Hybrid Cardiac Imaging

Preface
Contents
Part I: Generic Aspects of Hybrid Imaging
	1: Hybrid Imaging and Healthcare Economics
		1.1	 Hybrid Imaging in Stable CAD (SCAD): CTCA and MPI
		1.2	 Health-Economic Implications
		1.3	 Hybrid PET-MRI and Health-Economics Implications
		References
	2: Industry Perspective on Hybrid Cardiac Imaging
		2.1	 Introduction
		2.2	 Ultra-Fast Cardiac Cameras Based on CZT Technology
		2.3	 Pinhole Imaging
		2.4	 Hybrid Imaging for Dedicated Cardiac SPECT Cameras
		References
	3: Global and Regional Peculiarities: The IAEA Perspective
		3.1	 Introduction
		3.2	 Health Expenditures
		3.3	 The Challenge of Introducing Newer Technologies
		3.4	 Diagnostic Efficacy and Cost Effectiveness
		3.5	 Economic Evidence on the Use of Nuclear Cardiology
		3.6	 The Program in Human Health of the IAEA to Support Nuclear Medicine and Hybrid Imaging
		3.7	 Human Resources Capacity Building
		3.8	 The Growth of Hybrid Imaging in Developing World
		3.9	 Assessment of the Utilization of Hybrid Imaging Worldwide
		References
Part II: SPECT/CT
	4: Perfusion, Calcium Scoring, and CTA
		4.1	 Coronary Dominancy and Variations
		4.2	 Calcium Scoring and Assessment of Plaque and Stenosis
		4.3	 Myocardial CT Perfusion by Dynamic CTA
		4.4	 Hybrid Analysis and Image Fusion (SPECT or PET and CTA)
		4.5	 Future Direction and Visions
		References
	5: Hybrid Imaging of the Autonomic Cardiac Nervous System
		5.1	 Introduction
		5.2	 Cardiac Sympathetic Nervous System Imaging
		5.3	 SPECT and PET Tracers
			5.3.1	 Presynaptic
			5.3.2	 Post-synaptic
		5.4	 Principles in Analysis, Quantification, and Software
		5.5	 Clinical Applications
			5.5.1	 ANS and Myocardial Ischemia and Infarction and Heart Failure (CMP)/Heart Transplantation
			5.5.2	 Long QT, Brugada, ARVD Detection
			5.5.3	 Predicting Ventricular Arrhythmias and Sudden Cardiac Death with ANS Imaging
			5.5.4	 ANS and Cardiac Resynchronization
			5.5.5	 ANS and Cardiac Amyloidosis
			5.5.6	 ANS and DM
		5.6	 Conclusion and Future Perspectives
			5.6.1	 Potential Novel Tracers
			5.6.2	 Role of PET/MR
			5.6.3	 New Clinical Trial
			5.6.4	 Clinical Implementation
		5.7	 Conclusion
		References
	6: Dyssynchrony
		6.1	 Assessment of Left Ventricular Dyssynchrony by SPECT
		6.2	 Dyssynchrony as a Guide for Cardiac Resynchronization Therapy
		6.3	 Dyssynchrony as a Guide for Implantable Cardioverter Defibrillator
		6.4	 Value of Dyssynchrony in Ischemic Heart Disease
		6.5	 Technical Considerations in the Assessment of Dyssynchrony by SPECT
		References
	7: Novel Techniques: Solid-State Detectors, Dose Reduction (SPECT/CT)
		7.1	 Introduction
		7.2	 Technology
			7.2.1	 Solid-State Detectors
		7.3	 Dedicated Cardiac Systems
			7.3.1	 Detectors
			7.3.2	 Dedicated Cardiac Collimators and Geometries
		7.4	 SPECT/CT
		7.5	 Solid-State SPECT/CT Systems
		7.6	 Reconstruction Including Resolution Recovery and Anatomical Constraints
