Cardiac Imaging of Infiltrative Cardiomyopathies
Abstract Infiltrative cardiomyopathies are characterized by deposition of abnormal material in the intra- or extracellular compartment of the myocardium resulting in impairment in cardiac filling and relaxation. Disorders of myocardial infiltration are distinct with differing abnormalities in cardiac histology, pathophysiology, morphology, and function. Cardiac imaging plays a critical role in management, facilitating diagnosis, risk stratification, disease monitoring, and treatment. Importantly, advances in imaging technology have enabled earlier detection, providing opportunity for intervention and improved pat...
Source: Current Cardiovascular Imaging Reports - March 14, 2015 Category: Radiology Source Type: research

An Increasing Population with Metabolic Syndrome and/or Diabetes Mellitus in the Middle East—Is There an Added Value of Coronary Calcium Scoring to Myocardial Perfusion Imaging?
Abstract The population of the Middle East is a growing population characterized by increasing prevalence of metabolic syndrome, diabetes, and obesity. Both myocardial perfusion imaging (MPI) and coronary artery calcification (CAC) have a well-validated role in the diagnosis and prognosis of coronary artery disease (CAD). In the recent years, adding CAC score to myocardial perfusion imaging has been associated with incremental diagnostic and prognostic value. The aim of this paper is to review the diagnostic and prognostic value of adding CAC score to nuclear MPI in the Middle Eastern patients in the face of incr...
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

Lessons on Quality Control in Large Scale Imaging Trials: the Multi-Ethnic Study of Atherosclerosis (MESA)
This article reviews the influence of research management for quality control and work standardization processes in cardiac magnetic MRI results at the 10th year of follow-up in MESA. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

An Integrated Backscatter Ultrasound Technique for Coronary Plaque Imaging
Abstract The instability of atherosclerotic coronary plaques is related to their histological composition and the thickness of their fibrous caps. Therefore, recognition of the tissue characteristics of coronary plaques is important to understand and prevent coronary artery disease. Recently, an ultrasound integrated backscatter (IB) technique has been developed. Ultrasound signals have unique characteristics of reflection. That is, the ultrasound IB power ratio is a function of the difference in acoustic characteristic impedance between the medium and target tissue, and the acoustic characteristic impedance is d...
Source: Current Cardiovascular Imaging Reports - March 5, 2015 Category: Radiology Source Type: research

Relatively High Prevalence of Takotsubo Cardiomyopathy (Stress-Induced Cardiomyopathy) in the Japanese Population—Contribution of Cardiac Imaging in the Identification of Takotsubo Cardiomyopathy and its Differentiation from Acute Coronary Syndrome
Abstract Apical ballooning syndrome, the so-called takotsubo cardiomyopathy (TTC), is characterized by wall-motion abnormality. The wall-motion abnormality includes hypokinesis in the mid and apical segments of the left ventricle (LV) with hyperkinesis in the mid LV segment. The LV dysfunction is reversible. TTC has been reportedly been found in 1 to 2 % of patients suspected of having acute coronary syndrome (ACS). Although the wall-motion abnormality of TTC is a significant feature, clinical presentation involving chest pain or ECG abnormalities is similar to that for ACS. Therefore, the diagnosis of TTC i...
Source: Current Cardiovascular Imaging Reports - March 4, 2015 Category: Radiology Source Type: research

State of Overall Cardiovascular Risk and Imaging Strategies in India
Abstract Noninvasive cardiac imaging has undergone a recent resurgence in India with the development of new approaches for imaging coronary atherosclerosis. Noncontrast computed tomography (CT) for imaging the extent of coronary artery calcification (CAC) and contrast CT for noninvasive coronary angiography (CTA) are developments with a growing evidence base regarding risk assessment and the diagnosis of obstructive coronary disease. Stress myocardial perfusion SPECT (MPS) is the most commonly used stress imaging technique for patients with suspected or known coronary disease, which is slowly gaining popularity i...
Source: Current Cardiovascular Imaging Reports - March 4, 2015 Category: Radiology Source Type: research

Application of Cardiac Neurohormonal Imaging to Heart Failure, Transplantation, and Diabetes
Abstract The neurohormonal system adapts to body demands, but in cardiac disease it can become maladaptive. A key component, the sympathetic nervous system, can be imaged with radiotracers such as iodine-123-meta-iodobenzylguanidine (123I-mIBG), a norepinephrine analogue. Parameters assessed are the heart-to-mediastinal ratio (HMR), tracer washout, and regional single photon emission computed tomography (SPECT) defects. Much focus has been on heart failure that has a large neurohormonal pathophysiologic component. 123I-mIBG imaging has powerful risk stratification ability for this high morbidity/mortality conditi...
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research

