Coronary microcirculation in acute myocardial ischaemia: From non-invasive to invasive absolute flow assessment.

Although substantial progress has been made in recent decades in reducing mortality and performing optimal revascularization in patients with myocardial infarction, ischaemic heart disease, including acute coronary syndrome, remains the leading cause of mortality worldwide. One of the remaining challenges is to better detect, prevent and treat extended myocardial damage despite angiographically optimal revascularization. Several indices are available in clinical practice to evaluate myocardial damage, infarct size and potential myocardial recovery.

A new era in gated myocardial perfusion imaging: Feasibility of data-driven cardiac contraction gating with multiple pinhole CZT SPECT.

Background: We previously validated the use of a data-driven cardiac respiratory-motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). In this study, we adapted the same process used with REGAT for RM to generate data-driven cardiac contraction triggers and corresponding cardiac contraction-gated SPECT studies (GSPECT-DD). We aimed to study its feasibility and compare its performances to GSPECT studies generated with ECG monitor-based triggers (GSPECT-ECG).

Impact of data-driven cardiac respiratory motion correction on the extent and severity of myocardial perfusion defects with free-breathing CZT SPECT.

Background: We previously reported the clinical feasibility and positive impact on image characteristics of a data-driven cardiac respiratory motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). Here, we evaluate its impact on the extent and severity of myocardial perfusion defects (MPD).

Methods: We included 25 patients having a 1-day Tc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT.

Feasibility of data-driven cardiac respiratory motion correction of myocardial perfusion CZT SPECT: A pilot study.

Background: We developed a data-driven respiratory motion (RM) correction method (REGAT program) for multiple-pinhole detector CZT SPECT. We verified its clinical feasibility with myocardial perfusion imaging (MPI) and studied its impact on image characteristics.

Methods: This retrospective study included 18 patients having stress/rest Tc-Tetrofosmin MPI SPECT.

Early detection of right ventricular functional abnormalities in patients with complex right premature ventricular contractions.

Background: Right ventricular (RV) premature contractions, although generally benign, may represent the first manifestation of arrhythmogenic RV cardiomyopathy. The diagnostic and prognostic value of RV functional abnormalities evidenced by equilibrium radionuclide angiocardiography (ERNA) with multiharmonic Fourier analysis has been validated in patients with severe RV arrhythmias suspected of being affected by arrhythmogenic RV cardiomyopathy. The aim of this study was to assess the prevalence of the same RV functional abnormalities in patients with frequent left bundle branch block pattern premature ventricular contractions (PVCs), without known heart disease, using ERNA as a screening tool.

Electrocardiograph-gated single photon emission computed tomography radionuclide angiography presents good interstudy reproducibility for the quantification of global systolic right ventricular function.

Background: Electrocardiograph-gated single photon emission computed tomography (SPECT) radionuclide angiography provides accurate measurement of right ventricular ejection fraction and end-diastolic and end-systolic volumes.

Aim: In this study, we report the interstudy precision and reliability of SPECT radionuclide angiography for the measurement of global systolic right ventricular function using two, three-dimensional volume processing methods (SPECT-QBS, SPECT-35%). These were compared with equilibrium planar radionuclide angiography.

Comparison of interstudy reproducibility of equilibrium electrocardiography-gated SPECT radionuclide angiography versus planar radionuclide angiography for the quantification of global left ventricular function.

Background: Electrocardiography-gated single photon emission computed tomography (SPECT) radionuclide angiography (RNA) provides accurate measurement of both left ventricular (LV) ejection fraction (EF) and end-diastolic and end-systolic volumes. In this study we studied the interstudy precision and reliability of SPECT RNA as compared with planar RNA for the measurement of global systolic LV function.

Methods And Results: The population included 10 patients with chronic coronary artery disease having 2 sets of acquisitions, each consisting of planar and SPECT RNA.

Automatic quantification of right ventricular function with gated blood pool SPECT.

