Utilization Patterns of Single‐Photon Emission Cardiac Tomography Myocardial Perfusion Imaging Studies in a Rural Tertiary Care Setting

ConclusionsWe found that a majority of MPI studies are performed for appropriate indications regardless of ordering provider specialty. Few common scenarios accounted for the majority of the inappropriate or uncertain studies.
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Quality and Outcomes Source Type: research

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AbstractMyocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging moda...
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research
Conclusion: In symptomatic patients with CAD, very low hs-cTn concentrations, including hs-cTnI concentrations less than 2.5 ng/L, do not generally allow users to safely exclude inducible myocardial ischemia. Primary Funding Source: European Union, Swiss National Science Foundation, Kommission für Technologie und Innovation (Innosuisse), Swiss Heart Foundation, Cardiovascular Research Foundation Basel, University of Basel, University Hospital Basel, Roche, Abbott, and Singulex. PMID: 31905377 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
AbstractPurposeTo assess the feasibility of performing same-day vascular flow redistribution and Yttrium-90 radioembolization (90Y-RE) for hepatic malignancies.Materials and MethodsFrom November 2015 to February 2019, patients undergoing same-day hepatic flow redistribution during work-up angiography,99mTechnetium-labeled macroaggregated albumin (99mTc-MAA) SPECT/CT and 90Y microsphere-RE, were recruited. Within 18  h following the delivery of 90Y resin microspheres, an 90Y-PET/CT study was performed. According to patients’ vascular anatomy, flow redistribution was performed by microcoil embolization of extrahep...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
A 64-year-old woman with a history of cirrhosis and progressive difficulty breathing underwent pulmonary ventilation/perfusion SPECT to evaluate possible pulmonary embolism. The images demonstrated multiple mismatched ventilation/perfusion defects in both lungs, suggesting pulmonary embolism. However, there was also 99mTc-MAA radioactivity in the brain and bilateral kidney, with a right-to-left shunting rate of 8.8%. In addition, CT pulmonary angiography did not demonstrate embolus. The findings indicated that perfusion defects were caused by hepatopulmonary syndrome.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Abstract Background: Functional assessment to rule out myocardial ischemia using coronary computed tomography angiography (CCTA) is extremely important and data on the Brazilian population are still limited. Objective: To assess the diagnostic performance of myocardial perfusion by CCTA in the detection of severe obstructive coronary artery disease (CAD) compared with single-photon emission computerized tomography (SPECT). To analyze the importance of anatomical knowledge to understand the presence of myocardial perfusion defects on SPECT imaging that is not identified on computed tomography (CT) scan. Method: A total of 3...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Abstract Background: Functional assessment to rule out myocardial ischemia using coronary computed tomography angiography (CCTA) is extremely important and data on the Brazilian population are still limited. Objective: To assess the diagnostic performance of myocardial perfusion by CCTA in the detection of severe obstructive coronary artery disease (CAD) compared with single-photon emission computerized tomography (SPECT). To analyze the importance of anatomical knowledge to understand the presence of myocardial perfusion defects on SPECT imaging that is not identified on computed tomography (CT) scan. Method: A total of 3...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
This study aimed to assess and compare the diagnostic performance of the coronary artery to aortic luminal attenuation ratio (CAR), transluminal attenuation gradient (TAG), and corrected coronary opacification (CCO) difference on coronary CT angiography (cCTA) for detecting haemodynamically significant coronary artery stenosis. METHODS: Thirty-three patients who underwent cCTA, gated SPECT myocardial perfusion imaging (MPI), and invasive coronary angiography within 3 months were included in this retrospective study. The degree of coronary stenosis on cCTA was visually assessed in all patients. Additionally, CAR, TAG, ...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
Abstract BACKGROUND: Relative myocardial perfusion imaging can misdiagnose "balanced" ischemia caused by coronary artery disease (CAD). We assessed the feasibility of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) using dynamic single-photon emission computed tomography (SPECT) with a cadmium-zinc-telluride (CZT) camera for estimating underlying CAD in patients with normal stress myocardial perfusion SPECT (MPS). METHODS: 125 patients with normal stress MPS (summed stress score ≤3) were enrolled. All patients underwent coronary angiography (CAG) and stress/rest 201Tl dynamic S...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
AbstractBackgroundCadmium-zinc-telluride (CZT) SPECT allows the estimation of left ventricle myocardial volume (LVMV). We tested the clinical relevance of rest-stress LVMV changes ( Δ LVMV) in detecting coronary artery disease (CAD, coronary stenosis>  70%), using CZT-SPECT.MethodsWe prospectively enrolled 512 consecutive patients with known or suspected CAD (mean age: 70.3 ± 9.2 years, 72% male) for stress-rest myocardial perfusion imaging (MPI, single-day stress-rest protocol). We quantified summed stress scores (SSS), summed rest scores, and summed difference scores, together with LVMV and ejectio...
Source: Journal of Nuclear Cardiology - Category: Nuclear Medicine Source Type: research
We report the case of a 66-year-old woman who underwent 1-day stress/rest myocardial perfusion imaging (MPI) for coronary artery disease (CAD) screening. Relative MPI analysis was normal, whereas low-dose CT showed high calcium score. Myocardial blood flow and flow reserve were strongly impaired in all territories. Coronary angiography confirmed extended CAD. Flow parameters derived from cadmium-zinc-telluride SPECT MPI acquisition and calcium scoring can improve diagnostic accuracy and confidence of CAD.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
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