Cardiac Imaging in Latin America: Chagas Heart Disease
Abstract Patients with Chagas heart disease can be evaluated for diagnostic and prognostic purposes using several imaging methods, including the plain chest radiography and various echocardiography techniques for biventricular systolic and diastolic function assessment, myocardial perfusion scintigraphy for uncovering microvascular disturbances, and 123iodine-MIBG labeling of sympathetic myocardial innervation, MRI for detection and quantitation of myocardial fibrosis, and coronary angiography during cardiac catheterization to characterize the mechanism of myocardial ischemia. Through the careful analysis and int...
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research

Dye-Staining Angioscopy for Coronary Artery Disease
Abstract Novel imaging techniques using biomarkers have clarified the mechanisms of hitherto unanswered or misunderstood phenomena of coronary artery disease and enabled evaluation of myocardial blood and tissue fluid flows in vivo. Dye-staining coronary angioscopy using Evans blue (EB) as the biomarker can visualize fibrin and damaged endothelial cells, revealing that the so-called platelet thrombus is frequently a fibrin-rich thrombus; occlusive transparent fibrin thrombus, but not platelet thrombus, is not infrequently a cause of acute coronary syndrome; “fluffy” coronary luminal surface is caused ...
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research

Imaging in HF-PEF with Cardiovascular Magnetic Resonance
This report aims to highlight the potential role of CMR to identify specific aetiologies in HFPEF syndrome and to review the available CMR modalities for the evaluation of diastolic dysfunction. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - February 26, 2015 Category: Radiology Source Type: research

Myocardial Inflammation—Are We There Yet?
Abstract Several exogenous or endogenous factors can lead to inflammatory heart disease. Beside infectious myocarditis, other systemic inflammatory disorders such as sarcoidosis, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Churg-Strauss syndrome, and rheumatoid arthritis can affect the myocardium. Myocardial inflammation may have a major impact on the outcome of these patients, resulting in sudden cardiac death, severe arrhythmias, or end-stage heart failure. The current gold standard for definite confirmation of inflammatory heart disease is endomyocardial biopsy (EMB), but is invasive and suff...
Source: Current Cardiovascular Imaging Reports - February 18, 2015 Category: Radiology Source Type: research

Ischemic Heart Disease in Women: a Nuclear Cardiology Latin America Perspective
Abstract Cardiovascular disease is the leading cause of death in Latin America. The increasing prevalence of diabetes mellitus (DM), coupled with modern lifestyle and population aging are contributing to increase ischemic heart disease (IHD)-related deaths in this region. Diagnosis of IHD in women can be challenging as they often present with no chest pain or atypical symptoms, delaying diagnosis and appropriate management. Women tend to have more advanced coronary artery disease (CAD), to be older, and have worse prognosis than men after myocardial infarction and bypass surgery. Life expectancy is usually higher...
Source: Current Cardiovascular Imaging Reports - February 13, 2015 Category: Radiology Source Type: research

Deciphering Cardiovascular Disease in Systemic Inflammatory Diseases Using Advanced Magnetic Resonance Imaging
Abstract Cardiovascular involvement in systemic inflammatory diseases (SID) is underestimated despite its high mortality and morbidity. SID with cardiovascular involvement includes rheumatoid arthritis and the spondyloarthropathies, systemic lupus erythematosus, systemic vasculitides, inflammatory myopathies, systemic sclerosis, mixed connective tissue diseases (MCTD) and sarcoidosis (SRC). Cardiovascular magnetic resonance (CMR) is of great value in SID because myocardial inflammation, diffuse, subendocardial vasculitis and small scars due to inflammation or myocardial infarction and heart disease acuity can be ...
Source: Current Cardiovascular Imaging Reports - February 9, 2015 Category: Radiology Source Type: research

T 1 Mapping Techniques in Assessment of Ventricular Stiffness
Abstract Myocardial fibrosis is a fundamental process in the development of heart failure and can be quantified by cardiac magnetic resonance (CMR) imaging with T 1 mapping techniques. By measuring post-contrast myocardial T 1 time and obtaining invasively determined ventricular pressure-volume data, a mechanistic link between diffuse myocardial fibrosis and increased ventricular stiffness has recently been identified. The capacity to non-invasively evaluate diffuse myocardial fibrosis may enhance our understanding of cardiac diseases and facilitate trials of novel therapies. (Source: Curren...
Source: Current Cardiovascular Imaging Reports - January 26, 2015 Category: Radiology Source Type: research

