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Lehner S, Nowak I, Zacherl M, Brosch-Lenz J, Fischer M, Ilhan H, Rübenthaler J, Gosewisch A, Bartenstein P, Todica A. Quantitative myocardial perfusion SPECT/CT for the assessment of myocardial tracer uptake in patients with three-vessel coronary artery disease: Initial experiences and results. J Nucl Cardiol 2022; 29:2511-2520. [PMID: 34341952 PMCID: PMC9553851 DOI: 10.1007/s12350-021-02735-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/18/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND To evaluate quantitative myocardial perfusion SPECT/CT datasets for routine clinical reporting and the assessment of myocardial tracer uptake in patients with severe TVCAD. METHODS MPS scans were reconstructed as quantitative SPECT datasets using CTs from internal (SPECT/CT, Q_INT) and external (PET/CT, Q_EXT) sources for attenuation correction. TPD was calculated and compared to the TPD from non-quantitative SPECT datasets of the same patients. SUVmax, SUVpeak, and SUVmean were compared between Q_INT and Q_EXT SPECT datasets. Global SUVmax and SUVpeak were compared between patients with and without TVCAD. RESULTS Quantitative reconstruction was feasible. TPD showed an excellent correlation between quantitative and non-quantitative SPECT datasets. SUVmax, SUVpeak, and SUVmean showed an excellent correlation between Q_INT and Q_EXT SPECT datasets, though mean SUVmean differed significantly between the two groups. Global SUVmax and SUVpeak were significantly reduced in patients with TVCAD. CONCLUSIONS Absolute quantification of myocardial tracer uptake is feasible. The method seems to be robust and principally suitable for routine clinical reporting. Quantitative SPECT might become a valuable tool for the assessment of severe coronary artery disease in a setting of balanced ischemia, where potentially life-threatening conditions might otherwise go undetected.
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Affiliation(s)
- Sebastian Lehner
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
- Ambulatory Health Care Center Dr. Neumaier & Colleagues, Radiology, Nuclear Medicine, Radiation Therapy, Bahnhofstraße 24, 93047, Regensburg, Germany.
| | - Isabel Nowak
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Mathias Zacherl
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Julia Brosch-Lenz
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Maximilian Fischer
- Department of Internal Medicine, Cardiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Astrid Gosewisch
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Andrei Todica
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
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Narasimhan B, Narasimhan H, Lorente-Ros M, Romeo FJ, Bhatia K, Aronow WS. Therapeutic angiogenesis in coronary artery disease: a review of mechanisms and current approaches. Expert Opin Investig Drugs 2021; 30:947-963. [PMID: 34346802 DOI: 10.1080/13543784.2021.1964471] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Despite tremendous advances, the shortcomings of current therapies for coronary disease are evidenced by the fact that it remains the leading cause of death in many parts of the world. There is hence a drive to develop novel therapies to tackle this disease. Therapeutic approaches to coronary angiogenesis have long been an area of interest in lieu of its incredible, albeit unrealized potential. AREAS COVERED This paper offers an overview of mechanisms of native angiogenesis and a description of angiogenic growth factors. It progresses to outline the advances in gene and stem cell therapy and provides a brief description of other investigational approaches to promote angiogenesis. Finally, the hurdles and limitations unique to this particular area of study are discussed. EXPERT OPINION An effective, sustained, and safe therapeutic option for angiogenesis truly could be the paradigm shift for cardiovascular medicine. Unfortunately, clinically meaningful therapeutic options remain elusive because promising animal studies have not been replicated in human trials. The sheer complexity of this process means that numerous major hurdles remain before therapeutic angiogenesis truly makes its way from the bench to the bedside.
