Atlas of Nuclear Cardiology

Preface
Contents
Contributors
1: History of Nuclear Cardiology
	Discovery of Natural Radioactivity: Antoine Henri Becquerel
	Understanding the Nature of Radiation
	First Tracer Study in Humans: Herrmann Blumgart
	The Radiocardiogram: Myron Prinzmetal
	Radionuclide Imaging
	Scintillation Camera: Hal Anger
	Cardiac Studies
		Left Ventricular Ejection Fraction
		Myocardial Perfusion
	References
2: Principles of Nuclear Cardiology Imaging
	Introduction
	Fundamentals
	Formation of Radionuclides
	Imaging Devices and Principles
	Quality Control Procedures
	Advances in Cardiology Imaging
	References
3: Handling Radionuclides and Radiation Safety
	References
4: SPECT and PET Myocardial Perfusion Imaging: Tracers and Techniques
	Myocardial Perfusion, Uptake, and Clearance
	Image Interpretation and Quantitation
	SPECT Techniques: 201TI
	SPECT Techniques: 99mTc-labeled Perfusion Tracers
	PET Tracers and Techniques
	References
5: Physiologic and Pharmacologic Stressors
	Introduction
	Physiologic Stress
	Pharmacologic Stress
		Selective Adenosine-2A Receptor Agonists
		Pivotal Regadenoson Clinical Trials
		Selective A2A Receptor Agonist Side Effect Profiles
	Recent Clinical Applications
	Preoperative Cardiac Risk Stratification
		Pharmacologic Stress Myocardial Perfusion Imaging Literature
		Current Clinical Practice Guidelines
		Clinical Utility of Stress Imaging in Perioperative Risk Assessment
	Recent Clinical Applications
		Stress Imaging Modality Choice
	References
6: Coronary Physiology and Quantitative Myocardial Perfusion
	Why Coronary Physiology and Quantitative Perfusion?
	Clinical Coronary Physiology
	The Literature: Conflicts, Explanations, Resolutions
		Conflicts: Which Is Best, CFR or Stress Perfusion?
		Conflicts: Which Is Best for Diagnosis of Significant Stenosis, FFRCT or Quantitative PET Perfusion?
		Conflicts: Which Is Best for Diagnosis of Significant Stenosis, CT Angiography (CTA) or Quantitative PET Perfusion?
		Conflicts: What Is the Prevalence of Microvascular Disease?
		Making Physiologic Displays That Are Clinically Useful
	Interacting Clinical Physiology and Imaging Physics
	Clinical Coronary Physiology by PET to Guide Cardiac Care
	Physiologic Severity, Revascularization, and Outcomes
	Quantitative Myocardial Perfusion for Clinical Dilemmas
		Severe CAD Missed on Angiograms
		Recurrent Angina after Surgery
		Progression and Regression of CAD
	The Unmeasured Elephants in Cardiology: Methods Thinking Versus Physiology Thinking; Subendocardial Perfusion; Low-Risk Versus High-Risk Angina
	References
7: Assessment of Cardiac Function: First-Pass, Equilibrium Blood Pool, and Gated Myocardial SPECT
	Introduction
	Blood Pool Imaging of Ventricular Function
		First-Pass Versus Equilibrium Method
		First-Pass Analysis
		Equilibrium Analysis
		Gating Methods
		Clinical Parameters
		Radionuclide Angiography in Clinical Cardiology
		SPECT Blood Pool Imaging
	Gated Myocardial Perfusion SPECT
		Partial Volume Effect
		Gated Perfusion Imaging
	References
8: Prognostic Performance of Myocardial Perfusion and Function
	Introduction
	Pathophysiologic Basis for Risk Assessment in Myocardial Perfusion SPECT
	Differentiating Outcome Type by Nuclear Test Results
	Interpreting Perfusion Data in Conjunction with Pre-test Assessments of Risk
	Clinical Factors and Their Interactions with Ischemia
	The Effect of Changes in SPECT MPI Protocols and Technology
	The Role of Coronary Calcium Scoring
	Using Perfusion Imaging to Assess Survival Benefit from Revascularization
	References
9: Imaging Cardiac Metabolism
	Introduction
	Evolution of Knowledge of Cardiac Metabolism
	Metabolic Radiotracers
	Metabolic Signals in Normal and Diseased Heart: Opportunities for Molecular Imaging
	Clinical Application of Myocardial Metabolism: PET and SPECT Techniques
		PET Techniques: 11C-Palmitate
		SPECT Technique: 123I-BMIPP
		PET Technique: 11C-Acetate
	PET and SPECT Techniques: 18F-FDG
	Metabolic Pathways and Patterns
	References
10: Myocardial Viability
	Requirements for Cellular Viability
	Pathogenetic Basis of Altered Myocardial States
	Left Ventricular Ejection Fraction
	Evaluating Myocardial Viability
	Arithmetic of Altered Myocardial States
	References
11: Myocardial Innervation
	Autonomic Nervous System
	Radiotracers
	Normal Myocardial Innervation
	Heart Failure
	Ischemic Heart Disease
	Atrial and Ventricular Arrhythmias
	Diabetes
	Cardiac Transplantation
	References
12: Diagnosis and Risk Stratification in Acute Coronary Syndromes
	Introduction
	General Approach to Cardiovascular Imaging in ACS
	Radionuclide Imaging Early in the Evaluation of Suspected ACS
	Echocardiography in the Evaluation of Suspected ACS
	Cardiac CT Imaging in the Evaluation of Suspected ACS
	Cardiac MRI in the Evaluation of Suspected ACS
	Imaging of Myocardial Salvage in Patients with Acute Myocardial Infarction
	Role of Radionuclide Imaging Following an ACS
	References
13: Imaging Cardiac Sarcoidosis, Amyloidosis, and Cardiovascular Prosthetic Infections
	Cardiac Sarcoidosis
	Cardiovascular Prosthetic Infection
	Cardiac Amyloidosis
	References
14: Clinical Molecular Imaging of Inflammation and Calcification in Atherosclerosis
	Biology of At‑herosclerosis
	Imaging of Cardiovascular Inflammation
		Insights into Clinical Risk
		Imaging Coronary Plaque Inflammation
		Imaging of Vascular Microcalcification
		Gaining Insights Into Treatment Effects
		Multitissue Imaging to Gain Unique Biological Insights in Humans
	Potential Future Clinical Use
	References
Index