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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  [2469 journals]
  • Integration of coronary artery calcium scoring from CT attenuation scans
           by machine learning improves prediction of adverse cardiovascular events
           in patients undergoing SPECT/CT myocardial perfusion imaging

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      Abstract: Background Machine learning (ML) has been previously applied for prognostication in patients undergoing SPECT myocardial perfusion imaging (MPI). We evaluated whether including attenuation CT coronary artery calcification (CAC) scoring improves ML prediction of major adverse cardiovascular events (MACE) in patients undergoing SPECT/CT MPI. Methods From the REFINE SPECT Registry 4770 patients with SPECT/CT performed at a single center were included (age: 64 ± 12 years, 45% female). ML algorithm (XGBoost) inputs were clinical risk factors, stress variables, SPECT imaging parameters, and expert-observer CAC scoring using CT attenuation correction scans performed to obtain CT attenuation maps. The ML model was trained and validated using tenfold hold-out validation. Receiver Operator Characteristics (ROC) curves were analyzed for prediction of MACE. MACE-free survival was evaluated with standard survival analyses. Results During a median follow-up of 24.1 months, 475 patients (10%) experienced MACE. Higher area under the ROC curve for MACE was observed with ML when CAC scoring was included (CAC-ML score, 0.77, 95% confidence interval [CI] 0.75–0.79) compared to ML without CAC (ML score, 0.75, 95% CI 0.73–0.77, P = .005) and when compared to CAC score alone (0.71, 95% CI 0.68–0.73, P < .001). Among clinical, imaging, and stress parameters, CAC score had highest variable importance for ML. On survival analysis patients with high CAC-ML score (> 0.091) had higher event rate when compared to patients with low CAC-ML score (hazard ratio 5.3, 95% CI 4.3–6.5, P < .001). Conclusion Integration of attenuation CT CAC scoring improves the predictive value of ML risk score for MACE prediction in patients undergoing SPECT MPI.
      PubDate: 2022-10-04
       
  • Embers after fire: Are we close to real time visualization of persistent
           inflammation post-Kawasaki disease'

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      PubDate: 2022-10-03
       
  • FDG uptake patterns in isolated and systemic cardiac sarcoidosis

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      Abstract: Aims We aimed to investigate the pre-treatment characteristics and treatment responses of isolated and systemic cardiac sarcoidosis (ICS and SCS) from FDG-PET/CT studies and to compare the prognoses of the two groups. Methods FDG-PET/CT images taken before and after treatment of 31 ICS and 91 SCS patients were analyzed retrospectively. Treatment response and recurrence were determined from the course of FDG-PET/CT. Treatment response and the incidence of both recurrence and major adverse cardiac events (MACE) were assessed in 16 ICS and 35 SCS patients who had been treated for more than 2 years. Results A focal uptake pattern was more often observed than a focal-on-diffuse uptake pattern in both the ICS (74.2%) and SCS (63.7%) groups. Right ventricular involvement was significantly more frequent in SCS than ICS (44.0% vs. 9.6%, p < .001). SUVmax, cardiac metabolic volume (CMV), and cardiac metabolic activity (CMA) were significantly higher in SCS than ICS (SUVmax, 9.1 ± 4.1 vs. 4.8 ± 2.1; CMV, 118.0 ± 111.3 ml vs. 68.3 ± 94.7 ml; CMA, 541.6 ± 578.7 MBq vs. 265.1 ± 396.0 MBq, p < .001). Treatment responses in the two groups were similar, and complete resolution of cardiac uptake after immunosuppressive treatment was obtained in 62.5% of ICS patients and 77.1% of SCS patients (not significantly different). Likewise, no significant difference was found in the incidence of recurrence (40.0% for ICS, 44.4% for SCS) or MACE (25.0% for ICS, 22.8% for SCS). Conclusion SCS patients had more active and extensive CS lesions than ICS patients before treatment, but the two groups showed similar treatment responses and prognoses.
      PubDate: 2022-10-03
       
  • 64Cu-DOTATATE, the growing signal for PET imaging of vascular
           inflammation'