Radionuclide Imaging in Cardiac Amyloidosis: Are Nuclear Bone Tracers a Foreseeable Future?
Abstract Amyloidosis is an infiltrative disease caused by the extracellular deposition of misfolded proteins in organs and tissues resulting in progressive functional and structural impairment. Cardiac amyloidosis is a leading cause of morbidity and mortality in primary light-chain amyloid (AL) and transthyretin-related cardiac amyloid (ATTR) and results in a restrictive cardiomyopathy, heart failure, and death. With the emergence of new subtype-specific pharmacological therapies targeting misfolded amyloid fibrils, the need for early recognition of a cardiac amyloid subtype is of major therapeutic and prognostic...
Source: Current Cardiovascular Imaging Reports - January 26, 2015 Category: Radiology Source Type: research

Hybrid SPECT/CCTA Imaging in the Work-up of Patients with Suspected Coronary Artery Disease
Abstract In the past decade, hybrid single photon emission computed tomography (SPECT)/coronary computed tomography angiography (CCTA) has been demonstrated as an accurate diagnostic technique in patients suspected of significant coronary artery disease (CAD). With this combination of anatomical and functional imaging of CAD, negative and positive predictive values over 95 % were reported. The current review provides an update of recent literature on diagnostic accuracy and will position hybrid SPECT/CCTA imaging at the end of a non-invasive imaging cascade to virtually leave no diagnostic uncertainty about ...
Source: Current Cardiovascular Imaging Reports - January 26, 2015 Category: Radiology Source Type: research

Incremental Value of Hybrid PET/CT in Patients with Coronary Artery Disease
Abstract The noninvasive diagnosis of coronary artery disease (CAD) is a challenging task. Traditionally, myocardial perfusion imaging (MPI) has been widely used for this purpose whereby cardiac positron emission tomography (PET) is considered the gold standard. Alternatively, noninvasive anatomical imaging of coronary atherosclerosis with coronary computed tomography angiography (CCTA) has recently been successfully implemented in clinical practice. Cardiac hybrid imaging consists of the fusion of these modalities and provides detailed information on the presence and extent of CAD including its functional conseq...
Source: Current Cardiovascular Imaging Reports - December 9, 2014 Category: Radiology Source Type: research

Canadian Multiethnicity—Differences in Coronary Artery Disease Prevalence and Progression and Relevance to Cardiac Imaging
Abstract The ethnic diversity of Canada is attributed to a steady rise in immigration, particularly from Asia. The diverse population demographics encompass a variety of cultural, linguistic, genetic, socioeconomic status, and clinical factors. The prevalence of coronary artery disease (CAD) varies among ethnic subgroups, being higher in South Asians than in Europeans and Chinese. These differences may be due to interactions among genetic and environmental factors and other factors that are still poorly understood. The predisposition and prevalence of underlying risk factors, such as hypertension, diabetes, obesi...
Source: Current Cardiovascular Imaging Reports - December 8, 2014 Category: Radiology Source Type: research

From Physiology of the Coronary Circulation to Myocardial Perfusion Imaging
Abstract The present paper reviews important recent publications concerning the application of principles of coronary physiology to quantitative PET myocardial perfusion imaging. Invasive measurements as well as coronary computed tomography angiography are also considered. The review focuses on physiological concepts relevant to the understanding of the effects of coronary atherosclerosis on myocardial blood flow (MBF) responses to stress. It also highlights the increasing shift from an anatomical paradigm of stenosis severity assessment to a physiological one, emphasizing the importance of absolute measurements ...
Source: Current Cardiovascular Imaging Reports - December 4, 2014 Category: Radiology Source Type: research

Prognostic and Diagnostic Implications of Nonperfusion Data on SPECT Myocardial Perfusion Imaging
Abstract Nonperfusion information on single photon emission computed tomographic (SPECT) myocardial perfusion imaging provides information that has implications for both diagnosis, and in cardiac prognosis and risk. The widespread implementation of (electrocardiography) ECG-gated SPECT imaging allows routine assessment of left ventricular function parameters, both at rest and following stress imaging. This review will discuss and review the recent literature surrounding a number of nonperfusion parameters that have improved the diagnostic accuracy of SPECT myocardial perfusion imaging (MPI), including transient i...
Source: Current Cardiovascular Imaging Reports - November 25, 2014 Category: Radiology Source Type: research