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Affiliation(s)
- Bharat Narasimhan
- Department Of Medicine, Mount Sinai St.Lukes-Roosevelt, Icahn School Of Medicine At Mount Sinai, New York, NY, USA
| | | | - Marta Lorente-Ros
- Department Of Medicine, Mount Sinai St.Lukes-Roosevelt, Icahn School Of Medicine At Mount Sinai, New York, NY, USA
| | - Francisco Jose Romeo
- Department Of Medicine, Mount Sinai St.Lukes-Roosevelt, Icahn School Of Medicine At Mount Sinai, New York, NY, USA
| | - Kirtipal Bhatia
- Department Of Medicine, Mount Sinai St.Lukes-Roosevelt, Icahn School Of Medicine At Mount Sinai, New York, NY, USA
| | - Wilbert S Aronow
- Department of Cardiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA
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3
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Travin MI. It's not all in the numbers. J Nucl Cardiol 2016; 23:436-41. [PMID: 25802176 DOI: 10.1007/s12350-015-0105-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 02/22/2015] [Indexed: 01/08/2023]
Affiliation(s)
- Mark I Travin
- Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center and the Albert Einstein College of Medicine, 111 E. 210th Street, Bronx, NY, 10467-2490, USA.
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4
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Clements IP, Garcia EV, Chen J, Folks RD, Butler J, Jacobson AF. Quantitative iodine-123-metaiodobenzylguanidine (MIBG) SPECT imaging in heart failure with left ventricular systolic dysfunction: Development and validation of automated procedures in conjunction with technetium-99m tetrofosmin myocardial perfusion SPECT. J Nucl Cardiol 2016; 23:425-35. [PMID: 25788403 DOI: 10.1007/s12350-015-0097-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/29/2015] [Accepted: 01/30/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND The purpose of this study was to develop and validate new approaches to quantitative MIBG myocardial SPECT imaging in heart failure (HF) subjects. METHODS AND RESULTS Quantitative MIBG myocardial SPECT analysis methods, alone and in conjunction with 99mTc-tetrofosmin perfusion SPECT, were adapted from previously validated techniques for the analysis of SPECT and PET perfusion imaging. To account for underestimation of MIBG defect severity in subjects with global reduction in uptake, a mixed reference database based on planar heart/mediastinum (H/M) ratio categories was used. Extent and severity of voxel-based defects and number of myocardial segments with significant dysinnervation (derived score ≥2) were determined. MIBG/99mTc-tetrofosmin mismatch was quantified using regions with preserved innervation as the reference for scaling 99mTc-tetrofosmin voxel maps. Quantification techniques were tested on studies of 619 ischemic (I) and 319 non-ischemic (NI) HF subjects. Using all analytical techniques, IHF subjects had significantly greater and more severe MIBG SPECT abnormalities compared with NIHF subjects. Innervation/perfusion mismatches were also larger in IHF subjects. Findings were consistent between voxel- and myocardial-segment-based quantitation methods. CONCLUSIONS Multiple objective methods for quantitation of MIBG SPECT imaging studies provided internally consistent results for distinguishing the different patterns of uptake between IHF and NIHF subjects.
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Affiliation(s)
- Ian P Clements
- Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MA, USA.
