429142 DOI: 10.1097/01.hs9.0000848668.22824.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Arumugam P, Jayaseelan V. 15P N6-Methyladenosine modification of YY1 mRNA promotes cervical cancer tumorigenesis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Moody WE, Arumugam P. Assessment of stress adequacy with adenosine: Does the answer lie in the spleen? J Nucl Cardiol 2022; 29:1215-1218. [PMID: 33420661 DOI: 10.1007/s12350-020-02485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Affiliation(s)
- William E Moody
- Department of Cardiology, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
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Jane Monica S, John S, Madhanagopal R, Sivaraj C, Khusro A, Arumugam P, Gajdács M, Esther Lydia D, Umar Khayam Sahibzada M, Alghamdi S, Almehmadi M, Bin Emran T. Chemical composition of pumpkin (Cucurbita maxima) seeds and its supplemental effect on Indian women with metabolic syndrome. ARAB J CHEM 2022. [DOI: 10.1016/j.arabjc.2022.103985] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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19
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Assante R, Mainolfi CG, Zampella E, Gaudieri V, Nappi C, Mannarino T, D'Antonio A, Arumugam P, Petretta M, Cuocolo A, Acampa W. Correction to: Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging. J Nucl Cardiol 2022; 29:892. [PMID: 34755271 PMCID: PMC9172822 DOI: 10.1007/s12350-021-02832-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | | | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Parthiban Arumugam
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
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Arumugam P, Jayaseelan V. 14P A novel small molecule METTL3 inhibitor exerts promising antitumor effects on oral squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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21
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Siwach P, Arumugam P, Modi S, Ferreira LS, Maglione E. Proton emission study as a guide to astrophysical rp process. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202226011039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Proton emitters play an important role in deciding the path of the astrophysical rapid proton capture (rp) process. The lifetime of these nuclei depends on several factors, like the deformation, angular momentum of the emitted proton, residual interaction between valence proton and neutron (especially in case of odd-odd nuclei) and so on. Therefore, it is worth to investigate the structure of proton emitters to understand the rp process path. However, due to lack of data in this exotic region, the theoretical models should be robust and the dependence on the free parameters should be minimal. In this direction, we have developed the first microscopic approach to study the triaxially deformed odd-odd proton emitters. The application of the developed approach to 108I, a recently observed proton emitter to investigate the end cycle of the rp process, is discussed.
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22
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Armstrong IS, Hayden C, Memmott MJ, Arumugam P. A preliminary evaluation of a high temporal resolution data-driven motion correction algorithm for rubidium-82 on a SiPM PET-CT system. J Nucl Cardiol 2022; 29:56-68. [PMID: 32440990 PMCID: PMC8873161 DOI: 10.1007/s12350-020-02177-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND In myocardial perfusion PET, images are acquired during vasodilator stress, increasing the likelihood of intra-frame motion blurring of the heart in reconstructed static images to assess relative perfusion. This work evaluated a prototype data-driven motion correction (DDMC) algorithm designed specifically for cardiac PET. METHODS A cardiac torso phantom, with a solid defect, was scanned stationary and being manually pulled to-and-fro in the axial direction with a random motion. Non-motion-corrected (NMC) and DDMC images were reconstructed. Total perfusion deficit was measured in the defect and profiles through the cardiac insert were defined. In addition, 46 static perfusion images from 36 rubidium-82 MPI patients were selected based upon a perception of motion blurring in the images. NMC and DDMC images were reconstructed, blinded, and scored on image quality and perceived motion. RESULTS Phantom data demonstrated near-perfect recovery of myocardial wall visualization and defect quantification with DDMC compared with the stationary phantom. Quality of clinical images was NMC: 10 non-diagnostic, 31 adequate, and 5 good; DDMC images: 0 non-diagnostic, 6 adequate, and 40 good. CONCLUSION The DDMC algorithm shows great promise in rubidium MPI PET with substantial improvements in image quality and the potential to salvage images considered non-diagnostic due to significant motion blurring.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Charles Hayden
- Molecular Imaging, Siemens Medical Solutions USA, Inc., Knoxville, TN, USA
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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Megna R, Nappi C, Gaudieri V, Mannarino T, Assante R, Zampella E, Green R, Cantoni V, D'Antonio A, Arumugam P, Acampa W, Petretta M, Cuocolo A. Diagnostic value of clinical risk scores for predicting normal stress myocardial perfusion imaging in subjects without coronary artery calcium. J Nucl Cardiol 2022; 29:323-333. [PMID: 32601888 DOI: 10.1007/s12350-020-02247-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We evaluated if risk scores commonly used to predict the absence of significant stenosis at coronary computed tomography (CT) angiography are useful to predict a normal stress myocardial perfusion imaging (MPI) study. METHODS Our cohort included a total of 1422 consecutive patients with zero coronary artery calcium score (ZCS) who underwent 82Rb PET/CT for evaluation of suspected coronary artery disease (CAD). Predictive models were constructed as reported by Genders et al. and Alshahrani et al., and the probability of abnormal summed stress score (SSS) and of reduced myocardial perfusion reserve (MPR) based on these risk scores was assessed. RESULTS In the overall population, the prevalence of abnormal SSS was 0.10 and the prevalence of reduced MPR was 0.17 (both P < .001).The observed frequencies of abnormal SSS and reduced MPR vs the probabilities predicted by the Genders and Alshahrani models were above the diagonal identity line, highlighting an underestimation of the observed occurrence by these models. The areas under the receiver operating characteristic curve of the Genders and Alshahrani models indicated lack of discriminative ability for predicting abnormal SSS (0.547 and 0.527) and reduced MPR (0.509 and 0.538). The Hosmer-Lemeshow test revealed that both models underestimated the observed occurrence of abnormal SSS and reduced MPR. CONCLUSIONS Available models were unable to identify among patients with ZCS those with a low probability of a normal stress MPI study. Thus, an optimal approach to rule out from MPI patients without detectable coronary calcium still needs to be improved.
