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Journal of Nuclear Cardiology
Journal Prestige (SJR): 0.796
Citation Impact (citeScore): 2
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1071-3581 - ISSN (Online) 1532-6551
Published by Springer-Verlag Homepage  [2467 journals]
  • Evaluation of isolated cardiac sarcoidosis applying updated Japanese
           guidelines

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      PubDate: 2023-01-28
       
  • Performance of 8- vs 16 ECG-gated reconstructions in assessing myocardial
           function using Rubidium-82 myocardial perfusion imaging: Findings in a
           young, healthy population

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      Abstract: Background Current imaging guidelines recommend using at least 16 ECG gates when performing MUGA and cardiac SPECT to assess left ventricular ejection fraction (LVEF). However, for Rubidium-82 (82Rb) PET, 8 ECG-gated reconstructions have been a mainstay. This study investigated the implications of quantitative assessments when employing 16 gate, instead of 8 gate, reconstructions for 82Rb myocardial perfusion imaging (MPI). Methods The study comprised 25 healthy volunteers (median age 23 years) who underwent repeat MPI sessions employing 82Rb PET/CT. We report LVEF, its reserve (stress LVEF – rest LVEF), and their repeatability measures (RMS method) obtained for 8- and 16 ECG-gated reconstructions. Results Similar LVEF and LVEF reserve estimates were found for the 8- and 16-gated reconstructions ([%] LVEF (8/16 gates): rest = 61 ± 6/64 ± 6, stress = 68 ± 7/71 ± 6, LVEF reserve (8/16 gates): 8 ± 3/6 ± 4, and all P ≥ 0.13). Similar test–retest repeatability measures were observed for rest and stress LVEF and their reserves [LVEF (8/16 gates); Rest = 4.5/4.6 (P = 0.81), Stress = 3.5/3.2 (P = 0.33), LVEF reserve = 46.7/49.3 (P = 0.13)]. Conclusion In healthy subjects, 8 and 16 ECG gates can be used interchangeably if only volumetric assessments are desired. However, if filling and emptying rates are of interest, a minimum of 16 ECG gates should be employed.
      PubDate: 2023-01-28
       
  • Screening asymptomatic patients post PCI with myocardial perfusion imaging

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      PubDate: 2023-01-24
       
  • A level of confidence: beta-hydroxybutyrate and myocardial glucose uptake
           suppression on 18F-FDG PET imaging

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      PubDate: 2023-01-24
       
  • Detection and quantification of myocardial scar and LVEF with high
           efficiency digital SPECT: The expanding value proposition for clinical
           cardiology

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      PubDate: 2023-01-22
       
  • Coronary computed tomography angiography and single-photon emission
           computerized tomography in chronic total occlusions: the Rosetta Stone for
           PCI planning'

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      PubDate: 2023-01-22
       
  • A retrospective evaluation of Bayesian-penalized likelihood reconstruction
           for [15O]H2O myocardial perfusion imaging

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      Abstract: Background New Block-Sequential-Regularized-Expectation-Maximization (BSREM) image reconstruction technique has been introduced for clinical use mainly for oncologic use. Accurate and quantitative image reconstruction is essential in myocardial perfusion imaging with positron emission tomography (PET) as it utilizes absolute quantitation of myocardial blood flow (MBF). The aim of the study was to evaluate BSREM reconstruction for quantitation in patients with suspected coronary artery disease (CAD). Methods and Results We analyzed cardiac [15O]H2O PET studies of 177 patients evaluated for CAD. Differences between BSREM and Ordered-Subset-Expectation-Maximization with Time-Of-Flight (TOF) and Point-Spread-Function (PSF) modeling (OSEM-TOF-PSF) in terms of MBF, perfusable tissue fraction, and vascular volume fraction were measured. Classification of ischemia was assessed between the algorithms. OSEM-TOF-PSF and BSREM provided similar global stress MBF in patients with ischemia (1.84 ± 0.21 g⋅ml−1⋅min−1 vs 1.86 ± 0.21 g⋅ml−1⋅min−1) and no ischemia (3.26 ± 0.34 g⋅ml−1⋅min−1 vs 3.28 ± 0.34 g⋅ml−1⋅min−1). Global resting MBF was also similar (0.97 ± 0.12 g⋅ml−1⋅min−1 and 1.12 ± 0.06 g⋅ml−1⋅min−1). The largest mean relative difference in MBF values was 7%. Presence of myocardial ischemia was classified concordantly in 99% of patients using OSEM-TOF-PSF and BSREM reconstructions Conclusion OSEM-TOF-PSF and BSREM image reconstructions produce similar MBF values and diagnosis of myocardial ischemia in patients undergoing [15O]H2O PET due to suspected obstructive coronary artery disease
      PubDate: 2023-01-19
       