Comparison of the Diagnostic Accuracy of PET and SPECT for Coronary Artery Disease
Abstract Noninvasive assessment with a technique such as single-photon emission computed tomography (SPECT) or positron emission tomography (PET) myocardial perfusion imaging (MPI) is common and appropriate before coronary angiography to define coronary anatomy. The diagnostic accuracy of these techniques has been extensively studied with over well over 100 publications reporting the sensitivity, specificity, area under the receiver operating characteristic curve, and diagnostic odds ratio for identifying coronary artery disease with both of them throughout their evolution. Meta-analytic techniques have emerged t...
Source: Current Cardiovascular Imaging Reports - November 22, 2014 Category: Radiology Source Type: research

Positron Emission Tomography Myocardial Perfusion Imaging for Diagnosis and Risk Stratification in Obese Patients
Abstract Obesity is reaching pandemic proportions, and its prevalence is projected to increase over the next decade. Because of the strong association of obesity and cardiovascular disease, the demand for diagnostic and prognostic tests is also expected to increase. Although there are multiple imaging modalities available for the physician, appropriate selection of the imaging modality in obese patients will facilitate accurate diagnosis, patient management, and minimize unnecessary resource utilization and costs. To help select the most appropriate imaging modality in obese patients, it is vital that the physici...
Source: Current Cardiovascular Imaging Reports - November 22, 2014 Category: Radiology Source Type: research

PET/CT Imaging in Cardiac Sarcoidosis
Abstract Cardiac sarcoidosis (CS) is a potentially life-threatening disease, but diagnosing CS remains a challenge because of nonspecific clinical manifestations and significant proportion of asymptomatic patients. Also, there is no standardized work-up for early diagnosis and management of CS. In recent years, there has been increasing interest in the use of advanced imaging modalities for evaluation of CS, including cardiac magnetic resonance imaging (MRI) and positron emission tomography with 18f-fluorodeoxyglucose (FDG PET) integrated with computed tomography (PET/CT). The purpose of this review is to highlig...
Source: Current Cardiovascular Imaging Reports - November 22, 2014 Category: Radiology Source Type: research

123 I-MIBG Cardiac Imaging: Acquisition Protocols and Correction Methods for Quantitative Evaluation
Abstract Cardiac sympathetic imaging with 123I-MIBG offers unique insights into heart failure and neurodegenerative disease. Because of the diffuse nature of impairment, quantitative evaluation is indispensable, and the heart-to-mediastinum ratio is widely accepted as a valuable index. However, estimation of this index is highly dependent on acquisition protocol, especially collimator choice. A low-energy high-resolution collimator having thin septa is often used for 123I-MIBG imaging, and high-energy photons emitted from 123I readily penetrate the thin septa. The heart-to-mediastinum ratios are affected by accum...
Source: Current Cardiovascular Imaging Reports - November 22, 2014 Category: Radiology Source Type: research

Current and Future Status of PET Myocardial Perfusion Tracers
This article aims to review the currently available PET myocardial perfusion tracers as well as the question if those tracers that are being developed and about to be translated into clinics have the potential to overcome this issue. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - November 22, 2014 Category: Radiology Source Type: research

Toward Clinical μOCT—A Review of Resolution-Enhancing Technical Advances
Abstract Intravascular optical coherence tomography (IVOCT) has made significant clinical impact, providing a method of visualizing coronary plaques, optimizing percutaneous coronary intervention, and monitoring treatment results. Achieving cellular resolution in cardiovascular optical coherence tomography (OCT) adds even greater utility; thin-cap fibroatheromas (TCFA) that include microcalcifications, cholesterol crystals, and macrophages are hypothesized to correlate with rupture potential, yet are too small to be imaged by conventional OCT. In this review, we survey new developments in the optical technology t...
Source: Current Cardiovascular Imaging Reports - November 20, 2014 Category: Radiology Source Type: research

Development of Tissue Characterization Using Optical Coherence Tomography for Defining Coronary Plaque Morphology and the Vascular Responses After Coronary Stent Implantation
Abstract Cardiovascular disease is associated with a high burden of mortality secondary to acute coronary events. Assessment for vulnerable plaque and an understanding of the etiology of stent failure by intravascular imaging may facilitate a greater understanding of the underlying processes responsible for adverse clinical outcomes and guide future therapy. This review focuses on the role of optical coherence tomography in tissue characterization and highlights future advances within the field providing potential enhancement of image interpretation. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - November 20, 2014 Category: Radiology Source Type: research