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Affiliation(s)
- Rosario Megna
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
- 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
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- 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
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK
| | - Wanda Acampa
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
- 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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Ngo L, Lee W, Elwashahy M, Arumugam P. Very Long-term Outcomes of Patients Undergoing Catheter Ablation of Atrial Fibrillation: A Systematic Review and Meta-Analysis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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25
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Moody WE, Holloway B, Arumugam P, Gill S, Wahid YS, Boivin CM, Thomson LE, Berman DS, Armstrong MJ, Ferguson J, Steeds RP. Prognostic value of coronary risk factors, exercise capacity and single photon emission computed tomography in liver transplantation candidates: A 5-year follow-up study. J Nucl Cardiol 2021; 28:2876-2891. [PMID: 32394403 PMCID: PMC8709822 DOI: 10.1007/s12350-020-02126-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Although consensus-based guidelines support noninvasive stress testing prior to orthotopic liver transplantation (OLT), the optimal screening strategy for assessment of coronary artery disease in patients with end-stage liver disease (ESLD) is unclear. This study sought to determine the relative predictive value of coronary risk factors, functional capacity, and single photon emission computed tomography (SPECT) on major adverse cardiovascular events and all-cause mortality in liver transplantation candidates. METHODS Prior to listing for transplantation, 404 consecutive ESLD patients were referred to a University hospital for cardiovascular (CV) risk stratification. All subjects met at least one of the following criteria: inability to perform > 4 METs by history (62%), insulin-treated diabetes mellitus (53%), serum creatinine > 1.72 mg/dL (8%), history of MI, PCI or CABG (5%), stable angina (3%), cerebrovascular disease (1%), peripheral vascular disease (1%). Subjects underwent Technetium-99m SPECT with multislice coronary artery calcium scoring (CACS) using exercise treadmill or standard adenosine stress in those unable to achieve 85% maximal heart rate (Siemens Symbia T16). Abnormal perfusion was defined as a summed stress score (SSS) ≥ 4. RESULTS Of the 404 patients, 158 (age 59 ± 9 years; male 68%) subsequently underwent transplantation and were included in the primary analysis. Of those, 50 (32%) died after a mean duration follow-up of 5.4 years (maximal 10.9 years). Most deaths (78%) were attributed to noncardiovascular causes (malignancy, sepsis, renal failure). Of the 32 subjects with abnormal perfusion (20%), nine (6%) had a high-risk perfusion abnormality defined as a total perfusion defect size (PDS) ≥ 15% and/or an ischemic PDS ≥ 10%. Kaplan-Meier survival curves demonstrated abnormal perfusion was associated with increased CV mortality (generalized Wilcoxon, P = 0.014) but not all-cause death. Subjects with both abnormal perfusion and an inability to exercise > 4 METs had the lowest survival from all-cause death (P = 0.038). Abnormal perfusion was a strong independent predictor of CV death (adjusted HR 4.2; 95% CI 1.4 to 12.3; P = 0.019) and MACE (adjusted HR 7.7; 95% CI 1.4 to 42.4; P = 0.018) in a multivariate Cox regression model that included age, sex, diabetes, smoking and the ability to exercise > 4 METs. There was no association between CACS and the extent of perfusion abnormality, nor with outcomes. CONCLUSIONS Most deaths following OLT are noncardiovascular. Nonetheless, abnormal perfusion is prevalent in this high-risk population and a stronger predictor of cardiovascular morbidity and mortality than functional status. A combined assessment of functional status and myocardial perfusion identifies those at highest risk of all-cause death. (Exercise Capacity and Single Photon Emission Computed Tomography in Liver Transplantation Candidates [ExSPECT]; ClinicalTrials.gov Identifier: NCT03864497).
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Affiliation(s)
- William E Moody
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK.
| | - Benjamin Holloway
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - Sharon Gill
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
| | - Yasmin S Wahid
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
| | - Chris M Boivin
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
| | - Louise E Thomson
- Departments of Imaging and Medicine, S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Daniel S Berman
- Departments of Imaging and Medicine, S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Matthew J Armstrong
- Department of Liver Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, B15 2TH, UK
- Institute of Immunology and Immunotherapy, National Institute for Health Research (NIHR) Birmingham Liver Biomedical Research Centre (BRC), University of Birmingham, Birmingham, UK
| | - James Ferguson
- Department of Liver Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, B15 2TH, UK
- Institute of Immunology and Immunotherapy, National Institute for Health Research (NIHR) Birmingham Liver Biomedical Research Centre (BRC), University of Birmingham, Birmingham, UK
| | - Richard P Steeds
- Department of Nuclear Medicine, Centre for Clinical Cardiovascular Science, Nuffield House, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Edgbaston, B15 2TH, UK
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Assante R, Mainolfi CG, Zampella E, Gaudieri V, Nappi C, Mannarino T, D’Antonio A, Arumugam P, Petretta M, Cuocolo A, Acampa W. Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging. J Nucl Cardiol 2021; 28:1222-1233. [PMID: 33599942 PMCID: PMC8421293 DOI: 10.1007/s12350-021-02533-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND We assessed the prognostic value of structural abnormalities and coronary vasodilator function in diabetic patients referred to a PET/CT for suspected coronary artery disease (CAD). METHODS We studied 451 diabetics and 451 nondiabetics without overt CAD and normal myocardial perfusion. Myocardial blood flow (MBF) was computed from the dynamic rest and stress imaging. Myocardial flow reserve (MFR) was defined as ratio of hyperemic to baseline MBF and was considered reduced when < 2. RESULTS During a mean follow-up of 44 months 33 events occurred. Annualized event rate (AER) was higher in diabetic than nondiabetic patients (1.4% vs 0.3%, P < .001). Diabetic patients with reduced MFR had higher AER compared to those with preserved MFR (3.3% vs 0.4%, P < .001). At Cox analysis, age, BMI and reduced MFR were independent predictors of events in diabetic patients. Patients with diabetes and reduced MFR had lower event-free survival compared to nondiabetic patients and MFR < 2 (P < .001). Event-free survival was similar in patients with diabetes and normal MFR and those without diabetes and reduced MFR. CONCLUSIONS Diabetic patients with reduced MFR had higher AER and lower event-free survival compared to those with preserved MFR and to nondiabetic patients.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Emilia Zampella
- 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
| | - Carmela Nappi
- 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
| | - Adriana D’Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Parthiban Arumugam
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - 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
| | - 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
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27
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Armstrong IS, Memmott MJ, Saint KJ, Saillant A, Hayden C, Arumugam P. Assessment of motion correction in dynamic rubidium-82 cardiac PET with and without frame-by-frame adjustment of attenuation maps for calculation of myocardial blood flow. J Nucl Cardiol 2021; 28:1334-1346. [PMID: 31388967 DOI: 10.1007/s12350-019-01834-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patient motion during pharmacological stressing can have substantial impact on myocardial blood flow (MBF) estimated from dynamic PET. This work evaluated a motion correction algorithm with and without adjustment of the PET attenuation map. METHODS Frame-by-frame motion correction was performed by three users on 30 rubidium-82 studies. Data were divided equally into three groups of motion severity [mild (M1), moderate (M2) and severe (M3)]. MBF data were compared for non-motion corrected (NC), motion-corrected-only (MC) and with adjustment of the attenuation map (MCAC). Percentage differences of MBF were calculated in the coronary territories and 17-segment polar plots. Polar plots of spill-over were also generated from the data. RESULTS Median differences of 23% were seen in the RCA and 18% for the LAD in the M3 category for MC vs NC images. Differences for MCAC vs MC images were considerably smaller and typically < 10%. Spill-over plots for MC and MCAC were notably more uniform compared with NC images. CONCLUSION Motion correction for dynamic rubidium data is desirable for future MBF software updates. Adjustment of the PET attenuation map results in only marginal differences and therefore is unlikely to be an essential requirement. Assessing the uniformity of spill-over plots is a useful visual aid for verifying motion correction techniques.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK.
