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Nudi F, Biondi-Zoccai G, Nudi A, Neri G, Procaccini E, Schilllaci O. Comparative analysis between myocardial perfusion reserve and maximal ischemia score at single photon emission computed tomography with new-generation cadmium-zinc-telluride cameras. J Nucl Cardiol 2021; 28:1072-1084. [PMID: 31152316 DOI: 10.1007/s12350-019-01764-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/01/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Whether estimates of myocardial perfusion reserve (MPR) stemming from new-generation cadmium-zinc-telluride (CZT) cameras are accurate remains unclear. METHODS We queried our institutional database for patients undergoing MPR with CZT cameras. The primary goal was appraising the incremental diagnostic yield of MPR on top or at odds of maximal ischemia score (MIS). RESULTS A total of 66 subjects were included. When distinguishing patients according to normal vs abnormal MPR (cut-off 2.1 mL/min/g) and normal vs abnormal MIS, 4 groups could be identified: 12 (18.1%) individuals with normal MPR and MIS, 12 (18.1%) with normal MPR and abnormal MIS, 16 (24.2%) with abnormal MPR and normal MIS, and 26 (39.4%) with abnormal MPR and MIS. MIS was significantly associated with several baseline features, whereas MPR did not. There was no significant association between MPR and MIS, nor with regional perfusion. Clinical outcomes were uncommon and not significantly associated with MPR or MIS, whereas angiographically significant coronary artery disease (CAD) was associated solely with MIS (P < 0.05), and not with MPR. CONCLUSIONS There is limited agreement between CZT-derived MPR and baseline risk, perfusion and angiography results. Whether such discrepancies may still prove incrementally beneficial for the diagnosis or prognosis of CAD remains unclear.
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Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy.
- Replycare, Rome, Italy.
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | - Alessandro Nudi
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy
| | - Giandomenico Neri
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy
- Ostia Radiologica, Rome, Italy
| | - Enrica Procaccini
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy
- Ostia Radiologica, Rome, Italy
| | - Orazio Schilllaci
- Department of Nuclear Medicine, Tor Vergata University, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Toyama Y, Werner RA, Ruiz-Bedoya CA, Ordonez AA, Takase K, Lapa C, Jain SK, Pomper MG, Rowe SP, Higuchi T. Current and future perspectives on functional molecular imaging in nephro-urology: theranostics on the horizon. Theranostics 2021; 11:6105-6119. [PMID: 33897902 PMCID: PMC8058716 DOI: 10.7150/thno.58682] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/21/2021] [Indexed: 01/01/2023] Open
Abstract
In recent years, a paradigm shift from single-photon-emitting radionuclide radiotracers toward positron-emission tomography (PET) radiotracers has occurred in nuclear oncology. Although PET-based molecular imaging of the kidneys is still in its infancy, such a trend has emerged in the field of functional renal radionuclide imaging. Potentially allowing for precise and thorough evaluation of renal radiotracer urodynamics, PET radionuclide imaging has numerous advantages including precise anatomical co-registration with CT images and dynamic three-dimensional imaging capability. In addition, relative to scintigraphic approaches, PET can allow for significantly reduced scan time enabling high-throughput in a busy PET practice and further reduces radiation exposure, which may have a clinical impact in pediatric populations. In recent years, multiple renal PET radiotracers labeled with 11C, 68Ga, and 18F have been utilized in clinical studies. Beyond providing a precise non-invasive read-out of renal function, such radiotracers may also be used to assess renal inflammation. This manuscript will provide an overview of renal molecular PET imaging and will highlight the transformation of conventional scintigraphy of the kidneys toward novel, high-resolution PET imaging for assessing renal function. In addition, future applications will be introduced, e.g. by transferring the concept of molecular image-guided diagnostics and therapy (theranostics) to the field of nephrology.
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Affiliation(s)
- Yoshitaka Toyama
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Diagnostic Radiology, Tohoku University, Sendai, Japan
| | - Rudolf A. Werner
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg Germany
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Camilo A. Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alvaro A. Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University, Sendai, Japan
| | - Constantin Lapa
- Nuclear Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Sanjay K. Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martin G. Pomper
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven P. Rowe
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg Germany
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Nudi F, Biondi-Zoccai G, Di Belardino N, Nudi A, Schillaci O. Myocardial-coronary fusion imaging with positron emission tomography and computed tomography: Benchmarking and slingshotting. J Nucl Cardiol 2020; 27:1770-1773. [PMID: 30478665 DOI: 10.1007/s12350-018-01538-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardiac Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy.
- Ostia Radiologica, Rome, Italy.
- Replycare, Rome, Italy.
