Handbook of Nuclear Cardiology-Cardiac SPECT and Cardiac PET

Preface
Acknowledgments
Contents
Part I: Foundations of Nuclear Cardiology
	1: The Foundations of Nuclear Cardiology
		1.1	 Early History
		1.2	 Evolution
		1.3	 Applications
		1.4	 Conclusion
		References
	2: Basic Physics of Nuclear Cardiology
		2.1	 Introduction: Basic Physics
		2.2	 Characteristics of Commonly Used Isotopes
			2.2.1	 Single Photon Emitting Isotopes
			2.2.2	 Positron Emitting Isotopes
		2.3	 Interactions with Tissue
			2.3.1	 Absorption and Scatter
			2.3.2	 Attenuation
		2.4	 Acquisition and Processing of Data
			2.4.1	 SPECT
			2.4.2	 PET
			2.4.3	 Reconstruction
		2.5	 Radiation Dose to the Patient
		2.6	 Summary
		References
	3: Exercise Stress Testing
		3.1	 Introduction
		3.2	 Indications and Procedures
			3.2.1	 Class indication
		3.3	 Interpretation
			3.3.1	 ECG Abnormalities
		3.4	 Time to Heart-Rate Recovery
			3.4.1	 Blood Pressure Monitoring
			3.4.2	 Diagnostic Accuracy
			3.4.3	 Prognosis
			3.4.4	 Complications
		References
	4: Pharmacologic Stress Testing
		References
	5: Radiation Safety in Nuclear Cardiology
		5.1	 Introduction
		5.2	 Radiation Biology
		5.3	 Medical Radiation Exposure
		5.4	 Radiation Exposure of in Nuclear Cardiology: SPECT and PET
		5.5	 Methods for Radiation Reduction
		5.6	 Summary
		References
	6: SPECT Radiopharmaceuticals
		6.1	 Introduction
		6.2	 Thallium-201 (201Tl)
			6.2.1	 201Tl Imaging Protocol
		6.3	 Technetium-99m (99mTc)
			6.3.1	 99mTc Imaging Protocol
			6.3.2	 Stress-Only or Stress-First Imaging
		6.4	 Radiation Exposure from Myocardial Perfusion Imaging
		6.5	 Non-Perfusion Imaging SPECT Radiopharmaceuticals
		6.6	 Conclusion
		References
	7: SPECT Instrumentation
		7.1	 Introduction
			7.1.1	 Anger Camera
			7.1.2	 Newer Technology: Solid State Detectors
			7.1.3	 Collimation
		7.2	 Study Acquisition
			7.2.1	 Planar Acquisition
			7.2.2	 Tomographic Acquisition
			7.2.3	 ECG Gating
		7.3	 Reconstruction
			7.3.1	 Attenuation Correction
			7.3.2	 Scatter Compensation
			7.3.3	 Resolution Recovery
			7.3.4	 Motion Correction
		7.4	 Image Processing and Analysis
			7.4.1	 Filtering
			7.4.2	 Blood-Pool Analysis (Planar Scan)
			7.4.3	 Perfusion (SPECT Study)
		7.5	 Instrumentation QA
			7.5.1	 Energy Peaking
			7.5.2	 Uniformity Test
			7.5.3	 Resolution and Linearity
			7.5.4	 Center of Rotation (COR)
			7.5.5	 Multipurpose Plexiglas Phantoms
		References
	8: Radiopharmaceuticals for Cardiac PET Imaging
		8.1	 Introduction
			8.1.1	 Ideal Physiologic Characteristics of Perfusion Imaging Agents
		8.2	 Cardiac Positron Emitting Radiopharmaceuticals
			8.2.1	 Rubidium-82 (82Rb)
			8.2.2	 Nitrogen-13 Ammonia (13N-ammonia)
			8.2.3	 F-18 Fluorodeoxyglucose (18F FDG)
			8.2.4	 18F-Flurpiridaz
		8.3	 Conclusions
		References
	9: Cardiac PET Instrumentation
		9.1	 Introduction
		9.2	 Basics of Cardiac PET
			9.2.1	 PET Scanners
			9.2.2	 Attenuation Correction of PET
			9.2.3	 Radionuclide Source for Attenuation Correction
			9.2.4	 CT Source for Attenuation Correction
			9.2.5	 Scatter Correction
			9.2.6	 Randoms Corrections
			9.2.7	 Protocols for Cardiac PET Perfusion Acquisition
			9.2.8	 Reconstruction
		9.3	 Solid State “Digital” Detectors
		9.4	 PET Myocardial Blood Flow Instrumentation
		9.5	 Conclusions
		References
Part II: Clinical Applications of Radionuclide Perfusion Imaging
	10: Clinical Practice Guidelines and Appropriate Use Criteria
		10.1	 Introduction
		10.2	 Clinical Practice Guidelines
		10.3	 Appropriateness Use Criteria
		10.4	 Performance Measures
		10.5	 Conclusion
		References
	11: Interpretation and Reporting of SPECT/PET Myocardial Perfusion Imaging
		11.1	 Interpretation of SPECT and PET MPI
			11.1.1	 Soft Tissue Attenuation
			11.1.2	 Semi-Quantitative and Quantitative Analysis
			11.1.3	 Interpretation Differences for PET Perfusion with Myocardial Blood Flow
			11.1.4	 ECG Gating
		11.2	 Reporting
			11.2.1	 Components of the Report
				11.2.1.1	 Clerical Data
				11.2.1.2	 Patient Data
				11.2.1.3	 Indications
				11.2.1.4	 Procedures
				11.2.1.5	 Image Findings
				11.2.1.6	 Conclusion/Impression
		11.3	 Report Logistics
		References
	12: Assessment of Patients with Suspected Coronary Artery Disease
		12.1	 Introduction
		12.2	 The Symptomatic Patient