| | - Matthew J Memmott
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Kimberley J Saint
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
| | - Antoine Saillant
- Siemens Medical Solutions USA, Inc, Molecular Imaging, Knoxville, TN, USA
| | - Charles Hayden
- Siemens Medical Solutions USA, Inc, Molecular Imaging, Knoxville, TN, USA
| | - Parthiban Arumugam
- Nuclear Medicine, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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Gaudieri V, Mannarino T, Zampella E, Assante R, D'Antonio A, Nappi C, Cantoni V, Green R, Petretta M, Arumugam P, Cuocolo A, Acampa W. Prognostic value of coronary vascular dysfunction assessed by rubidium-82 PET/CT imaging in patients with resistant hypertension without overt coronary artery disease. Eur J Nucl Med Mol Imaging 2021; 48:3162-3171. [PMID: 33594472 PMCID: PMC8426234 DOI: 10.1007/s00259-021-05239-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/01/2021] [Indexed: 12/24/2022]
Abstract
Purpose The identification of coronary vascular dysfunction may enhance risk stratification in patients with resistant hypertension (RH). We evaluated if impaired coronary vascular function, assessed by rubidium-82 (82Rb) positron emission tomography/computed tomography (PET/CT) imaging, is associated with increased cardiovascular risk in patients with hypertension without overt coronary artery disease (CAD). Methods We studied 517 hypertensive subjects, 26% with RH, without overt CAD, and with normal stress-rest myocardial perfusion imaging at 82Rb PET/CT. The outcome end points were cardiac death, nonfatal myocardial infarction, coronary revascularization, and admission for heart failure. Results Over a median of 38 months (interquartile range 26 to 50), 21 cardiac events (4.1% cumulative event rate) occurred. Patients with RH were older (p < 0.05) and had a higher prevalence of left ventricular hypertrophy (p < 0.001), a lower hyperemic myocardial blood flow (MBF), and myocardial perfusion reserve (MPR) (both p < 0.001) compared to those without. Conversely, coronary artery calcium content and baseline MBF were not different between patients with and without RH. At univariable Cox regression analysis, age, RH, left ventricular ejection fraction, coronary artery calcium score, and reduced MPR were significant predictors of events. At multivariable analysis, age, RH, and reduced MPR (all p < 0.05) were independent predictors of events. Patients with RH and reduced MPR had the highest risk of events and the major risk acceleration over time. Conclusion The findings suggest that the assessment of coronary vascular function may enhance risk stratification in patients with hypertension.
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Affiliation(s)
- 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
| | - 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
| | - Adriana D'Antonio
- 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 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
| | | | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK
| | - Alberto Cuocolo
- 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.
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Gaudieri V, Zampella E, Nappi C, Assante R, Mannarino T, D"antonio A, Giordano A, Buongiorno P, Petretta M, Acampa W, Arumugam P, Cuocolo A. Prognostic value of pericoronary adipose tissue and coronary vascular function by cardiac 82Rb PET/CT imaging in patients with suspected coronary artery disease and normal myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Pericoronary adipose tissue, due to its proximity to coronary arteries, has been proposed contribute to the progression of coronary atherosclerosis.
Purpose
The aim of this study was to evaluate the prognostic value of pericoronary fat thickness (PCFT), coronary artery calcium (CAC) score and myocardial perfusion reserve (MPR) by hybrid 82Rubidium (82Rb) PET/CT imaging in patients with suspected coronary artery disease (CAD) and normal myocardial perfusion imaging (MPI).
Methods
A total of 640 patients without overt CAD and with normal rest-stress 82Rb PET/CT MPI were studied. PCFT was calculated on CT images as the maximum fat thickness (mm) between heart surface and visceral epicardium surrounding the main coronary arteries. CAC score was categorized as 0, <400 or ≥400. MPR was considered reduced when <2. Endpoints events were cardiac death, nonfatal myocardial infarction and coronary revascularization.