| | - Ernest V Garcia
- Department of Radiology, School of Medicine, Emory University, 1364 Clifton Road, NE, Room E163, Atlanta, USA
| | - Ji Chen
- Department of Radiology, School of Medicine, Emory University, 1364 Clifton Road, NE, Room E163, Atlanta, USA
| | - Russell D Folks
- Division of Nuclear Medicine, Emory University, Atlanta, USA
| | - Javed Butler
- Department of Radiology, School of Medicine, Emory University, 1364 Clifton Road, NE, Room E163, Atlanta, USA
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Papadimitriou L, Smith-Jones PM, Sarwar CM, Marti CN, Yaddanapudi K, Skopicki HA, Gheorghiade M, Parsey R, Butler J. Utility of positron emission tomography for drug development for heart failure. Am Heart J 2016; 175:142-52. [PMID: 27179733 DOI: 10.1016/j.ahj.2016.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 02/22/2016] [Indexed: 12/14/2022]
Abstract
Only about 1 in 5,000 investigational agents in a preclinical stage acquires Food and Drug Administration approval. Among many reasons for this includes an inefficient transition from preclinical to clinical phases, which exponentially increase the cost and the delays the process of drug development. Positron emission tomography (PET) is a nuclear imaging technique that has been used for the diagnosis, risk stratification, and guidance of therapy. However, lately with the advance of radiochemistry and of molecular imaging technology, it became evident that PET could help novel drug development process. By using a PET radioligand to report on receptor occupancy during novel agent therapy, it may help assess the effectiveness, efficacy, and safety of such a new medication in an early preclinical stage and help design successful clinical trials even at a later phase. In this article, we explore the potential implications of PET in the development of new heart failure therapies and review PET's application in the respective pathophysiologic pathways such as myocardial perfusion, metabolism, innervation, inflammation, apoptosis, and cardiac remodeling.
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Rischpler C, Nekolla SG, Kossmann H, Dirschinger RJ, Schottelius M, Hyafil F, Wester HJ, Laugwitz KL, Schwaiger M. Upregulated myocardial CXCR4-expression after myocardial infarction assessed by simultaneous GA-68 pentixafor PET/MRI. J Nucl Cardiol 2016; 23:131-3. [PMID: 26667813 DOI: 10.1007/s12350-015-0347-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 10/22/2022]
Affiliation(s)
- C Rischpler
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - S G Nekolla
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - H Kossmann
- Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - R J Dirschinger
- Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - M Schottelius
- Pharmazeutische Radiochemie, Technische Universität München, Garching, Germany
| | - F Hyafil
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - H J Wester
- Pharmazeutische Radiochemie, Technische Universität München, Garching, Germany
| | - K L Laugwitz
- Medizinische Klinik und Poliklinik I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - M Schwaiger
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Lamberts LE, Williams SP, Terwisscha van Scheltinga AG, Lub-de Hooge MN, Schröder CP, Gietema JA, Brouwers AH, de Vries EG. Antibody Positron Emission Tomography Imaging in Anticancer Drug Development. J Clin Oncol 2015; 33:1491-504. [DOI: 10.1200/jco.2014.57.8278] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
More than 50 monoclonal antibodies (mAbs), including several antibody–drug conjugates, are in advanced clinical development, forming an important part of the many molecularly targeted anticancer therapeutics currently in development. Drug development is a relatively slow and expensive process, limiting the number of drugs that can be brought into late-stage trials. Development decisions could benefit from quantitative biomarkers, enabling visualization of the tissue distribution of (potentially modified) therapeutic mAbs to confirm effective whole-body target expression, engagement, and modulation and to evaluate heterogeneity across lesions and patients. Such biomarkers may be realized with positron emission tomography imaging of radioactively labeled antibodies, a process called immunoPET. This approach could potentially increase the power and value of early trials by improving patient selection, optimizing dose and schedule, and rationalizing observed drug responses. In this review, we summarize the available literature and the status of clinical trials regarding the potential of immunoPET during early anticancer drug development.