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      PubDate: 2022-09-30
       
  • Value of PET ECG gating in a cross-validation study of cardiac function
           assessment by PET/MR imaging

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      Abstract: Background This work investigated the impact of different cardiac gating methods on the assessment of cardiac function by FDG-PET in a cross-validation PET/MR study. Methods and results MR- and PET-based left ventricular end-diastolic, end-systolic volumes, and ejection fraction (EDV, ESV, and EF) were delineated in 30 patients with a PET/MR examination. Cardiac PET imaging was performed using three ECG gating methods: fixed number of gates per beat (STD), STD with a beat acceptance window (STD-BR), and fixed gate duration (FW). High MR-PET correlations were found in all the values. ESVs correlated better than EDVs and EFs: Pearson’s r coefficient [0.92, 0.92, 0.92] in ESV vs [0.75, 0.81, 0.80] in EDV and [0.79, 0.91, 0.87] in EF, for each method [STD, STD-BR, FW]. Biases with respect to MRI for all the evaluated PET methods were less than 13% in EDV, 5% in ESV, and 14% in EF, but with wide limits of agreements, in the range (59-68)% in EDV, (65-70)% in ESV, and (49-71)% in EF. STD showed the strongest disagreement, while there were no marked differences between STD-BR and FW. Conclusion Based on these findings, PET- and MR-based cardiac function parameters were highly correlated but in substantial disagreement with variabilities introduced by the selected PET ECG gating method. The most significant differences were associated with the ECG gating method susceptible to highly irregular beats, while similar performance was observed in the methods using uniform adjustment of gates width per beat with the beat acceptance window, and fixed gate width along all the beats. Thus, strict quality controls of R peak detection are needed to minimize its impact on the function assessment.
      PubDate: 2022-09-30
       
  • Correction: Pulmonary artery imaging with 68¬†Ga-FAPI-04 in patients with
           chronic thromboembolic pulmonary hypertension

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      PubDate: 2022-09-19
       
  • Adenosine–caffeine: the agonist—antagonist couple for
           vasodilator stress tests

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      PubDate: 2022-09-19
       
  • Detection of acute myocarditis by ECG-triggered PET imaging of
           somatostatin receptors compared to cardiac magnetic resonance: preliminary
           results

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      Abstract: Somatostatin receptors are overexpressed by inflammatory cells but not by cardiac cells, under normal conditions. This study assesses the detection of acute myocarditis by the ECG-triggered digital-PET imaging of somatostatin receptors (68Ga-DOTATOC-PET), as compared to Cardiac Magnetic Resonance (CMR) imaging, which is the reference diagnostic method in this setting. Methods Fourteen CMR-defined acute myocarditis patients had a first 15-minutes ECG-triggered 68Ga-DOTATOC PET recording, 4.4 ± 3.0 days from peak troponin, and 10 had a second 4.3 ± 0.3 months later. Myocardial/blood SUVmax ratio was analyzed relative to the normal upper limit of 2.18, which had been previously determined from oncology 68Ga-DOTATOC-PET recordings of patients with a similar age range as the myocarditis patients. Results An increased myocardial 68Ga-DOTATOC uptake relative to blood activity was invariably observed during the acute phase. SUVmax ratio exceeded 2.18 in all patients during the acute phase but also in 3/10 patients at 4-months, at a time when there were no more signs of active inflammation on CMR. A residual myocardial 68Ga-DOTATOC uptake was still observed on all gated-PET cine loops at 4-months. Conclusion These preliminary results suggest that 68Ga-DOTATOC ECG-triggered digital-PET may be as sensitive as CMR at detecting myocarditis during the acute phase and more sensitive at later stages.
      PubDate: 2022-09-19
       
  • A quick glance at selected topics in this issue

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      Abstract: Abstract “A quick glance at selected topics in this issue” aims to highlight contents of the Journal and provide a quick review to the readers.
      PubDate: 2022-09-14
       