Results
During a follow-up of 42 ± 13 months, 29 events occurred (cumulative event rate 5%). Patients with events were older (66 ± 13 vs. 60 ± 13 years, p < 0.01), had higher PCFT (13 ± 2 vs 11 ± 2 mm, p < 0.001), higher prevalence of CAC score ≥400 (48% vs. 21%, p < 0.01), and lower MPR (2.1 ± 0.7 vs. 2.7 ± 0.7, p < 0.001) compared to those without. A higher prevalence of MPR <2 was observed in patients with events (48% vs. 18, p < 0.001) compared to those without. Patients with reduced MPR had higher PCFT compared to those with normal MPR (12 ± 2 vs. 11 ± 1 mm, p < 0.01). A PCFT value of 11.2 mm was the best trade-off between sensitivity and specificity to detect a reduced MPR. Event rate was higher in patients above this threshold compared to those below (8% vs. 1.5%, p < 0.001). At Cox univariate analysis, age (p < 0.05), PCFT >11.2 mm (p < 0.001), CAC score ≥400 (p < 0.01), and MPR <2 (p < 0.001) were predictors of events. At multivariate analysis, only PCFT >11.2 mm and MPR <2 were independent predictors of events (both p < 0.01). At incremental analysis, adding PCFT >11.2 to a model including clinical data and MPR <2 increased the global chi-square from 26 to 35 (p < 0.01). Classification tree analysis produced 3 terminal groups. For patients with MPR <2, no further split was needed (event rate 12% vs. 3%, p < 0.001). On the contrary, patients with MPR ≥2 were further stratified by PCFT (event rate 7% in patients with and 0.3% in those without (p < 0.001) PCFT >11.2.
Conclusions
In patients with suspected CAD and normal stress MPI, coronary vascular dysfunction and high PCFT are associated with increased cardiac risk. PCFT could help in identifying patients at higher risk of events. Combined evaluation of anatomical and functional vascular abnormalities by 82Rb PET/CT might allow a better risk stratification.
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Affiliation(s)
- V Gaudieri
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - E Zampella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Nappi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A D"antonio
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Giordano
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Buongiorno
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Petretta
- Federico II University of Naples, Department of Translational Medical Sciences, Naples, Italy
| | - W Acampa
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Arumugam
- Central Manchester University Hospitals NHS Foundation Trust, Department of Nuclear Medicine, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Cuocolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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Motwani M, Arumugam P, Rocci A, Venetucci L. Evaluating Suspected Cardiac Amyloidosis. JACC Case Rep 2019; 1:141-145. [PMID: 34316771 PMCID: PMC8301515 DOI: 10.1016/j.jaccas.2019.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
A 71-year-old-woman presented with breathlessness, general tiredness and orthopnea. Echocardiography and electrocardiogram were suspicious for cardiac amyloidosis. This case illustrates contemporary evaluation to confirm the diagnosis and distinguish between different types of amyloid. (Level of Difficulty: Beginner.)
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31
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Nappi C, Gaudieri V, Acampa W, Arumugam P, Assante R, Zampella E, Mannarino T, Mainolfi CG, Imbriaco M, Petretta M, Cuocolo A. Coronary vascular age: An alternate means for predicting stress-induced myocardial ischemia in patients with suspected coronary artery disease. J Nucl Cardiol 2019; 26:1348-1355. [PMID: 29359274 DOI: 10.1007/s12350-018-1191-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Coronary artery calcium (CAC) can be used to estimate vascular age in adults, providing a convenient transformation of CAC from Agatston units into a year's scale. We investigated the role of coronary vascular age in predicting stress-induced myocardial ischemia in subjects with suspected coronary artery disease (CAD). METHODS A total of 717 subjects referred to CAC scoring and 82Rb PET/CT stress-rest myocardial perfusion imaging for suspected CAD were studied. CAC score was measured according to the Agatston method and coronary vascular age by equating estimated CAD risk for chronological age and CAC using the formula 39.1 + 7.25 × ln(CAC + 1). RESULTS Stress-induced ischemia was present in 105 (15%) patients. Mean chronological age, CAC score, and coronary vascular age were higher (all P < .001) in patients with ischemia compared to those without. At incremental analysis, the global Chi square increased from 41.26 to 68.77 (P < .001) when chronological age was added to clinical variables. Including vascular age in the model, the global Chi square further increased from 68.77 to 106.38 (P < .001). Adding chronological age to clinical data, continuous net reclassification improvement (cNRI) was 0.57, while adding vascular age to clinical data and chronological age cNRI was 0.62. At decision curve analysis, the model including vascular age was associated with the highest net benefit compared to the model including only clinical data, to the model including chronological age and clinical data, and to a strategy considering that all patients had ischemia. The model including vascular age also showed the largest reduction in false-positive rate without missing any ischemic patients. CONCLUSIONS In subjects with suspected CAD, coronary vascular age is strongly associated with stress-induced ischemia. The communication of a given vascular age would have a superior emotive impact improving observance of therapies and healthier lifestyles.