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Affiliation(s)
- Laetitia E. Lamberts
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Simon P. Williams
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Anton G.T. Terwisscha van Scheltinga
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Marjolijn N. Lub-de Hooge
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Carolien P. Schröder
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Jourik A. Gietema
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Adrienne H. Brouwers
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
| | - Elisabeth G.E. de Vries
- Laetitia E. Lamberts, Anton G.T. Terwisscha van Scheltinga, Marjolijn N. Lub-de Hooge, Carolien P. Schröder, Jourik A. Gietema, Adrienne H. Brouwers, and Elisabeth G.E. de Vries, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; and Simon P. Williams, Genentech, South San Francisco, CA
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Lehner S, Todica A, Vanchev Y, Uebleis C, Wang H, Herrler T, Wängler C, Cumming P, Böning G, Franz WM, Bartenstein P, Hacker M, Brunner S. In vivo monitoring of parathyroid hormone treatment after myocardial infarction in mice with [68Ga]annexin A5 and [18F]fluorodeoxyglucose positron emission tomography. Mol Imaging 2015; 13. [PMID: 25249170 DOI: 10.2310/7290.2014.00035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[68Ga]Annexin A5 positron emission tomography (PET) reveals the externalization of phosphatidylserine as a surrogate marker for apoptosis. We tested this technique for therapy monitoring in a murine model of myocardial infarction (MI) including parathyroid hormone (PTH) treatment. MI was induced in mice, and they were assigned to the saline or the PTH group. On day 2, they received [68Ga]annexin A5 PET or histofluorescence TUNEL staining. Mice had 2-deoxy-2-[18F]fluoro-d-glucose (FDG)-PET examinations on days 6 and 30 for calculation of the left ventricular ejection fraction and infarct area. [68Ga]Annexin A5 uptake was 7.4 ± 1.3 %ID/g within the infarction for the controls and 4.5 ± 1.9 %ID/g for the PTH group (p = .013). TUNEL staining revealed significantly more apoptotic cells in the infarct area on day 2 in the controls (64 ± 9%) compared to the treatment group (52 ± 4%; p = .045). FDG-PET revealed a significant decrease in infarct size in the treatment group and an increase in the controls. Examinations of left ventricular ejection fraction on days 6 and 30 did not reveal treatment effects. [68Ga]Annexin A5 PET can detect the effects of PTH treatment as a marker of apoptosis 2 days after MI; ex vivo examination confirmed significant rescue of myocardiocytes. FDG-PET showed a small but significant reduction in infarct size but no functional improvement.
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Abstract
During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.
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Affiliation(s)
- Albert de Roos
- From the Department of Radiology, Leiden University Medical Center, C2-S, Albinusdreef 2, Leiden, South-Holland 2333 ZA, the Netherlands (A.d.R); and Department of Radiology, University of California-San Francisco, San Francisco, Calif (C.B.H.)
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Kaminsky SM, Rosengart TK, Rosenberg J, Chiuchiolo MJ, Van de Graaf B, Sondhi D, Crystal RG. Gene therapy to stimulate angiogenesis to treat diffuse coronary artery disease. Hum Gene Ther 2014; 24:948-63. [PMID: 24164242 DOI: 10.1089/hum.2013.2516] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Cardiac gene therapy offers a strategy to treat diffuse coronary artery disease (CAD), a disorder with no therapeutic options. The use of genes to revascularize the ischemic myocardium has been the focus of two decades of preclinical research with a variety of angiogenic mediators, including vascular endothelial growth factor, fibroblast growth factor, hepatocyte growth factor, and others encoded by DNA plasmids or adenovirus vectors. The multifaceted challenge for developing efficient induction of collateral vessels in the ischemic heart requires a choice for route of delivery, dosing level, a relevant animal model, duration of treatment, and assessment of phenotype for efficacy. Overall, studies of gene therapy for ischemia in experimental models are very encouraging, with clear evidence of safety and efficacy, strongly supporting the concept that gene therapy to induce angiogenesis is a viable therapeutic approach for CAD. Clinical studies of cardiac gene therapy with angiogenic factors have added substantially to the evidence for efficacy, but definitive studies have not yet led to commercial approval. This review provides the general concepts for angiogenesis-based therapeutic approaches for diffuse CAD and summarizes the results from key studies in the field with recommendations for refinement to a successful product design and evaluation.
