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Betacoronavirus , Cardiología , Enfermedades Cardiovasculares/diagnóstico , Infecciones por Coronavirus/diagnóstico , Laboratorios de Hospital/estadística & datos numéricos , Pandemias , Neumonía Viral/diagnóstico , COVID-19 , Enfermedades Cardiovasculares/complicaciones , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , SARS-CoV-2Asunto(s)
Betacoronavirus , Cardiología , Infecciones por Coronavirus/epidemiología , Medicina Nuclear , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , COVID-19 , Prueba de COVID-19 , Cardiología/educación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Humanos , Laboratorios , Medicina Nuclear/educación , Pandemias/prevención & control , Equipo de Protección Personal , Neumonía Viral/prevención & control , SARS-CoV-2 , Sociedades MédicasRESUMEN
The purpose of this document is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of gated equilibrium radionuclide angiocardiography (ERNA).
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Angiografía/métodos , Medicina Nuclear , Guías de Práctica Clínica como Asunto , Cintigrafía/métodos , Técnicas de Imagen Sincronizada Respiratorias/métodos , Sociedades Científicas , Europa (Continente) , HumanosAsunto(s)
Betacoronavirus , Cardiología , Infecciones por Coronavirus/prevención & control , Medicina Nuclear , Pandemias/prevención & control , Neumonía Viral/prevención & control , COVID-19 , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/epidemiología , Humanos , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , SARS-CoV-2Asunto(s)
Circulación Coronaria , Cardiopatías/diagnóstico por imagen , Imagen de Perfusión Miocárdica/normas , Sociedades Médicas/normas , Tomografía Computarizada de Emisión de Fotón Único/normas , Consenso , Difusión de Innovaciones , Cardiopatías/fisiopatología , Cardiopatías/terapia , Humanos , Interpretación de Imagen Asistida por Computador/normas , Imagen de Perfusión Miocárdica/métodos , Atención Dirigida al Paciente/normas , Valor Predictivo de las Pruebas , Pronóstico , Reproducibilidad de los Resultados , Tomografía Computarizada por Tomografía Computarizada de Emisión de Fotón Único/normasRESUMEN
This information statement from the American Society of Nuclear Cardiology highlights advances in cardiac SPECT imaging and supports the incorporation of new technology and techniques in laboratories performing nuclear cardiology procedures. The document focuses on the application of the latest imaging protocols and the utilization of newer hardware and software options to perform high quality, state-of-the-art SPECT nuclear cardiology procedures. Recommendations for best practices of cardiac SPECT imaging are discussed, highlighting what imaging laboratories should be doing as the standard of care in 2018 to achieve optimal results (based on the ASNC 2018 SPECT guideline [Dorbala et al., J Nucl Cardiol. 2018. https://doi.org/10.1007/s12350-018-1283-y ]).
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Cardiología , Corazón/diagnóstico por imagen , Medicina Nuclear , Tomografía Computarizada de Emisión de Fotón Único/métodos , Humanos , Sociedades MédicasRESUMEN
In thyroid cancer patients with renal impairment or other complicating factors, it is important to maximize I-131 therapy efficacy while minimizing bone marrow and lung damage. We developed a web-based calculator based on a modified Benua and Leeper method to calculate the maximum I-131 dose to reduce the risk of these toxicities, based on the effective renal clearance of I-123 as measured from two whole-body I-123 scans, performed at 0 and 24 h post-administration.
RESUMEN
The preferred method for performing stress testing with myocardial perfusion imaging is physical exercise. However, many patients are unable to reach an adequate endpoint. As an alternative, various pharmacologic options are available, which are explored in this article.
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Imagen de Perfusión Miocárdica/métodos , Estrés Fisiológico/efectos de los fármacos , Prueba de Esfuerzo , HumanosRESUMEN
OBJECTIVE: The recent introduction of high-efficiency solid-state gamma cameras for myocardial perfusion single photon emission computed tomography has enabled lower patient radiation dose, faster imaging, and improved image quality. However, artifacts still complicate interpretation. Prone imaging is a common maneuver to reduce artifacts and increase accuracy for detection of coronary artery disease, but its effect on imaging relative to supine imaging has not been fully characterized in these new systems. METHODS: In this IRB-approved, HIPAA-compliant retrospective study, 30 patients were reviewed, who underwent prone and supine imaging on the GE 530c multipinhole cadmium zinc telluride camera under both rest and stress conditions. Informed consent was waived. Perfusion was scored visually by two readers on a five-point scale according to the 17-segment model. Differences were assessed for significance using a multivariate linear effects model and restricted maximum likelihood method. RESULTS: Prone positioning resulted in increased activity in the basal inferior (P<0.001), basal inferolateral (P=0.009), basal inferoseptal (P<0.001), and mid-inferior (P<0.001) segments when taking into account factors such as stress versus rest, perfusion scores of other segments, and reader. CONCLUSION: Prone imaging on the GE 530c camera increases measured tracer activity in the basal inferior, basal inferolateral, basal inferoseptal, and mid-inferior segments. Caution is advised when diagnosing myocardial ischemia in these territories, particularly if clinical data are unavailable.