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Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Institute of Biostructure and Bioimaging, National Council of Research, 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
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester University Hospitals, Manchester, UK
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- 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
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Massimo Imbriaco
- 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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Ahmed FZ, Arumugam P. 18F-FDG PET/CT now endorsed by guidelines across all types of CIED infection: Evidence limited but growing. J Nucl Cardiol 2019; 26:971-974. [PMID: 29188432 DOI: 10.1007/s12350-017-1119-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Fozia Zahir Ahmed
- Manchester Heart Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK
| | - Parthiban Arumugam
- Nuclear Medicine Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
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33
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Armstrong IS, Memmott MJ, Saint KJ, Saillant A, Hayden C, Arumugam P. P396Assessment of motion correction on myocardial blood flow from dynamic rubidium-82 PET. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez149.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- I S Armstrong
- Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - M J Memmott
- Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - K J Saint
- Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Saillant
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, United States of America
| | - C Hayden
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, United States of America
| | - P Arumugam
- Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain & Northern Ireland
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34
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Gaudieri V, Acampa W, Rozza F, Nappi C, Zampella E, Assante R, Mannarino T, Mainolfi C, Petretta M, Verberne HJ, Arumugam P, Cuocolo A. P308Coronary vascular function in patients with resistant hypertension and normal myocardial perfusion imaging: a propensity score analysis. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez148.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Gaudieri
- National Research Council, Biostructure and Bioimaging, Naples, Italy
| | - W Acampa
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - F Rozza
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Nappi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - E Zampella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - C Mainolfi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Petretta
- Federico II University of Naples, Department of Translational Medical Sciences, Naples, Italy
| | - H J Verberne
- Academic Medical Center of Amsterdam, Department of Nuclear Medicine, Amsterdam, Netherlands (The)
| | - P Arumugam
- Central Manchester University Hospitals NHS Foundation Trust, Department of Nuclear Medicine, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Cuocolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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35
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Nappi C, Acampa W, Gaudieri V, Zampella Z, Assante R, Buongiorno P, Mannarino T, Raddi M, Genova A, D"antonio A, Arumugam P, Cuocolo A. 354Association between pericoronary fat thickness and coronary vascular function by 82Rb PET/CT in patients with suspected coronary artery disease and normal myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez146.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Nappi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - W Acampa
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - V Gaudieri
- National Research Council, Institute of Biostructure and Bioimaging, Naples, Italy
| | - Z Zampella
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - R Assante
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Buongiorno
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - T Mannarino
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - M Raddi
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A Genova
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - A D"antonio
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
| | - P Arumugam
- Central Manchester Foundation Trust, Department of Nuclear Medicine, Manchester, United Kingdom, United Kingdom of Great Britain & Northern Ireland
| | - A Cuocolo
- Federico II University of Naples, Department of Advanced Biomedical Sciences, Naples, Italy
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36
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Moody WE, Motwani M, Arumugam P. P124Sequential CT coronary angiography and 82-Rb positron emission tomography: Defining the quantitative relationships between coronary artery calcium, coronary stenosis and myocardial blood flow reserve. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W E Moody
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - M Motwani
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - P Arumugam
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
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Ananthasubramaniam K, Arumugam P. Quantitative 82Rb dynamic pet perfusion analysis with kinetic modeling for myocardial viability: Can we get away with just 82Rb perfusion kinetics? J Nucl Cardiol 2019; 26:387-390. [PMID: 30809756 DOI: 10.1007/s12350-019-01616-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 11/29/2022]
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Armstrong IS, Tonge CM, Arumugam P. Assessing time-of-flight signal-to-noise ratio gains within the myocardium and subsequent reductions in administered activity in cardiac PET studies. J Nucl Cardiol 2019; 26:405-412. [PMID: 28497418 DOI: 10.1007/s12350-017-0916-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 04/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Time-of-flight (TOF) is known to increase signal-to-noise ratio (SNR) and facilitate reductions in administered activity. Established measures of SNR gain are derived from areas of uniform uptake, which is not applicable to the heterogeneous uptake in cardiac PET images using fluoro-deoxyglucose (FDG). This study aimed to develop a technique to quantify SNR gains within the myocardium due to TOF. METHODS Reference TOF SNR gains were measured in 88 FDG oncology patients. Phantom data were used to translate reference SNR gains and validate a method of quantifying SNR gains within the myocardium from parametric images produced from multiple replicate images. This technique was applied to 13 FDG cardiac viability patients. RESULTS Reference TOF SNR gains of +23% ± 8.5% were measured in oncology patients. Measurements of SNR gain from the phantom data were in agreement and showed the parametric image technique to be sufficiently robust. SNR gains within the myocardium in the viability patients were +21% ± 2.8%. CONCLUSION A method to quantify SNR gains from TOF within the myocardium has been developed and evaluated. SNR gains within the myocardium are comparable to those observed by established methods. This allows guidance for protocol optimization for TOF systems in cardiac PET.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, UK.
| | - Christine M Tonge
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, UK
| | - Parthiban Arumugam
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, UK
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Moody WE, Schmitt M, Arumugam P. Coronary microvascular dysfunction in hypertrophic cardiomyopathy detected by Rubidium-82 positron emission tomography and cardiac magnetic resonance imaging. J Nucl Cardiol 2019; 26:666-670. [PMID: 29516367 PMCID: PMC6430745 DOI: 10.1007/s12350-018-1245-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 11/25/2022]
Affiliation(s)
- William E Moody
- Department of Cardiology, Nuffield House, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK.
- Nuclear Medicine Centre, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
| | - Matthias Schmitt
- Department of Cardiology, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Wythenshawe, Manchester, M23 9LT, UK
| | - Parthiban Arumugam
- Nuclear Medicine Centre, Manchester Royal Infirmary, Manchester, M13 9WL, UK
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Gaudieri V, Acampa W, Rozza F, Nappi C, Zampella E, Assante R, Mannarino T, Mainolfi C, Petretta M, Verberne HJ, Arumugam P, Cuocolo A. Coronary vascular function in patients with resistant hypertension and normal myocardial perfusion: a propensity score analysis. Eur Heart J Cardiovasc Imaging 2019; 20:949-958. [DOI: 10.1093/ehjci/jez025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/30/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Aims
Impaired myocardial perfusion reserve (MPR) may occur earlier than coronary atherosclerosis and it may be an early manifestation of developing coronary artery disease (CAD) in patients with resistant hypertension (RH). We evaluated the relationship between RH and MPR in patients with systemic arterial hypertension after balancing for coronary risk factors.
Methods and results
We studied 360 subjects without overt CAD and normal myocardial perfusion at stress-rest 82Rb positron emission tomography/computed tomography. To account for differences in baseline characteristics between patients with resistant and controlled hypertension, we created a propensity score-matched cohort considering clinical variables and coronary risk factors. Before matching, patients with RH were significantly older, had higher prevalence of male gender and hypercholesterolaemia, and showed significantly lower global hyperaemic myocardial blood flow (MBF) and MPR compared with those with controlled hypertension, while baseline MBF and coronary artery calcium (CAC) content were similar in both groups. After matching, there were no significant differences in clinical variables and coronary risk factors between patients with resistant and controlled hypertension, but patients with RH still had lower hyperaemic MBF and MPR (both P < 0.001). At univariable and multivariable linear regression analyses, age, RH, and CAC resulted significant predictors of lower MPR values (all P < 0.05).
Conclusion
After balancing clinical characteristic by propensity score analysis, patients with RH had a blunted hyperaemic MBF and MPR compared with patients with controlled hypertension. The identification of impaired MPR could help to identify early structural alterations of the arterial walls in patients with RH.
