Nuclear Cardiology and Correlative Imaging

by Vitola, Joao V.; Delbeke, Dominique; Alpert, Joseph S.; Depuey, E. Gordon MD; Delbeke, Dominique

• ISBN13: 9780387207070
• ISBN10: 0387207074
• Format: Hardcover
• Copyright: 2004-10-01
• Publisher: Springer Verlag

Summary

Edited by Drs. Joao V. Vitola and Dominique Delbeke, two highly respected experts, this case-based text advances the knowledge and skills of experienced nuclear medicine physicians, cardiologists, and radiologists while also preparing residents for the cutting-edge field of nuclear cardiology. Internationally recognized contributors offer an indispensable presentation of key techniques and the latest technology. Diagnostic tools, physics principles, instrumentation, radiopharmaceuticals, and protocols central to the field are covered. A comprehensive review of the applications of myocardial perfusion imaging includes applications in special populations and in emergency departments. Risk assessment, pitfalls, and artifacts are also addressed. Additional chapters examine correlative imaging and detail the value of cardiac MRI, multislice computed tomography, stress echocardiography, coronary angiography, intravascular ultrasound, and PET and PET/CT. Case presentations and a wealth of illustrations reinforce guidelines on diagnosis and image interpretation, highlighting situations that readers are likely to encounter in everyday practice. Book jacket.

Table of Contents

Foreword I	v
Joseph S. Alpert
Foreword II	vii
E. Gordon DePuey III
Contributors	xvii
Diagnostic Tools to Approach the Cardiac Patient	1	(12)
Joao V. Vitola
Dominique Delbeke
Imaging of Atherosclerosis by FDG PET-CT	9	(4)
Physics Principles and Instrumentation in Nuclear Cardiology	13	(36)
James A. Patton
Dose Infiltration at Site of Injection	38	(1)
Artifact Caused by Metal Object	39	(1)
Truncation Artifact	40	(1)
Motion Artifact	41	(1)
Diaphragmatic Attenuation Artifact	42	(1)
Breast Attenuation Artifact	43	(2)
Motion Artifact on PET-CT	45	(2)
Detector Malfunction in the PET System	47	(2)
Radiopharmaceuticals and Protocols in Nuclear Cardiology	49	(35)
Dominique Delbeke
Joao V. Vitola
William H. Martin
Biodistribution of 201TI and Clinical Protocols	56	(4)
Biodistribution of 99mTc-MIBI and Clinical Protocols	60	(4)
Dual Isotope Rest 201Tl/Stress 99mTc-Tetrofosmin Study	64	(2)
Extra-Cardiac 99mTc-MIBI Uptake in a Tumor	66	(2)
Pattern of FDG Uptake in the Heart	68	(2)
Puerperal Breast Uptake of FDG---Dose Radiation Issues	70	(1)
Semi-Quantitative Analysis of Perfusion and Function	71	(3)
Myocardial Perfusion Imaging with PET	74	(3)
Biodistribution of 99mTc-Pertechnetate	77	(2)
Perfusion Artifact Due to Gastrointestinal Uptake	79	(5)
Stress Modalities to Evaluate Myocardial Perfusion	84	(37)
Joao V. Vitola
Otavio J. Kormann
Arnaldo Laffitte Stier, Jr.