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Affiliation(s)
- Stephen M Kaminsky
- 1 Department of Genetic Medicine, Weill Cornell Medical College , New York, NY 10065
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11
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Lehner S, Sussebach C, Todica A, Uebleis C, Brunner S, Bartenstein P, Van Kriekinge SD, Germano G, Hacker M. Influence of SPECT attenuation correction on the quantification of hibernating myocardium as derived from combined myocardial perfusion SPECT and ¹⁸F-FDG PET. J Nucl Cardiol 2014; 21:578-87. [PMID: 24633501 DOI: 10.1007/s12350-014-9882-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND To evaluate the influence of SPECT attenuation correction on the quantification of hibernating myocardium derived from perfusion SPECT and (18)F-FDG PET. METHODS AND RESULTS 20 patients underwent rest (99m)Tc-tetrofosmin perfusion SPECT/CT and (18)F-FDG PET/CT. Perfusion images were reconstructed without attenuation correction (NC), with attenuation correction based on the CT from the SPECT/CT (AC_SPECT), and with attenuation correction based on the CT from the PET/CT (AC_PET). Another 56 patients had rest (99m)Tc-tetrofosmin perfusion SPECT and (18)F-FDG PET/CT. Perfusion images were reconstructed as NC and AC_PET. The amounts of hibernating myocardium and scar were quantified with QPS and corresponding AC and NC normative databases. In both cohorts, perfusion in the inferior wall was higher in the AC scans than without AC. Global and regional values for total perfusion deficit (TPD), hibernation and scar areas did not differ between NC, AC_SPECT, and AC_PET scans. In a retrospective evaluation with 7% cut-off of hibernating myocardium as a condition for revascularization, the therapeutic approach would have been altered in 5 of 56 patients, if the AC_PET approach had been used. CONCLUSIONS AC of SPECT perfusion scans with an attenuation map derived from PET/CT scans is feasible. If AC is unavailable, perfusion scans should be compared to NC normative databases for assessing TPD, hibernation, and mismatch. It should be taken into account that in approximately 10% of the patients, a therapeutic recommendation based on published thresholds for hibernating myocardium would be altered if NC scans were used as compared to AC scans.
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Affiliation(s)
- Sebastian Lehner
- Department of Nuclear Medicine, University of Munich, Munich, Germany
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Sciagrà R. SPECT and PET Protocols for Imaging Myocardial Viability. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9270-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Allman KC. Noninvasive assessment myocardial viability: current status and future directions. J Nucl Cardiol 2013; 20:618-37; quiz 638-9. [PMID: 23771636 DOI: 10.1007/s12350-013-9737-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 05/22/2013] [Indexed: 12/22/2022]
Abstract
Observations of reversibility of cardiac contractile dysfunction in patients with coronary artery disease and ischemia were first made more than 40 years ago. Since that time a wealth of basic science and clinical data has been gathered exploring the mechanisms of this phenomenon of myocardial viability and relevance to clinical care of patients. Advances in cardiac imaging techniques have contributed greatly to knowledge in the area, first with thallium-201 imaging, then later with Tc-99m-based tracers for SPECT imaging and metabolic tracers used in conjunction with positron emission tomography (PET), most commonly F-18 FDG in conjunction with blood flow imaging with N-13 ammonia or Rb-82 Cl. In parallel, stress echocardiography has made great progress also. Over time observational studies in patients using these techniques accumulated and were later summarized in several meta-analyses. More recently, cardiac magnetic resonance imaging (CMR) has contributed further information in combination with either late gadolinium enhancement imaging or dobutamine stress. This review discusses the tracer and CMR imaging techniques, the pooled observational data, the results of clinical trials, and ongoing investigation in the field. It also examines some of the current challenges and issues for researchers and explores the emerging potential of combined PET/CMR imaging for myocardial viability.
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Affiliation(s)
- Kevin C Allman
- Department of PET and Nuclear Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.
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Positron emission tomography based in-vivo imaging of early phase stem cell retention after intramyocardial delivery in the mouse model. Eur J Nucl Med Mol Imaging 2013; 40:1730-8. [DOI: 10.1007/s00259-013-2480-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 06/03/2013] [Indexed: 01/13/2023]
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