  • Exercise ECG must be considered in conjunction with conventional SPECT

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      PubDate: 2023-01-17
       
  • Nuclear cardiology in the literature: A selection of recent, original
           research papers

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      PubDate: 2023-01-17
       
  • Relationship between impaired myocardial blood flow by positron emission
           tomography and low-attenuation plaque burden and pericoronary adipose
           tissue attenuation from coronary computed tomography: From the prospective
           PACIFIC trial

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      Abstract: Background Positron emission tomography (PET) is the clinical gold standard for quantifying myocardial blood flow (MBF). Pericoronary adipose tissue (PCAT) attenuation may detect vascular inflammation indirectly. We examined the relationship between MBF by PET and plaque burden and PCAT on coronary CT angiography (CCTA). Methods This post hoc analysis of the PACIFIC trial included 208 patients with suspected coronary artery disease (CAD) who underwent [15O]H2O PET and CCTA. Low-attenuation plaque (LAP, < 30HU), non-calcified plaque (NCP), and PCAT attenuation were measured by CCTA. Results In 582 vessels, 211 (36.3%) had impaired per-vessel hyperemic MBF (≤ 2.30 mL/min/g). In multivariable analysis, LAP burden was independently and consistently associated with impaired hyperemic MBF (P = 0.016); over NCP burden (P = 0.997). Addition of LAP burden improved predictive performance for impaired hyperemic MBF from a model with CAD severity and calcified plaque burden (P < 0.001). There was no correlation between PCAT attenuation and hyperemic MBF (r = − 0.11), and PCAT attenuation was not associated with impaired hyperemic MBF in univariable or multivariable analysis of all vessels (P > 0.1). Conclusion In patients with stable CAD, LAP burden was independently associated with impaired hyperemic MBF and a stronger predictor of impaired hyperemic MBF than NCP burden. There was no association between PCAT attenuation and hyperemic MBF.
      PubDate: 2023-01-16
       
  • Prednisone vs methotrexate in treatment naïve cardiac sarcoidosis

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      Abstract: Background Side effects limit the long-term use of glucocorticoids in cardiac sarcoidosis (CS), and methotrexate has gained attention as steroid sparing agent although the supporting evidence is poor. This study compared prednisone monotherapy, methotrexate monotherapy or a combination of both, in the reduction of myocardial Fluorine-18 fluorodeoxyglucose (FDG) uptake and clinical stabilization of CS patients. Methods and results In this retrospective cohort study, 61 newly diagnosed and treatment naïve CS patients commenced treatment with prednisone (N = 21), methotrexate (N = 30) or prednisone and methotrexate (N = 10) between January 2010 and December 2017. Primary outcome was metabolic response on FDG PET/CT and secondary outcomes were treatment patterns, major adverse cardiovascular events, left ventricular ejection fraction, biomarkers and side effects. At a median treatment duration of 6.2 [5.7-7.2] months, 71.4% of patients were FDG PET/CT responders, and the overall myocardial maximum standardized uptake value decreased from 6.9 [5.0-10.1] to 3.4 [2.1-4.7] (P < 0.001), with no significant differences between treatment groups. During 24 months of follow-up, 7 patients (33.3%; prednisone), 6 patients (20.0%; methotrexate) and 1 patient (10.0%; combination group) experienced at least one major adverse cardiovascular event (P = 0.292). Left ventricular ejection fraction was preserved in all treatment groups. Conclusions Significant suppression of cardiac FDG uptake occurred in CS patients after 6 months of prednisone, methotrexate or combination therapy. There were no significant differences in clinical outcomes during follow-up. These results warrant further investigation of methotrexate treatment in CS patients.
      PubDate: 2023-01-14
       
  • Does financial hardship associate with abnormal quantitative myocardial
           perfusion and major adverse cardiovascular event'

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      Abstract: Background Data on impact of financial hardship on coronary artery disease (CAD) remain incomplete. Methods Consecutive subjects referred for clinical rest/stress cardiac positron emission tomography (PET) were enrolled. Financial hardship is defined as patients’ inability to pay for their out-of-pocket expense for cardiac PET. Abnormal cardiac PET is defined as at least moderate relative perfusion defects at stress involving > 10% of the left ventricle or global coronary flow reserve ≤ 2.0. Patients were followed for major adverse cardiovascular event (MACE) comprised of all-cause mortality, non-fatal myocardial infarction, and late coronary revascularization. Results We analyzed a total of 4173 patients with mean age 65.6 ± 11.3 years, 72.2% men, and 93.6% reported as having medical insurance. Of these, 504 (12.1%) patients had financial hardship. On multivariable analysis, financial hardship associated with abnormal cardiac PET (odds ratio 1.377, p = 0.004) and MACE (hazard ratio 1.432, p = 0.010) and its association with MACE was mostly through direct effect with small proportion mediated by abnormal cardiac PET or known CAD. Conclusion Among patients referred for cardiac rest/stress PET, financial hardship independently associates with myocardial perfusion abnormalities and MACE; however, its effect on MACE is largely not mediated by abnormal myocardial perfusion or known CAD suggesting distinct impact of financial hardship beyond traditional risk factors and CAD that deserves attention and intervention to effectively reduced adverse outcomes. Having medical insurance does not consistently protect from financial hardship and a more preventive-oriented restructuring may provide better outcomes at lower cost.
      PubDate: 2023-01-13
       