		12.3	 The Asymptomatic Patient
		12.4	 Diagnostic Accuracy of Functional Testing
		12.5	 Acute Rest Myocardial Perfusion Imaging
		12.6	 Conclusion
		References
	13: Evaluation of Patients with Known Coronary Artery Disease
		13.1	 Introduction
		13.2	 Symptomatic Patients with Known CAD
			13.2.1	 Assessing the Success of Medical Therapy with  Stress MPI
			13.2.2	 Stress MPI Following Percutaneous Coronary Intervention
			13.2.3	 Stress MPI Following Coronary Artery Bypass Grafting
		13.3	 Value of Cardiac Radionuclide Imaging in Patients with Acute Coronary Syndrome
			13.3.1	 ST Elevation Myocardial Infarction
			13.3.2	 Non-ST Elevation MI/Unstable Angina
		13.4	 Conclusions
		References
	14: Myocardial Perfusion Imaging in Specific Patient Populations
		14.1	 Introduction
		14.2	 Assessment in Obese Patients
			14.2.1	 Conclusions-Obesity
		14.3	 Assessment in Chronic Kidney Disease
			14.3.1	 Conclusions-Chronic Kidney Disease
		14.4	 Assessment in Diabetes
			14.4.1	 Conclusions-Diabetes
		14.5	 Assessment in the Elderly
			14.5.1	 Conclusions-Elderly
		14.6	 Assessment in Women
			14.6.1	 Conclusions-Women
		14.7	 Conclusion
		References
	15: Preoperative Evaluation
		15.1	 Introduction
		15.2	 Risk Stratification
		15.3	 Role of Nuclear Cardiology in Perioperative Evaluation
		References
	16: Cardiac Imaging in Heart Failure
		16.1	 Introduction
		16.2	 Etiology of Cardiomyopathy
		16.3	 Assessment of Left Ventricular (LV) Function
			16.3.1	 ECG-Gated SPECT Imaging
			16.3.2	 Equilibrium Radionuclide Angiography (ERNA)
		16.4	 Risk Stratification in Patients with Left Ventricular Dysfunction
			16.4.1	 Myocardial Perfusion Imaging (MPI)
			16.4.2	 Autonomic Neuronal Imaging Using 123I-MIBG
		16.5	 Assessment of Myocardial Viability
		16.6	 Dyssynchrony
		16.7	 Conclusions
		References
	17: Assessment of Myocardial Blood Flow with Cardiac PET Perfusion Imaging
		17.1	 Introduction
		17.2	 Myocardial Blood Flow Assessment and Performance
		17.3	 Collection of Myocardial Blood Flow Data
			17.3.1	 Resting Myocardial Blood Flow Data
			17.3.2	 Stress Myocardial Blood Flow Data
			17.3.3	 Myocardial Blood Flow Reserve Data
		17.4	 Interpretation of Myocardial Blood Flow Data
			17.4.1	 What Is Considered Normal and Abnormal Myocardial Blood Flow Reserve?
		17.5	 Clinical Value of Myocardial Blood Flow
			17.5.1	 Clinical Value of Myocardial Blood Flow Reserve in Patients with No Known CAD
			17.5.2	 Clinical Value of Myocardial Blood Flow Reserve in Patients with Known CAD
			17.5.3	 Additional Clinical Observations Regarding Myocardial Blood Flow
		17.6	 Reporting of MBF and MBFR
		17.7	 SPECT Imaging and Myocardial Blood Flow Assessment
		17.8	 Conclusion
		References
Part III: Non-perfusion Applications of Nuclear Cardiology
	18: Ventricular Function Assessment
		18.1	 Introduction
		18.2	 ECG Gating
		18.3	 ERNA Scan
			18.3.1	 Imaging Technique
			18.3.2	 Indications
			18.3.3	 Gated Blood Pool SPECT
		18.4	 Gated SPECT/PET MPI
			18.4.1	 Interpretation of the Gated SPECT/PET
			18.4.2	 Dyssynchrony
			18.4.3	 Caveats to Gated SPECT/PET MPI
		18.5	 Conclusion
		References
	19: Imaging Cardiac Amyloidosis
		19.1	 Introduction
		19.2	 Value of Various Cardiac Imaging Procedures
			19.2.1	 Echocardiography
			19.2.2	 Cardiac Magnetic Resonance Imaging (CMR)
			19.2.3	 Scintigraphy with Bone-Avid Radiopharmaceuticals
				19.2.3.1	 Imaging Technique
				19.2.3.2	 Interpretation and Reporting
			19.2.4	 PET Amyloid Imaging
		19.3	 Conclusions
		References
	20: Role of 18-Fluorine Fluorodeoxyglucose (18F-FDG) PET CT in Cardiovascular Diseases
		20.1	 Introduction
		20.2	 Myocardial Viability
		20.3	 Cardiac Sarcoidosis
		20.4	 Prosthetic Valve Endocarditis
		20.5	 CIED Related Infections
		20.6	 Summary
		References
	21: Hybrid Imaging in Nuclear Cardiology
		21.1	 Introduction
		21.2	 Hybrid (Attenuation Correction) Myocardial Perfusion Imaging
		21.3	 Calcium Scoring with Hybrid Imaging
		21.4	 SPECT/CT Cardiac Amyloidosis Imaging
		21.5	 PET/CT Myocardial Metabolism Imaging
		21.6	 Incidental Findings
		21.7	 Conclusion
		References
	22: Assessment of Coronary Calcium
		22.1	 Introduction
		22.2	 Gated Image Acquisition
		22.3	 Clinical Use
		22.4	 Indications for CAC
		22.5	 Conclusion
		References
Index