			7.6.1	 Performance
		7.7	 Impact on the Field
			7.7.1	 Current Clinical Use
		7.8	 Clinical Protocols
			7.8.1	 Two-Position Imaging: Upright/Supine or Supine/Prone
			7.8.2	 Low-Dose Protocols
		7.9	 Simultaneous Dual-Isotope MPI
		7.10	 Normal Perfusion Limits for Solid-State Cameras
			7.10.1	 Combined Quantification from Two Positions
		7.11	 Motion Correction on Solid-State Cameras
		7.12	 Potential Pitfalls
		7.13	 Emerging Clinical Techniques
			7.13.1	 SPECT Myocardial Blood Flow
			7.13.2	 Early EF
			7.13.3	 Large-Scale Clinical Validation
		7.14	 Future Hardware Designs
		7.15	 Summary
		References
Part III: PET/CT
	8: Myocardial Blood Flow Quantification with PET/CT: Applications
		8.1	 Introduction
		8.2	 Coronary Circulation
		8.3	 Pre-clinical Experience/Validation Studies
		8.4	 Myocardial Blood Flow with PET: Reference Values
		8.5	 MBF and CFR in Ischemic Heart Disease
		8.6	 Relationship of CFR with FFR in Ischemic Heart Disease
		8.7	 Prognostic Value of Stress MBF and CFR for Risk Stratification
		8.8	 Summary
		References
	9: Hybrid PET-CT Evaluation of Myocardial Viability
		9.1	 Background
		9.2	 Patterns of Viability by PET
		9.3	 Metabolic Considerations
		9.4	 Protocols for Assessment of Myocardial Viability by FDG
		9.5	 Diagnostic Accuracy of FDG Myocardial Viability Assessment
		9.6	 Prognostic Implications of FDG Myocardial Viability Assessment
		9.7	 FDG Myocardial Viability Assessment for Guiding Therapeutic Decision
		9.8	 Hybrid PET-Computed Tomography for Myocardial Viability Assessment
		9.9	 Conclusions
		References
	10: Myocardial Inflammation: Focus on Cardiac Sarcoidosis
		10.1	 Introduction
		10.2	 Sarcoidosis Overview
			10.2.1	 Epidemiology and Demographics
			10.2.2	 Epidemiology and Demographics
			10.2.3	 Cardiac Sarcoidosis
		10.3	 Cardiac Sarcoidosis Diagnosis
			10.3.1	 Pathology
			10.3.2	 Imaging
		10.4	 Imaging Methods
			10.4.1	 Cardiac MRI
			10.4.2	 PET
			10.4.3	 Patient Preparation for FDG Myocardial Inflammation PET
			10.4.4	 Myocardial Inflammation PET Imaging Protocol
			10.4.5	 PET Image Interpretation
			10.4.6	 Pitfalls in FDG Image Interpretation
			10.4.7	 Hybrid Imaging
		10.5	 Role of Imaging
			10.5.1	 Cardiac Sarcoid Diagnosis
			10.5.2	 Prognosis
			10.5.3	 Response Assessment
		10.6	 Guidelines
		10.7	 Future Directions for Myocardial Inflammation PET
		10.8	 Conclusions
		References
	11: Novel SPECT and PET Tracers and Myocardial Imaging
		11.1	 Overview
		11.2	 Physiological Imaging
			11.2.1	 Myocardial Perfusion Imaging
				11.2.1.1	 SPECT Perfusion Imaging
				11.2.1.2	 PET Perfusion Imaging
		11.3	 Targeted Molecular Imaging
			11.3.1	 Inflammation
				11.3.1.1	 SPECT Radiotracers
				11.3.1.2	 PET Radiotracers
			11.3.2	 Cell Death
				11.3.2.1	 Apoptosis Imaging
				11.3.2.2	 Cell Necrosis Imaging
