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Myocardial perfusion imaging

Niels Peter Rønnow Sand, Karsten Tange Veien, Søren Steen Nielsen, Bjarne Linde Nørgaard, Pia Larsen, Allan Johansen, Søren Hess, Lone Deibjerg, Majed Husain, Anders Junker, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen
OBJECTIVES: This study sought to compare the per-patient diagnostic performance of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT ) with that of single-photon emission computed tomography (SPECT), using a fractional flow reserve (FFR) value of ≤0.80 as the reference for diagnosing at least 1 hemodynamically significant stenosis in a head-to-head comparison of patients with intermediate coronary stenosis as determined by coronary CTA. BACKGROUND: No previous study has prospectively compared the diagnostic performance of FFRCT and myocardial perfusion imaging by SPECT in symptomatic patients with intermediate range coronary artery disease (CAD)...
June 9, 2018: JACC. Cardiovascular Imaging
Melinda D Wu, Federico Moccetti, Eran Brown, Brian P Davidson, Tamara Atkinson, J Todd Belcik, George Giraud, P Barton Duell, Sergio Fazio, Hagai Tavori, Sotirios Tsimikas, Jonathan R Lindner
OBJECTIVES: The study evaluated whether lipoprotein apheresis produces immediate changes in resting perfusion in subjects with severe hypercholesterolemia, and whether there is a difference in the response between peripheral and coronary microcirculations. BACKGROUND: Lipoprotein apheresis is used in patients with severe hypercholesterolemia to reduce plasma levels of low-density lipoprotein cholesterol. METHODS: Quantitative contrast-enhanced ultrasound perfusion imaging of the myocardium at rest and skeletal muscle at rest and during calibrated contractile exercise was performed before and immediately after lipoprotein apheresis in 8 subjects with severe hypercholesterolemia, 7 of whom had a diagnosis of familial hypercholesterolemia...
June 9, 2018: JACC. Cardiovascular Imaging
Paul K R Dasari, Judson P Jones, Michael E Casey, Yuanyuan Liang, Vasken Dilsizian, Mark F Smith
BACKGROUND: The effect of time-of-flight (TOF) and point spread function (PSF) modeling in image reconstruction has not been well studied for cardiac PET. This study assesses their separate and combined influence on 82 Rb myocardial perfusion imaging in obese patients. METHODS: Thirty-six obese patients underwent rest-stress 82 Rb cardiac PET. Images were reconstructed with and without TOF and PSF modeling. Perfusion was quantitatively compared using the AHA 17-segment model for patients grouped by BMI, cross-sectional body area in the scanner field of view, gender, and left ventricular myocardial volume...
June 15, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Felix G Meinel, U Joseph Schoepf, Jacob C Townsend, Brian A Flowers, Lucas L Geyer, Ullrich Ebersberger, Aleksander W Krazinski, Wolfgang G Kunz, Kolja M Thierfelder, Deborah W Baker, Ashan M Khan, Valerian L Fernandes, Terrence X O'Brien
We aimed to determine the diagnostic yield and accuracy of coronary CT angiography (CCTA) in patients referred for invasive coronary angiography (ICA) based on clinical concern for coronary artery disease (CAD) and an abnormal nuclear stress myocardial perfusion imaging (MPI) study. We enrolled 100 patients (84 male, mean age 59.6 ± 8.9 years) with an abnormal MPI study and subsequent referral for ICA. Each patient underwent CCTA prior to ICA. We analyzed the prevalence of potentially obstructive CAD (≥50% stenosis) on CCTA and calculated the diagnostic accuracy of ≥50% stenosis on CCTA for the detection of clinically significant CAD on ICA (defined as any ≥70% stenosis or ≥50% left main stenosis)...