  • The “power of zero” CAC validated for absence of ischemia on
           PET'

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      PubDate: 2023-01-10
       
  • Machine learning based model to diagnose obstructive coronary artery
           disease using calcium scoring, PET imaging, and clinical data

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      Abstract: Introduction Accurate risk stratification in patients with suspected stable coronary artery disease is essential for choosing an appropriate treatment strategy. Our aim was to develop and validate a machine learning (ML) based model to diagnose obstructive CAD (oCAD). Method We retrospectively have included 1007 patients without a prior history of CAD who underwent CT-based calcium scoring (CACS) and a Rubidium-82 PET scan. The entire dataset was split 4:1 into a training and test dataset. An ML model was developed on the training set using fivefold stratified cross-validation. The test dataset was used to compare the performance of expert readers to the model. The primary endpoint was oCAD on invasive coronary angiography (ICA). Results ROC curve analysis showed an AUC of 0.92 (95% CI 0.90-0.94) for the training dataset and 0.89 (95% CI 0.84-0.93) for the test dataset. The ML model showed no significant differences as compared to the expert readers (p ≥ 0.03) in accuracy (89% vs. 88%), sensitivity (68% vs. 69%), and specificity (92% vs. 90%). Conclusion The ML model resulted in a similar diagnostic performance as compared to expert readers, and may be deployed as a risk stratification tool for obstructive CAD. This study showed that utilization of ML is promising in the diagnosis of obstructive CAD.
      PubDate: 2023-01-09
       
  • The power of zero calcium in 82-Rubidium PET irrespective of sex and age

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      Abstract: Background Despite clinical suspicion, many non-invasive tests for coronary artery disease (CAD) are normal. Coronary artery calcification score (CACS) is a well-validated method to detect and risk stratify CAD. Patients with zero calcium score (ZCS) rarely have abnormal tests. Therefore, aims were to evaluate CACS as a gatekeeper to further functional downstream testing for CAD and estimate potential radiation and cost savings. Methods Consecutive patients with suspected CAD referred for PET were included (n = 2640). Prevalence and test characteristics of ZCS were calculated in different groups. Summed stress score ≥ 4 was considered abnormal and summed difference score ≥ 7 equivalent to ≥ 10% ischemia. To estimate potential radiation/cost reduction, PET scans were hypothetically omitted in ZCS patients. Results Mean age was 65 ± 11 years, 46% were female. 21% scans were abnormal and 26% of patients had ZCS. CACS was higher in abnormal PET (median 561 vs 27, P < 0.001). Abnormal PET was significantly less frequent in ZCS patients (2.6% vs 27.6%, P < 0.001). Sensitivity/negative predictive value (NPV) of ZCS to detect/exclude abnormal PET and ≥ 10% ischemia were 96.8% (95%-CI 95.0%-97.9%)/97.4% (95.9%-98.3%) and 98.9% (96.7%-99.6%)/99.6% (98.7%-99.9%), respectively. Radiation and cost reduction were estimated to be 23% and 22%, respectively. Conclusions ZCS is frequent, and most often consistent with normal PET scans. ZCS offers an excellent NPV to exclude an abnormal PET and ≥ 10% ischemia across different gender and age groups. CACS is a suitable gatekeeper before advanced cardiac imaging, and potential radiation/cost savings are substantial. However, further studies including safety endpoints are needed.
      PubDate: 2023-01-09
       
  • Cardiovascular disease in the literature: a selection of recent original
           research papers

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      PubDate: 2023-01-08
       
  • Methotrexate for cardiac sarcoidosis: is it justifiable'

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      PubDate: 2023-01-07
       
  • Correction to: Coronary vasculopathy due to moyamoya disease

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      PubDate: 2023-01-06
       
  • Use of SPECT imaging to confirm ATTR cardiac amyloid in a Tc99m
           pyrophosphate study artefactually compromised by a recent V/Q scan

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      PubDate: 2023-01-06
       
  • Quality metrics for single-photon emission computed tomography myocardial
           perfusion imaging: an ASNC information statement

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      PubDate: 2023-01-06
       
 
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