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Affiliation(s)
- Valeria Gaudieri
- Institute of Biostructure and Bioimaging, National Council of Research, Via De Amicis 95, Naples, Italy
| | - Wanda Acampa
- Institute of Biostructure and Bioimaging, National Council of Research, Via De Amicis 95, Naples, Italy
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Francesco Rozza
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Ciro Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Via Pansini 5, Naples, Italy
| | - Hein J Verberne
- Department of Nuclear Medicine, Academic Medical Center University of Amsterdam, Meibergdreef 9, AZ, Amsterdam, The Netherlands
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester Foundation Trust, Manchester, UK
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, Naples, Italy
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Memmott MJ, Tonge CM, Saint KJ, Arumugam P. Impact of pharmacological stress agent on patient motion during rubidium-82 myocardial perfusion PET/CT. J Nucl Cardiol 2018; 25:1286-1295. [PMID: 28054183 DOI: 10.1007/s12350-016-0767-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patient motion has been demonstrated to have a significant impact on the quality and accuracy of rubidium-82 myocardial perfusion PET/CT. This study aimed to investigate the effect on patient motion of two pharmacological stressing agents, adenosine and regadenoson. METHODS AND RESULTS Dynamic data were retrospectively analyzed in 90 patients undergoing adenosine (n = 30), incremental adenosine (n = 30), or regadenoson (n = 30) rubidium-82 myocardial perfusion PET/CT. Severity of motion was scored qualitatively using a four-point (0-3) scale and quantitatively using frame-to-frame pixel shifts. The type of motion, returning or non-returning, and the frame in which it occurred were also recorded. There were significant differences in both the qualitative and quantitative scores comparing regadenoson to adenosine (P = .025 and P < .001) and incremental adenosine (P = .014, P = .015), respectively. The difference in scores between adenosine and incremental adenosine was not significant. Where motion was present, significantly more adenosine patients were classed as non-returning (P = .018). The median frames for motion occurring were 12 for regadenoson and 14 for both adenosine cohorts. CONCLUSIONS The choice of stressing protocol impacts significantly on patient motion. Patients stressed with regadenoson have significantly lower motion scores than those stressed with adenosine, using local protocols. This motion is more likely to be associated with a drift of the heart away from a baseline position, coinciding with the termination of infusion.
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Affiliation(s)
- Matthew J Memmott
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom.
| | - Christine M Tonge
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Kimberley J Saint
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Parthiban Arumugam
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
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Armstrong IS, Memmott MJ, Tonge CM, Arumugam P. The impact of prompt gamma compensation on myocardial blood flow measurements with rubidium-82 dynamic PET. J Nucl Cardiol 2018; 25:596-605. [PMID: 27624818 DOI: 10.1007/s12350-016-0583-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 06/17/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Rubidium-82 myocardial perfusion imaging is a well-established technique for assessing myocardial ischemia. With continuing interest on myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements, there is a requirement to fully appreciate the impact of technical aspects of the process. One such factor for rubidium-82 is prompt gamma compensation (PGC). This study aims to assess the impact of PGC on MBF and MFR calculated from dynamic Rb-82 data. METHODS Dynamic rest and stress images were acquired on a Siemens Biograph mCT and reconstructed with and without PGC in 50 patients (29 male). MBF and MFR were measured in the three main coronary territories as well as globally. RESULTS With PGC, statistically significant reductions in MBF were observed in LAD (-6.9%), LCx (-4.8%), and globally (-6.5%) but only in obese patients. Significant increases in MBF were observed in RCA (+6.4%) in only nonobese patients. In very obese patients, differences of up to 40% in MBF were observed between PGC and non-PGC images. In nearly all cases, similar PGC differences were observed at stress and rest so there were no significant differences in MFR; however, in a small number of very obese patients, differences in excess of 20% were observed. CONCLUSION PGC results in statistically significant changes in MBF, with the greatest reductions observed in the LAD and LCx territories of obese patients. In most cases, the impact on stress and rest data is of similar relative magnitudes and changes to MFR are small.
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Affiliation(s)
- Ian S Armstrong
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom.
| | - Matthew J Memmott
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Christine M Tonge
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Parthiban Arumugam
- Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
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Wilson G, Mullamitha S, Bentley D, Bell J, Mullan D, Carter L, Chittalia A, Howell S, Laasch HU, Westwood T, Jeans S, Tipping J, Ryder D, Farquharson F, Arumugam P, Sheen A, Rajashanker B, Armstrong A, Misra V, Manoharan P, Lawrance J. Abstract P1-14-06: Selective internal radiation therapy (SIRT) with Yttrium-90 resin microspheres and FOLFOX/5FU chemotherapy in pre-treated breast cancer patients with liver metastases: A retrospective analysis of response rates, times to progression and survival of patients treated in Manchester UK between 2010 and 2016. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-14-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
SIRT is a globally licensed technique of Radio-Embolization (RE) of hepatic tumors via intra-arterial infusion of β-particle emitting Yttrium-90 (Y-90) radio-labelled microspheres. It increases response rates and hepatic time to progression in metastatic colorectal cancer when used in combination with 5FU/Oxaliplatin (FOLFOX) chemotherapy with acceptable toxicity profile. FOLFOX gives a radio-sensitizing effect and also controls disease outside the liver. Breast cancer liver metastases (BCLM) patients often have extra-hepatic disease and respond to multiple lines of systemic therapy and SIRT is infrequently used.
Methods and patients
Between 2010 and 2016 we treated 25 BCLM patients with Y-90 SIRT.
Receptor status: 20 ER+ve/HER-2 -ve, 3 ER-ve/HER-2 +ve, 2 triple -ve.
Eleven patients had liver only disease with 14 also having known extra-hepatic disease. Average number of previous lines of therapy in metastatic setting: chemotherapy = 2.4; endocrine = 1. Sixty-four % patients had prior Capecitabine (n=16); 12% platinum (n=3, all Carboplatin). Twenty patients received chemotherapy with SIRT: 17 had modified FOLFOX6 (Oxaliplatin/bolus 5FU day1, infusional 5FU day 1-3 (46 hrs); 3 patients had Modified de Gramont style 5FU alone. Five patients had no chemotherapy.