William Azem Chalela
Luis E. Mastrocolla
Dominique Delbeke
Exercise 99mTc-MIBI Demonstrating Multivessel CAD with Borderline ECG Changes	97	(2)
Dipyridamole 99mTc-MIBI Demonstrating RCA and LCX Ischemia in a Patient with LBBB	99	(2)
Combined Dipyridamole-Low Exercise 99mTc-MIBI Demonstrating Multivessel CAD	101	(1)
Combined Dipyridamole-Low Exercise 99mTc-MIBI with Severe ST Segment Elevation	102	(3)
Dobutamine 99mTc-MIBI Demonstrating Extensive Three-vessel CAD	105	(1)
Dipyridamole 99mTc-MIBI in a Patient with a Pacemaker	106	(1)
Adenosine 99mTc-MIBI Demonstrating Significant Endothelial Dysfunction	107	(1)
Differential Hepatic and Gastrointestinal Uptake of 99mTc-MIBI after Exercise and Dipyridamole Stress	108	(2)
Dipyridamole Induced Coronary Steal and ST Segment Depression	110	(2)
Interference of Medications with MPI	112	(9)
Myocardial Perfusion Imaging: Detection of Coronary Artery Disease and Miscellaneous Clinical Applications	121	(34)
Joao V. Vitola
Dominique Delbeke
C. Andrew Smith
Carlos Cunha Pereira Neto
William H. Martin
M. Reza Habibian
Left Main Occlusion Diagnosed by MPI	122	(2)
Myocardial Bridging of the LAD	124	(2)
Exercise Induced Artifact in a Patient with LBBB	126	(1)
LAD Ischemia in a Patient with LBBB	127	(2)
Transient Ischemic LV Dilatation	129	(3)
Multivessel Disease on MPI and Myocardial Stunning	132	(1)
Reverse Distribution on 201Tl Imaging	133	(2)
Anomalous Take Off of the RCA	135	(2)
Anomalous Take Off of the LCA	137	(2)
Transposition of the Great Vessels	139	(1)
Moderate Lesion Causing Ischemia	140	(2)
Chest Pain due to Multiple Pulmonary Emboli	142	(2)
Coronary Spasm	144	(2)
Semi-Quantitative Analysis Using Different Commercial Software Packages	146	(9)
Myocardial Perfusion Imaging in the Emergency Department	155	(23)
Olimpio Ribeiro Franca Neto
Dominique Delbeke
Joao V. Vitola
Jack A. Ziffer
Occluded LCX Detected by Rest 99mTc-MIBI	158	(2)
Occluded OM Detected by Rest 99mTc-MIBI	160	(2)
Correlation of Rest 99mTc-MIBI and MRI for ACS	162	(2)
Normal Rest but Abnormal Stress MPI	164	(1)
Value of Prone Imaging for Rest MPI	165	(1)
AMI Diagnosed by Rest 99mTc-MIBI and 99mTc-Pyrophosphate	166	(3)
Acute Pulmonary Embolism as a Differential Diagnosis in the ED	169	(1)
AMI Detected By Rest 99mTc-MIBI	170	(3)
Acute Cholecystitis versus ACS	173	(5)
Evaluation of Cardiac Function	178	(27)
Kenneth J. Nichols
Marvin W. Kronenberg
Sabahat Bokhari
RVG and LVEF: 8 versus 16 Frames	182	(2)
LVEF: Concordance Between RVG and Contrast Ventriculography	184	(1)
Gated SPECT and LVEF: Improved Accuracy with 16 Frames	185	(2)
Exercise Induced Ischemia and LV Dysfunction Detected by RVG	187	(1)
Dipyridamole Induced LV Dysfunction by RVG	188	(1)
Anthracycline-Induced Cardiomyopathy Detected by RVG	189	(2)
Evaluation of CHF by RVG	191	(1)
RVG SPECT to Follow-Up Chemotherapy	192	(1)
RVG SPECT to Follow-Up Heart Transplantation	193	(1)
LV Dysfunction Following Heart Transplantation	194	(1)
Aortic Insufficiency Evaluated by RVG SPECT	195	(1)
Eisenmenger Syndrome Evaluated by RVG SPECT	196	(1)
Anterior MI Evaluated by RVG SPECT	197	(1)
Idiopathic Dilated Cardiomyopathy Evaluated by RVG SPECT	198	(1)
Pulmonary Fibrosis and Pulmonary Hypertension by RVG SPECT	199	(6)
Evaluation of Myocardial Viability	205	(48)
Dominique Delbeke
Jeroen J. Bax
William H. Martin
Martin P. Sandler
Anterior Myocardial Infarction---99mTc SPECT MIBI/FDG PET	220	(2)
Inferoseptal Myocardial Viability---99mTc SPECT MIBI/FDG PET	222	(1)
Anterolateral Myocardial Viability---99mTc SPECT MIBI/FDG PET	223	(2)
Anteroapical Myocardial Viability---99mTc SPECT MIBI/FDG PET	225	(2)
Myocardial Viability: Anteroseptal, Inferior Wall and Apex-24H-201Tl/FDG PET	227	(2)
Myocardial Viability in a Diabetic Patient: Anterior and Inferior Wall---99mTc SPECT MIBI/FDG SPECT Single Acquisition	229	(3)
Myocardial Infarction: Inferior Wall---99mTc SPECT MIBI/FDG SPECT Single Acquisition	232	(1)
