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Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/terapia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/terapia , Neoplasias da Glândula Tireoide/patologia , Linfonodos/patologia , Estudos RetrospectivosRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Patient preparation is crucial for reliable interpretation of cardiac inflammation FDG PET. We share our experience of improved reporting confidence and propose a simple approach of prolonging preparation (from 24 to 48 hours) with the high-fat, no-carbohydrate, and protein-permitted diet followed by fasting in cardiac sarcoidosis in cases with diffuse or focal-on-diffuse myocardial FDG uptake.
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Cardiomiopatias , Miocardite , Sarcoidose , Humanos , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Cardiomiopatias/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tomografia por Emissão de Pósitrons/métodos , Sarcoidose/diagnóstico por imagemRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Tomografia Computadorizada de Emissão de Fóton Único , HumanosRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Humanos , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
Assuntos
Medicina Nuclear , HumanosRESUMO
BACKGROUND: An absent left ventricular ejection fraction (LVEF) reserve with vasodilator stress with PET cardiac imaging has been shown to provide significant independent and incremental value to the perfusion images for prediction of future cardiovascular adverse events. However, the prognostic value of LVEF reserve has not been well characterized with SPECT myocardial perfusion imaging (MPI). METHODS: We studied 858 consecutive patients with normal and abnormal perfusion pattern with regadenoson SPECT MPI. Change in LVEF was calculated as post-stress LVEF-rest LVEF. Absent LVEF reserve was defined as a drop in LVEF by 5% or more on the post-stress images. The primary outcome was a composite of cardiac death, non-fatal myocardial infarction and late coronary revascularization. RESULTS: An absent LVEF reserve was more common in patients with abnormal vs normal MPI (31% vs 19%, P = .001). During a median follow-up of 32 months, the primary outcome was experienced by 31% of the study population. An absent LVEF reserve was not associated with an increased risk of the primary outcome in patients with normal (hazard ratio 1.1, 95% CI .4-2.7, P = .8) or abnormal (.75, .56-1.00, P = .05) MPI. There was no significant correlation between extent of ischemia and post-stress change in LVEF (Pearson r = - .072, P = .07). CONCLUSIONS: In patients undergoing regadenoson SPECT MPI, absent LVEF reserve is not associated with worse cardiac outcomes. Thus, routine reporting of both post-stress and rest LVEF measurements in this setting may not be necessary.
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Imagem de Perfusão do Miocárdio , Humanos , Imagem de Perfusão do Miocárdio/métodos , Prognóstico , Purinas , Pirazóis , Volume Sistólico , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Função Ventricular EsquerdaRESUMO
BACKGROUND: SPECT myocardial perfusion imaging (MPI) provides an assessment of LV mechanical dyssynchrony (LVMD) which correlates with CVD outcomes in diverse populations including those awaiting renal transplant (RT). The current study examines the association of LVMD on pre-transplant MPI with long-term CVD mortality post RT. METHODS: We identified consecutive patients who underwent RT at the University of Alabama at Birmingham between 2008 and 2012 from our prospectively collected database. 675 patients in the database underwent MPI and had images amenable for phase analysis. A blinded investigator retrieved the studies and derived LVMD indices including histogram bandwidth (BW), standard deviation (SD), phase peak, phase skewness, and phase kurtosis. The primary outcome was CVD death after RT. RESULTS: The study cohort had a median age of 54 years, 56% were men, 43% had diabetes, and 7% had prior myocardial infarction. Patients were on dialysis for a median of 3.4 years prior to RT and 34% received living donor transplants. During a median follow-up time after RT of 4.7 years (IQR 3.5 to 6.3 years) 59 patients (9%) succumbed to CVD death. Patients with wider BW, wider SD, lower skewness, and lower kurtosis had an increased risk of CVD death. On multivariate adjustment, BW and skewness remained as independent predictors of CVD deaths. CONCLUSIONS: LVMD by phase analysis of gated SPECT MPI is associated with increased risk of CVD death after RT. This association is independent of demographics, comorbidities, and traditional findings on MPI and added incremental prognostic information. Assessment of LVMD should be considered for risk stratification in these patients.
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Tomografia Computadorizada por Emissão de Fóton Único de Sincronização Cardíaca , Transplante de Rim , Imagem de Perfusão do Miocárdio , Disfunção Ventricular Esquerda , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Tomografia Computadorizada por Emissão de Fóton Único de Sincronização Cardíaca/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Prognóstico , Imagem de Perfusão do Miocárdio/métodosRESUMO
PURPOSE: The aim of this study is to evaluate the rate of abnormal myocardial perfusion imaging (MPI) studies at a single medical center during the COVID-19 pandemic compared to prior to the pandemic. METHODS: We retrospectively studied stress single-photon emission computed tomography (SPECT)-MPI studies performed during the peak of COVID-19 restrictions at the University of Alabama Medical Center in comparison to the same time period in 2019. RESULTS: SPECT-MPI volume was reduced from 553 per month in 2019 to 105 per month in 2020. The proportion of abnormal SPECT-MPI for the 2020 cohort (61 ± 13 years, 48% men, 41% black) was not different from the 2019 cohort (62 ± 12 years, 48% men, 42% black) (31% vs. 27%, p = 0.4). Similar proportion of patients in the 2 cohorts had abnormal myocardial perfusion, moderate-large perfusion defects, myocardial ischemia, myocardial scar, and abnormal left ventricular ejection fraction. The proportion of abnormal SPECT-MPIs was not different based on whether patients were evaluated face-to-face or by telemedicine (28% vs. 27%, p > 0.9) but was higher for cardiology providers (40% vs. 20%, p < 0.001). CONCLUSIONS: There was a significant reduction in the number of SPECT-MPI studies performed during the peak restrictions from the pandemic. Despite this restriction, the rate of abnormal studies remained stable. Our study suggests that it remains difficult to predict which patients will have abnormal SPECT-MPI even when providers and stress laboratories are forced to prioritize the performance of studies to high-yield patients.