Sir-spheres were inserted on day 2 of FOLFOX with the 5FU infusion pump continuing to day 3. Further 2-weekly FOLFOX chemo cycles were at clinician's discretion: average number delivered 3.8. Four patients had the liver treated in two halves, approximately 6 weeks apart. One patient received SIRT only to half the liver. Patients were imaged with PET-CT/CT before and 2-3 months after SIRT. Retrospective case note review was performed and data correlated to evaluate tumor response (RR); hepatic and extra hepatic progression free survival (HPFS and EHPFS) and overall survival (OS). Accurate toxicity data was not recorded.
Results
Hepatic CT response rates: PR 56% (n=14), SD 28% (n=7) and PD 16% (n=4). Hepatic PET response rates: CR 32% (n=8), PR 40% (n=10), SD 12% (n=3), PD 16%(n=4). (Overall PET liver disease control rate = 84%).
Eight patients (32%) had extra-hepatic PD at first assessment. Of them, 4 had PR, 2 SD and 2 PD in the liver at that assessment. Two HER-2 +ve patients had brain metastases as first sign of PD within 75 days, an area not previously screened. Of 16 pre-treated with Capecitabine, liver CT response rates: 62.5% PR, 18.75% SD (n=10,3). Post SIRT/FOLFOX, average number of therapy lines: 2 for chemo and 0.75 for endocrine, with 8 patients still alive at time of censoring.
Median OS: 766 HPFS: 210 days (CI 140-286). Median EHPFS in patients with extra-hepatic disease: 152 days (CI 96-636).
Conclusions
SIRT with FOLFOX in previously treated BCLM patients produces high response rates, excellent tumor control and time to progression in the liver with good overall survival. It does not seem to decrease the ability to give further lines of chemotherapy and can be considered as an option for breast cancer patients with liver metastases.
Citation Format: Wilson G, Mullamitha S, Bentley D, Bell J, Mullan D, Carter L, Chittalia A, Howell S, Laasch H-U, Westwood T, Jeans S, Tipping J, Ryder D, Farquharson F, Arumugam P, Sheen A, Rajashanker B, Armstrong A, Misra V, Manoharan P, Lawrance J. Selective internal radiation therapy (SIRT) with Yttrium-90 resin microspheres and FOLFOX/5FU chemotherapy in pre-treated breast cancer patients with liver metastases: A retrospective analysis of response rates, times to progression and survival of patients treated in Manchester UK between 2010 and 2016 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-14-06.
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Affiliation(s)
- G Wilson
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Mullamitha
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Bentley
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Bell
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Mullan
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - L Carter
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Chittalia
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Howell
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - H-U Laasch
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - T Westwood
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - S Jeans
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Tipping
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - D Ryder
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - F Farquharson
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - P Arumugam
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Sheen
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - B Rajashanker
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - A Armstrong
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - V Misra
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - P Manoharan
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
| | - J Lawrance
- The Christie NHS Foundation Trust, Manchester, Lancashire, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester, Lancashire, United Kingdom
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Assante R, Acampa W, Zampella E, Arumugam P, Nappi C, Gaudieri V, Mainolfi CG, Panico M, Magliulo M, Tonge CM, Petretta M, Cuocolo A. Prognostic value of atherosclerotic burden and coronary vascular function in patients with suspected coronary artery disease. Eur J Nucl Med Mol Imaging 2017; 44:2290-2298. [PMID: 28815291 DOI: 10.1007/s00259-017-3800-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/03/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE To evaluate the prognostic value of coronary atherosclerotic burden, assessed by coronary artery calcium (CAC) score, and coronary vascular function, assessed by coronary flow reserve (CFR) in patients with suspected coronary artery disease (CAD). METHODS We studied 436 patients undergoing hybrid 82Rb positron emission tomography/computed tomography imaging. CAC score was measured according to the Agatston method, and patients were categorized into three groups (0, <400, and ≥400). CFR was calculated as the ratio of hyperemic to baseline myocardial blood flow, and it was considered reduced when <2. RESULTS Follow-up was 94% complete during a mean period of 47±15 months. During follow-up, 17 events occurred (4% cumulative event rate). Event-free survival decreased with worsening of CAC score category (p < 0.001) and in patients with reduced CFR (p < 0.005). At multivariable analysis, CAC score ≥400 (p < 0.01) and CFR (p < 0.005) were independent predictors of events. Including CFR in the prognostic model, continuous net reclassification improvement was 0.51 (0.14 in patients with events and 0.37 in those without). At classification and regression tree analysis, the initial split was on CAC score. For patients with a CAC score < 400, no further split was performed, while patients with a CAC score ≥400 were further stratified by CFR values. Decision curve analyses indicate that the model including CFR resulted in a higher net benefit across a wide range of decision threshold probabilities. CONCLUSIONS In patients with suspected CAD, CFR provides significant incremental risk stratification over established cardiac risk factors and CAC score for prediction of adverse cardiac events.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.,Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Parthiban Arumugam
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | | | - Mariarosaria Panico
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Mario Magliulo
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Christine M Tonge
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Aslam S, Khan M, Venetucci L, Arumugam P. Adenosine induced coronary vasospasm during Rubidium PET myocardial perfusion scan in a patient with Takayasu's Arteritis. J Nucl Cardiol 2017; 24:1114-1116. [PMID: 27324345 DOI: 10.1007/s12350-016-0566-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Saadia Aslam
- Manchester Royal Infirmary, Manchester Heart Centre, Manchester, United Kingdom
| | - Muhammad Khan
- Manchester Royal Infirmary, Manchester Heart Centre, Manchester, United Kingdom
| | - Luigi Venetucci
- Manchester Royal Infirmary, Manchester Heart Centre, Manchester, United Kingdom
| | - Parthiban Arumugam
- Manchester Royal Infirmary, Nuclear Medicine Centre, Manchester, United Kingdom.