Implications of Attenuation Correction of FDG PET Images Compared to 99mTc-Tetrofosmin Without Attenuation Correction	233	(1)
Myocardial Viability: Resting and Nitrate-Enhanced 99mTc-MIBI	234	(2)
Ischemia in LAD Territory Demonstrated by Nitrate-Enhanced 99mTc-MIBI	236	(3)
18FDG SPECT More Sensitive than Dobutamine Echocardiography for Detection of Myocardial Viability	239	(2)
Myocardial Viability and Prognosis---Rest 201Tl/FDG SPECT	241	(2)
Myocardial Viability and LV Remodeling-Rest-Redistribution 201Tl and FDG SPECT	243	(1)
Myocardial Infarction---Rest/Dobutamine and Delayed Gd-Enhancement MRI	244	(9)
Myocardial Perfusion Imaging for Cardiac Risk Stratification	253	(26)
Sean W. Hayes
Daniel S. Berman
Rory Hachamovitch
Guido Germano
Patients Without Known Coronary Artery Disease	254	(3)
Added Value of Gated SPECT	257	(2)
Diabetic Women	259	(2)
Elderly	261	(3)
Post-Myocardial Infarction	264	(2)
Post-Angioplasty	266	(4)
Early, Symptomatic Post-Coronary Artery Bypass Surgery	270	(2)
Late, Asymptomatic Post-Coronary Artery Bypass Surgery	272	(3)
Extensive Coronary Calcium	275	(4)
Nuclear Cardiology for Imaging the Effects of Therapy	279	(30)
Leslee J. Shaw
Gary V. Heller
Ronald G. Schwartz
Carlos Cunha Pereira Neto
Vinicius Ludwig
Joao V. Vitola
Dominique Delbeke
Daniel S. Berman
MPI Demonstrating Successful PCI	294	(2)
MPI Post-Drug-Eluting Stent with Rapamycin	296	(2)
Post-Saphenous Graft Stent with Improved Perfusion and Function	298	(2)
MPI Showing Successful CABG	300	(2)
MPI Showing Poor Results of CABG	302	(1)
Early Post-Stent MPI Demonstrating Endothelial Dysfunction	303	(6)
Risk Assessment Before Noncardiac Surgery	309	(22)
Jeffrey A. Leppo
Seth Dahlberg
Preoperative Evaluation of High-Risk Surgery in an Asymptomatic Patient with Poor Exercise Tolerance	321	(2)
Moderate Inferoapical Ischemia Improving with Medical Therapy in a Patient with Good Exercise Tolerance Demonstrated with Stress/Rest SPECT MPI Performed for Preoperative Evaluation and Follow-Up	323	(2)
Normal MPI in a Patient with Documented CAD Stratified as Low Preoperative Risk	325	(6)
Applications of Myocardial Perfusion Imaging in Special Populations	331	(14)
Jennifer H. Mieres
Jean M. Cacciabaudo
Mikhail Levin
MPI Detecting LAD Ischemia in a Woman with Atypical Presentation	331	(3)
Atrial Fibrillation Inducing a Septal Artifact in a Patient with LBBB	334	(2)
Diabetes Mellitus Woman with Significant Ischemia on MPI	336	(2)
CHF and Chagas Disease	338	(2)
Incremental Value of MPI in an Asymptomatic Man with a Positive Exercise ECG	340	(5)
Pitfalls and Artifacts in Cardiac Imaging	345	(33)
Ernest V. Garcia
Cesar Santana
Gabriel Grossman
Russell Folks
Tracy Faber
Incorrect Axis Selection	346	(5)
Incorrect Base Selection	351	(4)
Suboptimal Display	355	(2)
Patient Motion	357	(4)
Incorrect Filtering and Small Ventricle Affecting LVEF and Volumes	361	(2)
Artifacts Related to Poor ECG Gating	363	(3)
Inferior Wall Attenuation Resolved by ECG Gating and Attenuation Correction	366	(3)
Breast Attenuation Artifact Resolved by Attenuation Correction	369	(2)
Artifact Related to LBBB	371	(7)
Correlation of Nuclear Imaging with Cardiac MRI	378	(17)
Jose Claudio Meneghetti
Carlos Eduardo Rochitte
Large Anterior MI Treated with Medical Therapy, LV Rupture and Death	380	(2)
Nontransmural MI with Collateral Circulation	382	(2)
Small Apical and Septal MI Treated with Stent Placement	384	(2)
Small MI, Viable Tissue, and Function Recovery with Revascularization	386	(2)
Large Anterior MI with Significant Remodeling and Aneurysm Formation	388	(3)
Multivessel Myocardial Ischemia Detected by MRI and MPI	391	(4)
Cardiac Applications of Multislice Computed Tomography	395	(11)
Jaydip Datta
Anomalous Origin and Course of the RCA	396	(3)
Accessory Right-Sided Pulmonary Venous Ostia	399	(2)
Left Atrial Appendage Thrombus in a Patient with Atrial Fibrillation	401	(5)
Correlation of Nuclear Cardiology with Stress Echocardiography	406	(18)
Joao V. Vitola
Wilson Mathias, Jr.