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COVID-19 , Doença da Artéria Coronariana , Isquemia Miocárdica , Imagem de Perfusão do Miocárdio , Feminino , Humanos , Masculino , Pandemias , Prevalência , Estudos Retrospectivos , SARS-CoV-2 , Volume Sistólico , Tomografia Computadorizada de Emissão de Fóton Único , Função Ventricular EsquerdaRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Técnicas de Imagem Cardíaca , Cardiologia , Doenças Cardiovasculares/diagnóstico por imagem , Medicina Nuclear , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , HumanosRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Cardiopatias/diagnóstico por imagem , Técnicas de Imagem Cardíaca , Cardiopatias/complicações , Cardiopatias/terapia , Humanos , CintilografiaRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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BACKGROUND. Despite advances in prostate cancer treatment, rates of biochemical recurrence remain high, relating to lack of detection of small-volume metastatic disease using conventional imaging for initial staging. OBJECTIVE. The purpose of this study was to assess the potential use of 18F-fluciclovine PET/MRI for initial staging of high-risk prostate cancer and evaluating response to androgen deprivation therapy (ADT). METHODS. This prospective clinical trial enrolled 14 men with newly diagnosed high-risk prostate cancer and negative or equivocal conventional staging imaging for metastatic disease between January 2018 and February 2019. All patients underwent pretreatment 18F-fluciclovine PET/MRI including multiparametric prostate MRI; 12 underwent 18F-fluciclovine PET/MRI after surgery or between ADT and radiotherapy. Confidence in identification of the primary intraprostatic lesion and nodal metastases was independently rated on a 0-3 Likert scale by three readers with nuclear medicine experience for 18F-fluciclovine PET/MRI and three readers with abdominal imaging experience for MRI alone. Findings scored as 2 or 3 by at least two readers of a given modality were considered positive. A single reader measured SUVmean, SUVmax, and volume of the MRI-defined intraprostatic lesion and SUVmax of suspicious lymph nodes on PET before and after initiation of ADT. Changes in SUV were analyzed using nonparametric Wilcox-on signed-rank tests. RESULTS. The biopsy-proven lesion in the prostate gland was accurately identified in all 14 patients on both MRI and 18F-fluciclovine PET/MRI. Suspected nodal metastases were detected in three patients on MRI and seven patients on 18F-fluciclovine PET/MRI. After ADT, all patients showed decreased activity within the intraprostatic lesion and/or all suspicious lymph nodes. The primary lesion SUVmean was 4.5 ± 1.1 (range, 2.7-6.5) before treatment and 2.4 ± 1.1 (range, 0.0-3.6) after initiation of ADT (p = .008). For suspicious lymph nodes, the pretreatment SUVmax was 5.5 ± 3.7 (range, 2.8-12.7) and the post-treatment SUVmax was 2.8 ± 1.4 (range, 1.4-5.5) (p = .03). CONCLUSION.18F-labeled fluciclovine PET/MRI shows potential utility in initial staging of high-risk prostate cancer and in evaluating response to ADT. CLINICAL IMPACT. Given the FDA approval and widespread availability of 18F-fluciclovine, the findings could have an impact in the immediate future in guiding initial management of patients with prostate cancer. TRIAL REGISTRATION. ClinicalTrials.gov NCT03264456.
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Antagonistas de Androgênios/uso terapêutico , Ácidos Carboxílicos , Ciclobutanos , Imageamento por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Estadiamento de Neoplasias , Projetos Piloto , Estudos Prospectivos , Próstata/diagnóstico por imagem , Próstata/patologia , Neoplasias da Próstata/patologia , Compostos Radiofarmacêuticos , Risco , Resultado do TratamentoRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Cardiologia/métodos , Diagnóstico por Imagem/métodos , Cardiopatias/diagnóstico por imagem , Coração/diagnóstico por imagem , Imagem Molecular/métodos , Humanos , Inflamação , Medicina Nuclear , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Cardiologia/métodos , Doenças Cardiovasculares/diagnóstico por imagem , Coração/diagnóstico por imagem , Endocardite/diagnóstico por imagem , Fluordesoxiglucose F18 , Cardiopatias , Humanos , Imagem de Perfusão do Miocárdio , Medicina Nuclear , Revisão por Pares , Tomografia por Emissão de Pósitrons , Sociedades Médicas , Tecnécio , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Estados UnidosRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Cardiopatias/diagnóstico por imagem , Cardiopatias/fisiopatologia , Humanos , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.
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Técnicas de Imagem Cardíaca , Medicina Nuclear , HumanosRESUMO
"A quick glance at selected topics in this issue" aims to highlight contents of the Journal and provide a quick review to the readers.