  • Metastatic adrenocortical carcinoma of the interventricular septum

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      PubDate: 2022-09-12
       
  • Seeing is believing: Visualization of multivariable risk models

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      PubDate: 2022-09-12
       
  • The impact of coronary calcium score as an addition to myocardial
           perfusion imaging in altering clinical management (ICCAMPA trial)

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      Abstract: Introduction: Aim Myocardial perfusion imaging (MPI) is a key tool for the identification and risk stratification of patients with coronary artery disease. The use of a coronary calcium score further adds to prognostic data above MPI alone. In this study, our aim was to evaluate the extent to which the use of a coronary artery calcium (CAC) score, when co-reported with MPI, impacts changes in clinical management in patients without a history of coronary artery disease (CAD) undergoing functional imaging. Methods This is a multicenter international study which incorporated a standardized questionnaire to evaluate changes in clinician management after MPI results were given with and without the additional information of a CAC score. Calcium scoring on a SPECT-CT system was performed via a semiquantitative Shemesh score (0-12) with a 0-3 score from the left main, left anterior descending, left circumflex, and right coronary arteries. CT of the chest was read independently, and non-coronary findings were reported alongside the CAC score. Results A total of 281 patients were enrolled across 3 international centers (Brazil, Australia, New Zealand). Of the 281 patients, 133 (47%) had management altered after the clinician was made aware of the CAC score. The impact of the CAC in changing clinical management was significant, particularly in patients with a negative MPI (P < 0.0001), but also in MPI-positive patients (P = 0.0021). The most common management change was the addition or intensification of statin therapy. Conclusion The addition of the CAC component to MPI yielded significant management changes in nearly half of all patients undergoing MPI for suspected CAD. This trend was observed across all centers in the three countries involved and was particularly evident in patient with a negative MPI.
      PubDate: 2022-09-12
       
  • Deep-learning-based estimation of attenuation map improves attenuation
           correction performance over direct attenuation estimation for myocardial
           perfusion SPECT

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      Abstract: Background Deep learning (DL)-based attenuation correction (AC) is promising to improve myocardial perfusion (MP) SPECT. We aimed to optimize and compare the DL-based direct and indirect AC methods, with and without SPECT and CT mismatch. Methods One hundred patients with different 99mTc-sestamibi activity distributions and anatomical variations were simulated by a population of XCAT phantoms. Additionally, 34 patients 99mTc-sestamibi stress/rest SPECT/CT scans were retrospectively recruited. Projections were reconstructed by OS-EM method with or without AC. Mismatch between SPECT and CT images was modeled. A 3D conditional generative adversarial network (cGAN) was optimized for two DL-based AC methods: (i) indirect approach, i.e., non-attenuation corrected (NAC) SPECT paired with the corresponding attenuation map for training. The projections were reconstructed with the DL-generated attenuation map for AC; (ii) direct approach, i.e., NAC SPECT paired with the corresponding AC SPECT for training to perform direct AC. Results Mismatch between SPECT and CT degraded DL-based AC performance. The indirect approach is superior to direct approach for various physical and clinical indices, even with mismatch modeled. Conclusion DL-based estimation of attenuation map for AC is superior and more robust to direct generation of AC SPECT.
      PubDate: 2022-09-12
       
  • Nuclear cardiology in the literature: A selection of recent, original
           research papers

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      PubDate: 2022-09-08
       
  • Cardiovascular disease in the literature: A selection of recent original
           research papers

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      PubDate: 2022-09-08
       
  • Correction: Quantitation in ATTR cardiac amyloidosis: the next step is
           almost there!

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      PubDate: 2022-09-06
       
  • What is this image' 2022 image 2 result: Right atrial angiosarcoma
           detected with 13N-NH3 myocardial PET/CT and 18F-FDG PET/CT

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      PubDate: 2022-09-06
       
  • 2022 ASNC/AAPM/SCCT/SNMMI guideline for the use of CT in hybrid nuclear/CT
           cardiac imaging

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      PubDate: 2022-09-02
       
  • The challenges of using radionuclide imaging to guide cardiac device
           implantation in patients with heart failure

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      PubDate: 2022-09-02
       
  • Moving forward—back to the future

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      PubDate: 2022-09-01
       
 
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