June 15, 2018: Scientific Reports
Alan Rozanski, Daniel S Berman
PURPOSE OF REVIEW: This review aims to assess the synergistic use of coronary artery calcium (CAC) scanning and stress-rest SPECT myocardial perfusion imaging (MPI) for the workup of patients with suspected coronary artery disease (CAD). RECENT FINDINGS: The CAC score bears a proportional relationship to both the frequency of obstructive CAD and inducible ischemia. Consequently, the test can be used to improve the Bayesian assessment of pre-test CAD likelihood and assist in triaging patients for stress testing...
June 13, 2018: Current Cardiology Reports
Xiaochun Lai, Yoann Petibon, Georges El Fakhri, Jinsong Ouyang
Myocardial perfusion imaging (MPI) using rest/stress single photon emission computed tomography (SPECT) allows non-invasive assessment of reversible cardiac perfusion defects. Conventionally, reversible defects are identified using a difference image, called reversible map, obtained by subtracting the stress image from the rest image after registration and normalization of the two images. The identification of reversible defects using the conventional subtraction method is however limited by noise. We propose to jointly reconstruct rest and stress projection data to directly obtain the reversible map in a single reconstruction framework to improve the detectability of reversible defects...
June 13, 2018: Physics in Medicine and Biology
Michael McGee, David Ferreira, Olav Tvedten, Ehsan Mahmoodi, Nicholas Whitehead, David Baker, Stuart Sugito, Allan Davies, Stuart Turner, Andrew Boyle
Myocardial perfusion scanning (MPS) is commonly used to assess patients with an intermediate to high risk of coronary artery disease. Concerns have been raised about the accuracy of this test. There is little recent data regarding the specificity of the MPS in the context of current medical therapy. The primary objective of this study is to determine the specificity of MPS in diagnosing obstructive coronary artery disease. A total of 184 patients fulfilled study criteria. The overall specificity of MPS for obstructive coronary artery disease was 54%...
May 27, 2018: Heart, Lung & Circulation
Mojtaba Ansari, Hoda Hashemi, Mehdi Soltanshahi, Mohsen Qutbi, Zahra Azizmohammadi, Faraj Tabeie, Hamid Javadi, Esmail Jafari, Maryam Barekat, Majid Assadi
OBJECTIVE: Evaluating the effects of heart cavity volume, presence and absence of perfusion defect, gender and type of study (stress and rest) on the difference of systolic parameters of myocardial perfusion scan in 16 and 8 framing gated SPECT imaging. METHODS: Cardiac gated SPECT in both 16 and 8 framing simultaneously and both stress and rest phases at one-day protocol was performed for 50 patients. Data have been reconstructed by filter back projection (FBP) method and left ventricular (LV) systolic parameters were calculated by using QGS software...
June 7, 2018: Molecular Imaging and Radionuclide Therapy
Heng Ma, Yue Zhang, Jingjing Chen, Jun Yang
RATIONALE AND OBJECTIVES: Sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution, and signal-to-noise ratio compared to the conventional 3-slice saturation recovery turbo-fast low-angle shot (SR-Turbo-FLASH) sequence. We prospectively compared the diagnostic value of whole leftventricular coverage myocardial perfusion magnetic resonance imaging (MRI) and conventional 3-slice technique in patients with suspected coronary artery disease (CAD)...
June 7, 2018: Academic Radiology
Christopher W Ives, Wael A AlJaroudi, Vineeta Kumar, Ayman Farag, Dana V Rizk, Suzanne Oparil, Ami E Iskandrian, Fadi G Hage
PURPOSE: Noninvasive stress testing is commonly performed as part of pre-renal transplantation (RT) evaluation. We evaluated the prognostic value of myocardial perfusion imaging (MPI)-myocardial perfusion, left ventricular ejection fraction (LVEF) and heart rate response (HRR)-post-RT. METHODS: Consecutive RT recipients were identified at our institution. MPI was considered abnormal when there was a perfusion defect or reduced ejection fraction. HRR to vasodilator stress was calculated as percentage change from baseline...