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | | | - Alessandro Nudi
- Service of Hybrid Cardiac Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy
| | - Orazio Schillaci
- IRCCS Neuromed, Pozzilli, Italy
- Department of Nuclear Medicine, Tor Vergata University of Rome, Rome, Italy
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Nudi F, Biondi-Zoccai G, Romagnoli A, Schillaci O, Nudi A, Versaci F. Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components. J Nucl Cardiol 2019; 26:752-762. [PMID: 30565061 DOI: 10.1007/s12350-018-01562-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 09/19/2018] [Indexed: 02/05/2023]
Abstract
Coronary artery disease (CAD) is the most common and important cause of ischemic heart disease, with major implications on global morbidity and mortality. Non-invasive testing is crucial in the diagnostic and prognostic work-up of patients with or at risk of CAD, and also to guide decision making in terms of pharmacologic and revascularization therapy. The traditional paradigm is to view anatomic (i.e., coronary computed tomography) and functional imaging (e.g., myocardial perfusion scintigraphy) tests as opposing alternatives. Such approach is too reductionist and does not capitalize on the strengths of each type of test while risking to overlook the inherent limitations. The combination of anatomic and functional tests in a logic of hybrid imaging holds the promise of overcoming the limitations inherent to anatomic and functional testing, enabling more accurate diagnosis, prognosis, and guidance for revascularization in patients with CAD.
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Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna Della Fiducia Clinic, Rome, Italy.
- Ostia Radiologica, Rome, Italy.
- Replycare, Viale Africa 36, 00144, Rome, Italy.
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- IRCCS NEUROMED, Pozzilli, Italy
| | | | - Orazio Schillaci
- IRCCS NEUROMED, Pozzilli, Italy
- Department of Nuclear Medicine, Tor Vergata University, Rome, Italy
| | - Alessandro Nudi
- Service of Hybrid Cardio Imaging, Madonna Della Fiducia Clinic, Rome, Italy
- Replycare, Viale Africa 36, 00144, Rome, Italy
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Nudi F, Schillaci O, Nudi A, Biondi-Zoccai G. What is this image? 2018: Image 1 result : The value of diastole perfusion. J Nucl Cardiol 2018; 25:1075-1082. [PMID: 29855983 DOI: 10.1007/s12350-018-1314-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy.
- Ostia Radiologica, Rome, Italy.
- ETISAN, Rome, Italy.
| | - Orazio Schillaci
- Division of Nuclear Medicine, Tor Vergata University, Rome, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | | | - Giuseppe Biondi-Zoccai
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
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Nudi F, Nudi A, Biondi-Zoccai G, Schillaci O. Bridging the Atlantic gap in clinical guidelines for non-ST-elevation acute coronary syndromes. J Nucl Cardiol 2018; 25:780-784. [PMID: 29435859 DOI: 10.1007/s12350-018-1216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna Della Fiducia Clinic, Via Giuseppe Mantellini 3, 00179, Rome, Italy.
- Ostia Radiologica, Rome, Italy.
- Etisan, Rome, Italy.
| | | | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Orazio Schillaci
- Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
- Division of Nuclear Medicine, Tor Vergata University, Rome, Italy
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Nudi F, Schilllaci O, Biondi-Zoccai G, Pinto A, Neri G, Procaccini E, Versaci F, Nudi A, Tomai F, Frati G, Iskandrian AE. Impact of specific coronary lesions on regional ischemia at single photon emission computed tomography. J Cardiovasc Med (Hagerstown) 2018; 19:329-336. [PMID: 29846303 DOI: 10.2459/jcm.0000000000000675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS Prior studies using stress myocardial perfusion imaging (MPI), which examined the association between obstructive epicardial coronary disease and presence of myocardial ischemia did not provide a detailed assessment on a regional level. We examined this relationship in a large population of patients in whom the coronary anatomy was defined by invasive coronary angiography. METHODS We retrospectively extracted details on individuals undergoing MPI with single photon emission computed tomography (SPECT) who had coronary angiography within 12 months. A 17-segment model for native coronary anatomy and a 7-region model for myocardial perfusion were used with a dedicated matching algorithm. RESULTS A total of 2564 patients were included, yielding a total of 6279 stenoses matched with 17 948 myocardial regions. From such a cohort, 151 (5.9%) patients had normal perfusion, 1878 (73.2%) had myocardial ischemia (reversible defects), 260 (10.1%) had myocardial necrosis (scar or fixed defects), and 275 (10.7%) had ischemia and necrosis. At per-patient analysis, significant angiographic disease was more common in the ischemic group (prevalence between 69.6 and 80.0%) than other groups. At per-region analysis, abnormal perfusion in the coronary-specific regions varied depending on location of stenosis; it was 96% for left main disease, 81% for proximal left anterior descending disease, 85% for proximal left circumflex disease, and 82% for proximal right coronary artery disease and <60% for posterior descending artery disease. CONCLUSION The correlation between significant coronary stenosis and presence of corresponding regional perfusion abnormality depends on the location of the lesion and the corresponding myocardial region.
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Affiliation(s)
- Francesco Nudi
- Service of Nuclear Cardiology, Madonna della Fiducia Clinic.,ETISAN
| | | | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli
| | - Annamaria Pinto
- Service of Nuclear Cardiology, Madonna della Fiducia Clinic.,Ostia Radiologica, Rome
| | | | | | | | | | | | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina.,Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli
| | - Ami E Iskandrian
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama, USA
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