Background: Quantification of right ventricular (RV) function is clinically relevant for the risk stratification and follow-up of patients with a wide spectrum of disease. This can be achieved with electrocardiography-gated blood pool single photon emission computed tomography (GBPS). We aimed to evaluate the accuracy of the completely automatic QBS GBPS processing software as compared with equilibrium planar radionuclide angiography (RNA) and with a GBPS manual segmentation method (GBPS(35%)) for the measurement of global RV ejection fraction (EF), taking the first-pass RNA (FP-RNA) as the gold standard.

The value of a completely automatic ECG gated blood pool SPECT processing method for the estimation of global systolic left ventricular function.

Objectives: Electrocardiographically gated blood pool SPECT (GBPS) is an interesting method for measuring left ventricular (LV) ejection fraction (LVEF) and volume. Recently, the availability of completely automatic GBPS processing software has been reported. We aimed to evaluate its reliability in measuring global LV systolic function.

Discordance between exercise SPECT lung Tl-201 uptake and left ventricular transient ischemic dilation in patients with CAD.

Background: In patients with coronary artery disease (CAD), the characteristics of those with discordant exercise thallium 201 single photon emission computed tomography (SPECT) lung uptake (lung-to-heart [L/H] ratio) and left ventricular (LV) transient ischemic dilation (LVTID) are not well defined.

Methods And Results: The population included 310 patients having exercise Tl-201 SPECT and coronary angiography. The population was subclassified into 4 subgroups: increased L/H ratio only, increased LVTID only, both, and neither.

Comparative value of ECG-gated blood pool SPET and ECG-gated myocardial perfusion SPET in the assessment of global systolic left ventricular function.

Both electrocardiographically (ECG) gated blood pool SPET (GBPS) and ECG-gated myocardial perfusion SPET (GSPET) are currently used for the measurement of global systolic left ventricular (LV) function. In this study, we aimed to compare the value of GSPET and GBPS for this purpose. The population included 65 patients who underwent rest thallium-201 GSPET imaging at 15 min after (201)Tl injection followed by planar (planar(RNA)) and GBPS equilibrium radionuclide angiography immediately after 4-h redistribution myocardial perfusion SPET imaging.

Performance of OSEM and depth-dependent resolution recovery algorithms for the evaluation of global left ventricular function in 201Tl gated myocardial perfusion SPECT.

Unlabelled: It is unknown whether the use of ordered-subsets expectation maximization (OSEM) and depth-dependent resolution recovery (RR) will increase the accuracy of (201)Tl electrocardiogram-gated SPECT (GSPECT) for the measurement of global left ventricular (LV) function.

Methods: Fifty-six patients having both rest (201)Tl GSPECT and planar equilibrium radionuclide angiography (planar(RNA)) on the same day were studied. Twenty-nine patients also had LV conventional contrast angiography (Rx).

Detection of neuroendocrine tumors: 99mTc-P829 scintigraphy compared with 111In-pentetreotide scintigraphy.

Unlabelled: The aim of this study was to evaluate the diagnostic value of a new somatostatin analog, 99mTc-P829, compared with that of 111In-pentetreotide.

Methods: Forty-three patients (32 men, 11 women; age range, 24-78 y; mean age, 56 y) with biologically or histologically proven neuroendocrine tumors were prospectively included: 11 patients with Zollinger-Ellison syndrome, 16 patients with carcinoid tumors, and 16 patients with other types of functioning (n = 6) or nonfunctioning (n = 10) endocrine tumors. 111In-Pentetreotide planar images (head, chest, abdomen, and pelvis) were obtained 4 and 24 h after injection of 10 microg somatostatin analog labeled with 148 +/- 17 MBq 111In, and SPECT was performed 24 h after injection.

Identification of extensive coronary artery disease: incremental value of exercise Tl-201 SPECT to clinical and stress test variables.

Background: The ability of the size of a total myocardial perfusion defect (MPD) to detect extensive coronary artery disease (CAD) is currently suboptimal with exercise thallium 201 single photon emission computed tomography (SPECT). To improve its performance, exercise electrocardiography and indirect scintigraphic markers of extensive CAD were proposed (increased right ventricular Tl-201 uptake, lung-to-heart [L/H] ratio, and left ventricular transient ischemic dilation ratio). We aimed to determine the additive value of these criteria for the detection of extensive CAD.