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Assante R, Zampella E, Arumugam P, Acampa W, Imbriaco M, Tout D, Petretta M, Tonge C, Cuocolo A. Quantitative relationship between coronary artery calcium and myocardial blood flow by hybrid rubidium-82 PET/CT imaging in patients with suspected coronary artery disease. J Nucl Cardiol 2017; 24:494-501. [PMID: 26780529 DOI: 10.1007/s12350-015-0359-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/20/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND We assessed the relationship between coronary artery calcium (CAC) score, myocardial blood flow (MBF) and coronary flow reserve (CFR) in patients undergoing hybrid 82Rb positron emission tomography (PET)/computed tomography (CT) imaging for suspected CAD. We also evaluated if CAC score is able to predict a reduced CFR independently from conventional coronary risk factors. METHODS A total of 637 (mean age 58 ± 13 years) consecutive patients were studied. CAC score was measured according to the Agatston method and patients were categorized into 4 groups (0, 0.01-99.9, 100-399.9, and ≥400). Baseline and hyperemic MBF were automatically quantified. CFR was calculated as the ratio of hyperemic to baseline MBF and it was considered reduced when <2. RESULTS Global CAC score showed a significant inverse correlation with hyperemic MBF and CFR (both P < .001), while no correlation between CAC score and baseline MBF was found. At multivariable logistic regression analysis age, diabetes and CAC score were independently associated with reduced CFR (all P < .001). The addition of CAC score to clinical data increased the global chi-square value for predicting reduced CFR from 81.01 to 91.13 (P < .01). Continuous net reclassification improvement, obtained by adding CAC score to clinical data, was 0.36. CONCLUSIONS CAC score provides incremental information about coronary vascular function over established CAD risk factors in patients with suspected CAD and it might be helpful for identifying those with a reduced CFR.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Parthiban Arumugam
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - 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
| | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Deborah Tout
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Christine Tonge
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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Armstrong IS, Saint KJ, Tonge CM, Arumugam P. Evaluation of general-purpose collimators against high-resolution collimators with resolution recovery with a view to reducing radiation dose in myocardial perfusion SPECT: A preliminary phantom study. J Nucl Cardiol 2017; 24:596-604. [PMID: 26809437 DOI: 10.1007/s12350-015-0368-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/28/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is a growing focus on reducing radiation dose to patients undergoing myocardial perfusion imaging. This preliminary phantom study aims to evaluate the use of general-purpose collimators with resolution recovery (RR) to allow a reduction in patient radiation dose. METHODS Images of a cardiac torso phantom with inferior and anterior wall defects were acquired on a GE Infinia and Siemens Symbia T6 using both high-resolution and general-purpose collimators. Imaging time, a surrogate for administered activity, was reduced between 35% and 40% with general-purpose collimators to match the counts acquired with high-resolution collimators. Images were reconstructed with RR with and without attenuation correction. Two pixel sizes were also investigated. Defect contrast was measured. RESULTS Defect contrast on general-purpose images was superior or comparable to the high-resolution collimators on both systems despite the reduced imaging time. Infinia general-purpose images required a smaller pixel size to be used to maintain defect contrast, while Symbia T6 general-purpose images did not require a change in pixel size to that used for standard myocardial perfusion SPECT. CONCLUSION This study suggests that general-purpose collimators with RR offer a potential for substantial dose reductions while providing similar or better image quality to images acquired using high-resolution collimators.
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Affiliation(s)
- Ian S Armstrong
- Department of Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom.
| | - Kimberley J Saint
- Department of Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Christine M Tonge
- Department of Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
| | - Parthiban Arumugam
- Department of Nuclear Medicine, Central Manchester University Hospitals, Oxford Road, Manchester, M13 9WL, United Kingdom
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Assante R, Acampa W, Zampella E, Arumugam P, Nappi C, Gaudieri V, Panico M, Magliulo M, Tonge CM, Petretta M, Cuocolo A. Coronary atherosclerotic burden vs. coronary vascular function in diabetic and nondiabetic patients with normal myocardial perfusion: a propensity score analysis. Eur J Nucl Med Mol Imaging 2017; 44:1129-1135. [PMID: 28293706 DOI: 10.1007/s00259-017-3671-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 02/28/2017] [Indexed: 01/25/2023]
Abstract
PURPOSE To assess the relationship between coronary atherosclerotic burden and vascular function in diabetic and nondiabetic patients after balancing for coronary risk factors. METHODS We studied 672 patients without overt coronary artery disease and normal myocardial perfusion on stress 82Rb PET/CT imaging. To account for differences in baseline characteristics between diabetic patients and nondiabetic patients, we created a propensity score-matched cohort considering clinical variables and coronary risk factors. RESULTS Before matching, diabetic patients had higher coronary artery calcium (CAC) scores (p < 0.001) and lower coronary flow reserve (CFR; p < 0.001) than nondiabetic patients. After matching, CAC scores were comparable between diabetic and nondiabetic patients, but diabetic patients still had lower hyperaemic myocardial blood flow (p < 0.001) and CFR (p < 0.05). Patients were categorized by ln(CAC score) quartiles. There was a decrease in CFR with increasing CAC score quartile in both diabetic patients (p for trend < 0.01) and nondiabetic patients (p for trend < 0.005). Diabetes was associated with lower CFR across quartile categories (p < 0.002). In a multivariable linear regression analysis, CAC score was inversely related to CFR in both diabetic patients (p < 0.05) and nondiabetic patients (p < 0.001). CONCLUSION Diabetic patients had higher CAC scores than nondiabetic patients, but the difference disappeared when clinical characteristics were taken into account. Of note, diabetic patients also had lower CFR regardless of CAC score than nondiabetic patients after matching. Thus, coronary atherosclerotic burden and vascular function have to be seen as two different entities.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.,Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Parthiban Arumugam
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Valeria Gaudieri
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Mariarosaria Panico
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Mario Magliulo
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Christine M Tonge
- Nuclear Medicine Center, Central Manchester University Teaching Hospitals, Manchester, UK
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
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Rajesh V, Sophiya J, Jacob SJP, Arumugam P, Jayaraman P. Biosynthesis of Silver Nanoparticles Using Diospyros ferrea (willd.) Bakh. Leaves and Evaluation of Its Antioxidant, Anti-Inflammatory, Antimicrobial and Anticancer Activity. ACTA ACUST UNITED AC 2017. [DOI: 10.1166/jbns.2017.1408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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