June 7, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Nicole M Bhave, Christoph A Nienaber, Rachel E Clough, Kim A Eagle
In diagnosing and following patients with acute aortic syndromes and thoracic aortic aneurysms, high-quality imaging of the thoracic aorta is indispensable. Mainstay modalities for thoracic aortic imaging are echocardiography, computed tomographic angiography, and magnetic resonance angiography. For any given clinical scenario, the imaging modality and protocol chosen will have a significant impact on sensitivity and specificity for the aortic diagnosis of concern. Imaging can also provide important ancillary information regarding myocardial performance, aortic valve morphology and function, and end-organ perfusion...
June 2018: JACC. Cardiovascular Imaging
Masanao Naya, Yukari Uemura, Naoya Matsumoto, Mitsuru Momose, Takao Kato, Satoshi Hida, Takao Yamauchi, Takatomo Nakajima, Eriko Suzuki, Nagara Tamaki
BACKGROUND: The effects of initial tests on long-term events have been unknown. PATIENTS AND METHODS: In this observational retrospective study, we analyzed the effects of initial noninvasive tests by myocardial perfusion imaging (MPI) and computed tomography angiography (CTA) on long-term major adverse cardiac events (MACEs) among patients with suspected coronary artery disease during a median follow-up of 8.1 years (interquartile range: 7.7-8.9). RESULTS: Sex difference in the rate of abnormal findings on initial tests was observed in both the MPI (female vs...
June 5, 2018: Coronary Artery Disease
Rene Nkoulou, Tobias Fuchs, Aju P Pazhenkottil, Mathias Wolfrum, Ronny R Buechel, Oliver Gaemperli, Philipp A Kaufmann
Aims: We validated a 1-day myocardial perfusion imaging (MPI) protocol using an ultra low-dose(ULD) equal for stress and rest on a cadmium zinc telluride (CZT). Methods and results: Fifty-six patients underwent a 1-day MPI protocol using a standard (SD) 99mTc-tetrofosmin dose at stress (320 MBq) and rest (960 MBq) with 5 min acquisition time each (SD). Within 2 weeks MPI was repeated using ULD 99mTc-tetrofosmin equal for stress and rest (160 MBq) with 15 min acquisition time each (ULD)...
June 2, 2018: European Heart Journal Cardiovascular Imaging
Sanjay R Kharche, Aaron So, Fabio Salerno, Ting-Yim Lee, Chris Ellis, Daniel Goldman, Christopher W McIntyre
Dialysis prolongs life but augments cardiovascular mortality. Imaging data suggests that dialysis increases myocardial blood flow (BF) heterogeneity, but its causes remain poorly understood. A biophysical model of human coronary vasculature was used to explain the imaging observations, and highlight causes of coronary BF heterogeneity. Post-dialysis CT images from patients under control, pharmacological stress (adenosine), therapy (cooled dialysate), and adenosine and cooled dialysate conditions were obtained...
2018: Frontiers in Physiology
Pieter van der Bijl, Victoria Delgado, Marianne Bootsma, Jeroen J Bax
The etiology of dilated cardiomyopathy (DCM) can be grouped as either genetic or nongenetic. More than 50 pathogenic genes have been described, with sarcomeric and lamin A/C mutations being the most common. Mutation carriers for genetic DCM are often asymptomatic until cardiac disease manifests with heart failure, arrhythmias, or sudden cardiac death. Preventive strategies are promising but can only be applied and tested adequately if genetic DCM can be diagnosed at an early stage. Early diagnosis of mutation carriers that may develop overt DCM requires advanced imaging techniques that can detect subtle structural and functional abnormalities...