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Cadmio , Imagen de Perfusión Miocárdica/métodos , Posición Prona , Posición Supina , Telurio , Tomografía Computarizada de Emisión de Fotón Único/métodos , Zinc , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Imagen de Perfusión Miocárdica/instrumentación , Descanso , Estudios Retrospectivos , Estrés Fisiológico , Tomografía Computarizada de Emisión de Fotón Único/instrumentaciónRESUMEN
Technological advances in processing have allowed nuclear cardiology labs to increase efficiency as well as reduce radiation exposure to both patients and staff. With increased awareness on reduced radiation exposure, efficiency and quality resolution recovery reconstruction is a perfect fit for nuclear cardiology. Having a basic understanding of what is required as well as being aware of the potential pitfalls can provide some clarity on how to incorporate resolution recovery reconstruction into the existing workflow of a nuclear cardiology lab.
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Algoritmos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Tomografía Computarizada de Emisión de Fotón Único/métodos , Flujo de Trabajo , Humanos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: New multipinhole cadmium-zinc-telluride (CZT) cameras allow for faster imaging and lower radiation doses for single photon emission computed tomography (SPECT) studies, but assessment of prognostic ability is necessary. METHODS AND RESULTS: We collected data from all myocardial SPECT perfusion studies performed over 15 months at our institution, using either a CZT or conventional Anger camera. A Cox proportional hazards model was used to assess the relationship between camera type, imaging results, and either death or myocardial infarction (MI). Clinical variables including age, sex, body mass index (BMI), and historical risk factors were used for population description and model adjustments. We had 2,088 patients with a total of 69 deaths and 65 MIs (122 events altogether). A 3% increase in DDB (difference defect burden) represented a 12% increase in the risk of death or MI, whereas a 3% increase in rest defect burden or stress defect burden represented an 8% increase; these risks were the same for both cameras (P > .24, interaction tests). CONCLUSIONS: The CZT camera has similar prognostic values for death and MI to conventional Anger cameras. This suggests that it may successfully be used to decrease patient dose.
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Cadmio , Cámaras gamma/estadística & datos numéricos , Infarto del Miocardio/diagnóstico por imagen , Infarto del Miocardio/mortalidad , Imagen de Perfusión Miocárdica/instrumentación , Telurio , Tomografía Computarizada de Emisión de Fotón Único/instrumentación , Zinc , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Imagen de Perfusión Miocárdica/estadística & datos numéricos , North Carolina/epidemiología , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Medición de Riesgo , Sensibilidad y Especificidad , Distribución por Sexo , Análisis de Supervivencia , Adulto JovenAsunto(s)
Tomografía Computarizada por Emisión de Fotón Único Sincronizada Cardíaca/métodos , Interpretación de Imagen Asistida por Computador/métodos , Imagen de Perfusión Miocárdica/métodos , Disfunción Ventricular Izquierda/diagnóstico por imagen , Anciano , Femenino , Humanos , Aumento de la Imagen/métodos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: We hypothesized that the severity of resting perfusion abnormalities assessed by the summed rest score (SRS) would be associated with a higher rate of adverse outcomes in patients with heart failure (HF) and reduced left ventricular (LV) ejection fraction (EF). METHODS: A subset of 240 subjects from HF-ACTION underwent resting technetium-99m tetrofosmin-gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Images were evaluated using a 17-segment model to derive the SRS and additional nuclear variables. RESULTS: After adjusting for prespecified covariates, SRS was significantly associated with the primary end point (hazard ratio 0.98, 95% confidence interval [CI] 0.97-1.00, P = .04), with a higher SRS corresponding to lower risk of an event. This association was not present in the unadjusted analysis. The relationship between SRS and the primary outcome was likely due to a higher event ratein patients with ischemic HF and a low SRS. The LV phase SD was not predictive of the primary outcome (hazard ratio 1.00, 95% confidence interval 0.99-1.01, P = .49). In a post hoc analysis, nuclear variables provided incremental prognostic information when added to clinical information (P = .006). CONCLUSIONS: Gated SPECT MPI provides important information in patients with HF and reduced LVEF. In the adjusted analysis, SRS has an unexpected relationship with the primary end point. Phase SD was not associated with the primary end point. Rest-gated SPECT MPI provides incrementally greater prognostic information than clinical information alone.