Jose Claudio Meneghetti
Dominique Delbeke
Concordance Between Stress Nuclear Imaging and Dobutamine Echocardiography to Demonstrate Myocardial Ischemia in Two-Vessel Territories (LAD and RCA)	412	(1)
Hyperdynamic Response of the LV to Dobutamine with Echocardiography Masking Mild Ischemia	413	(1)
Multivessel (LAD and RCA) Ischemia Detected with Exercise/Rest Gated SPECT and LAD Ischemia Detected with Contrast-Enhanced Adenosine Echocardiography	414	(2)
Extensive Acute Anterior Wall MI with No-Reflow Phenomenon Demonstrated with Myocardial Contrast Echocardiography and SPECT	416	(2)
Two-Vessel CAD Detected with Both Dipyridamole/Rest SPECT and Adenosine Stress Echocardiography with Ultrasonic Contrast Whereas There was No Stress-Induced Wall Motion Abnormality on Dobutamine Echocardiography	418	(1)
Incremental Value of Parametric Imaging Associated with Contrast-Enhanced Adenosine Echocardiography	419	(5)
Advances in Cardiac Applications for PET and PET/CT	424	(20)
Dominique Delbeke
Thomas H. Schindler
David Townsend
Philipp A. Kaufmann
Gustav K. von Schulthess
Heinrich R. Schelbert
Endothelial Dysfunction Demonstrated with Cold Pressor Testing/Rest 13N-Ammonia PET	432	(6)
Feasibility of Integrated CT Angiography/13N-Ammonia PET Imaging	438	(1)
Feasibility of Integrated CT Angiography/13N-Ammonia PET Imaging (Second Case)	439	(5)
Future Directions in Nuclear Cardiology	444	(27)
Raed Al-Dallow
Robert C. Hendel
Adenosine/Rest 99mTc-Teboroxime/Rest 201Tl SPECT Images Demonstrating a Fixed Defect in the Inferior Wall and Partial Reversibility in the Inferoseptal Region	444	(2)
Stress/Rest 99mTc-N-NOET Demonstrating Ischemia in the LAD Territory	446	(2)
99mTc-Annexin Demonstrating Apoptosis	448	(2)
99mTc-Glucarate Demonstrating Acute Myocardial Necrosis in the Anterolateral Wall of the LV	450	(2)
Selective Adenosine Receptor Stress 99mTc-MIBI/Rest 201Tl Demonstrating Ischemia in the LAD Territory	452	(2)
Dobutamine/Rest 99mTc-MIBI Demonstrating Extensive Three-Vessel CAD	454	(1)
Cardiac Transplant Rejection Demonstrated with 67Ga	455	(1)
Treatment of Heart Failure Monitored with 123I-MIBG	456	(3)
123I-BMIPP Demonstrating ``Ischemic Memory'' in LAD Territory	459	(1)
Better Visualization of the Endocardial Borders with Contrast Echocardiography in an Obese Patient	460	(2)
Extensive Calcification on EBCT Leading to Further Testing and Diagnosis of Ischemia in the LAD Territory	462	(2)
Anteroseptal MI Demonstrated with Delayed-Gd-Enhanced MRI	464	(1)
Better Quality of SPECT Images with IR than FBP Reconstruction	465	(6)
Index	471