June 5, 2018: Circulation
Narges Salehi, Arman Rahmim, Emad Fatemizadeh, Afshin Akbarzadeh, Mohammad Hossein Farahani, Saeed Farzanefar, Mohammad Reza Ay
INTRODUCTION: Cardiac contraction significantly degrades quality and quantitative accuracy of gated myocardial perfusion SPECT (MPS) images. In this study, we aimed to explore different techniques in motion-compensated temporal processing of MPS images and their impact on image quality and quantitative accuracy. MATERIAL AND METHOD: 50 patients without known heart condition underwent gated MPS. 3D motion compensation methods using Motion Freezing by Cedars Sinai (MF), Log-domain Diffeomorphic Demons (LDD) and Free-Form Deformation (FFD) were applied to warp all image phases to fit the end-diastolic (ED) phase...
May 2018: Physica Medica: PM
Nikolaos Karogiannis, Anastasia Vamvakidou, Sothinathan Gurunathan, Jatinder Pabla, Grace Young, Roxy Senior
BACKGROUND: Single-photon emission computed tomography (SPECT) is a well-established method to evaluate patients with coronary artery disease. Myocardial contrast echocardiography (MCE) is an imaging technique that allows the assessment of myocardial perfusion in real time. Previous research has shown that vasodilator MCE is superior to SPECT for the prediction of hard events. The aim of this study was to investigate the long-term association of SPECT and MCE with clinical outcomes in patients with known or suspected coronary artery disease...
May 31, 2018: Journal of the American Society of Echocardiography
Mamoru Nanasato, Naoya Matsumoto, Kenichi Nakajima, Taishiro Chikamori, Masao Moroi, Kazuya Takehana, Mitsuru Momose, Hidetaka Nishina, Tokuo Kasai, Shunichi Yoda, Keisuke Kiso, Hiroyuki Yamamoto, Shigeyuki Nishimura, Akira Yamashina, Hideo Kusuoka, Atsushi Hirayama, Tsunehiko Nishimura
AIM: Whether myocardial ischemia identified using myocardial perfusion imaging (MPI) can be an alternative target of coronary revascularization to reduce the incidence of cardiac events remains unclear. METHODS AND RESULTS: This multicenter, prospective cohort study aimed to clarify the prognostic impact of reducing myocardial ischemia. Among 494 registered patients with possible or definite coronary artery disease (CAD), 298 underwent initial pharmacological stress 99m Tc-tetrofosmin MPI before, and eight months after revascularization or medical therapy, and were followed up for at least one year...
May 24, 2018: International Journal of Cardiology
Sangwon Han, Young-Hak Kim, Jung-Min Ahn, Soo-Jin Kang, Jungsu S Oh, Eonwoo Shin, Changhwan Sung, Sun Young Chae, Seung-Jung Park, Gillan Grimberg, Gil Kovalski, Dae Hyuk Moon
PURPOSE: We evaluated the feasibility of dynamic stress 201 Tl/rest 99m Tc-tetrofosmin SPECT imaging using a cardiac camera equipped with cadmium-zinc-telluride detectors for the quantification of myocardial perfusion reserve (MPR). METHODS: Subjects with stable known or suspected coronary artery disease (CAD) who had undergone or were scheduled to undergo fractional flow reserve (FFR) measurement were prospectively enrolled. Dynamic stress 201 Tl/rest 99m Tc-tetrofosmin SPECT imaging was performed using a dedicated multiple pinhole SPECT camera with cadmium-zinc-telluride detectors...
June 2, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Evan C Adelstein, Andrew D Althouse, David Schwarzman, Sandeep K Jain, Prem Soman, Samir Saba
BACKGROUND: Patients with non-specific intraventricular conduction delay (IVCD) benefit less from cardiac resynchronization therapy (CRT) than patients with left bundle-branch block (LBBB). OBJECTIVE: To determine whether post-CRT outcome differences in patients with ischemic cardiomyopathy (ICM) relate to intrinsic QRS pattern and/or scar burden. METHODS: We analyzed 393 consecutive ICM patients with LVEF ≤35%, QRS duration >120 ms, and LBBB or non-specific IVCD who underwent single-photon emission computed tomography myocardial perfusion imaging and CRT-defibrillator implant...
May 28, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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