		11.4	 Sympathetic and Parasympathetic Imaging
		11.5	 Sympathetic Imaging
			11.5.1	 SPECT Radiotracers
			11.5.2	 PET Radiotracers
		11.6	 Clinical Applications of SNS Imaging
		11.7	 Parasympathetic Imaging
			11.7.1	 Angiogenesis
				11.7.1.1	 αvβ3 Integrin Targeted Imaging
				11.7.1.2	 Vascular Endothelial Growth Factor (VEGF) and Endothelial Cell Imaging
		11.8	 Imaging Fibrosis and Extracellular Matrix (ECM)
			11.8.1	 Clinical Applications
				11.8.1.1	 Imaging Somatostatin Receptor
				11.8.1.2	 Imaging Integrins
				11.8.1.3	 Imaging Collagen
				11.8.1.4	 Imaging of Extracellular Matrix Proteases
		11.9	 Monitoring Cell and Gene-Based Therapies with Novel Reporter Probe Imaging
			11.9.1	 Direct Labeling
			11.9.2	 Reporter Genes
		11.10	 Theranostics
		References
Part IV: PET/MR
	12: PET/MR: Perfusion and Viability
		12.1	 Introduction
		12.2	 Technical Specialities of PET/MRI Systems
		12.3	 Myocardial Perfusion Imaging
		12.4	 Myocardial Viability Imaging
		12.5	 Conclusion
		References
	13: PET/MRI: “Inflammation”
		13.1	 Introduction: A Brief History of Hybridization
		13.2	 Challenges to PET/MRI
			13.2.1	 Technical Issues
				13.2.1.1	 Hardware Incompatibilities
				13.2.1.2	 Attenuation Correction
				13.2.1.3	 Motion Correction
				13.2.1.4	 Magnet Bore and FOV
				13.2.1.5	 Software Considerations
			13.2.2	 Patient/Workflow Issues
			13.2.3	 Personnel Issues
			13.2.4	 Cost
		13.3	 Advantages of PET/MRI
			13.3.1	 Compared to Separate PET and MRI
			13.3.2	 Compared to PET/CT
		13.4	 Applications of PET/MRI in Inflammatory Heart Disease
			13.4.1	 Sarcoidosis
				13.4.1.1	 Background
					The Hybrid Approach
			13.4.2	 Myocarditis
			13.4.3	 Endocarditis
			13.4.4	 Atherosclerotic Plaque Risk Stratification
			13.4.5	 Preclinical Applications
		13.5	 Acquisition Protocol and Patient Preparation
			13.5.1	 Inflammation Protocol
		13.6	 Study Interpretation and Reporting
		13.7	 Future Directions
		References
	14: Innovations in Cardiovascular MR and PET-MR Imaging
		14.1	 Introduction
		14.2	 Innovations in Cardiac MR: Quantitative Cardiac MRI
			14.2.1	 Cardiac T1 and T2 mapping
			14.2.2	 Cardiac MR Fingerprinting
			14.2.3	 Cardiovascular MRI Multitasking
		14.3	 Innovations in Cardiac MR: Towards Efficient 3D Whole-Heart Imaging
			14.3.1	 Dealing with Physiological Motion
			14.3.2	 Accelerating Data Acquisition
			14.3.3	 Coronary MR Imaging
			14.3.4	 Myocardial Viability MR Imaging
			14.3.5	 Multi-Contrast Whole-Heart MR Imaging
			14.3.6	 Whole-Heart Quantitative T1 and T2 Mapping
		14.4	 Innovations in Cardiac PET-MR Imaging
			14.4.1	 Motion-Compensated Cardiac PET-MR Imaging
				14.4.1.1	 Respiratory Motion Compensation
				14.4.1.2	 Cardiac Motion Compensation
				14.4.1.3	 Respiratory and Cardiac Motion Compensation
			14.4.2	 Novel PET Radiotracers for Clinical Cardiac PET-MR Applications
		14.5	 Concluding Remarks
		References