Current Development of Molecular Coronary Plaque Imaging using Magnetic Resonance Imaging towards Clinical Application
Abstract Cardiovascular disease (CVD) remains the leading cause of death in Western countries despite improvements in prevention, diagnosis and treatment. Atherosclerosis is a chronic inflammatory disease that remains clinically silent for many decades. Sudden rupture of “high-risk/vulnerable” plaques has been shown to be responsible for the majority of acute cardiovascular events, including myocardial infarction and stroke. Therefore, early detection of biological processes associated with atherosclerosis progression and plaque instability may improve diagnosis and treatment and help to better monito...
Source: Current Cardiovascular Imaging Reports - October 28, 2014 Category: Radiology Source Type: research

Three-dimensional Echocardiographic Analysis of left Atrial size and Volumetric Function — Clinical Implications and Comparison with Other Imaging Modalities
Abstract Since a number of imaging approaches are used to measure left atrial volume, it is important to know whether values obtained by different imaging modalities or by the same imaging modality using different measurement algorithms are interchangeable. This is particularly relevant for follow-up examinations. The advent of real-time full-volume three-dimensional echocardiography allows rapid measurement of chamber volume without making geometric assumptions. Furthermore, the semiautomatic methods allow repeat measurement of volume changes during the cardiac cycle thus permitting volumetric quantification of ...
Source: Current Cardiovascular Imaging Reports - October 1, 2014 Category: Radiology Source Type: research

Echocardiographic Assessment of Cardiac Dyssynchrony. Where do We Stand?
Abstract During the last two decades there has been an increasing interest in cardiac resynchronization therapy (CRT) in patients with heart failure. Major randomized clinical trials which tested the effectiveness of CRT included patients based on electrocardiographic (ECG) criteria amongst other features. However, there is an assumption that mechanical synchrony, as may be assessed by echocardiography, is the underlying mechanism that improves left ventricular function and finally the clinical outcome. Large multi-centre trials have failed to prove the usefulness of echocardiography in both selection of patients...
Source: Current Cardiovascular Imaging Reports - September 30, 2014 Category: Radiology Source Type: research

Real-Time Three-Dimensional Echocardiographic Flow Quantification in Valvular Heart Disease
Abstract Besides providing unique anatomic information, real-time three-dimensional (3D) echocardiography (RT3DE) using color Doppler has the potential to overcome the limitations of flow quantification using conventional two-dimensional color Doppler methods. Recent studies have validated the application of color Doppler RT3DE for the assessment of flow based on the vena contracta area (VCA) and proximal isovelocity surface area as well as on mitral inflow minus aortic outflow. In particular, the assessment of VCA by color Doppler RT3DE led to a change of paradigm as a consequence of understanding the VCA as str...
Source: Current Cardiovascular Imaging Reports - September 27, 2014 Category: Radiology Source Type: research

Echocardiographic Deformation Imaging for the Assessment of Left Ventricular Function: Clinical Implications and Perspectives— Update 2014
Abstract Echocardiographic deformation imaging is an emerging clinical method, which allows quantifying global and regional myocardial function. Its potential has been demonstrated in a large number of research settings, and it is now approaching routine clinical practice. This review provides an update on the recent developments in the field of deformation imaging and highlights current and potential future clinical applications of this promising technique. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - September 20, 2014 Category: Radiology Source Type: research

Clinical Implications from Three-dimensional Echocardiographic Analysis in Hypertrophic Cardiomyopathy
Abstract Hypertrophic cardiomyopathy (HCM) is a complex and the most common inheritable cardiovascular disease. Echocardiography has numerous clinical advantages, including its availability, time and cost-efficiency, and ease of use in most patients and clinical settings. 3-dimensional echocardiography, by addressing the limitations of 2-dimensional imaging, may become the technique of choice for clinical evaluation of cardiac chambers and function in this clinical scenario. This review summarizes the role of 3D echocardiography in HCM with a focus on its diagnostic features, improving the quantification of left ...
Source: Current Cardiovascular Imaging Reports - September 10, 2014 Category: Radiology Source Type: research

Cardiac CT Prior to Left Atrial Appendage Closure Device Implantation and Percutaneous Mitral Valve Interventions
Abstract Recent advances in percutaneous techniques have allowed them to emerge as an attractive alternative to surgery in select patients. Left atrial appendage closure has emerged as a novel therapeutic option in patients an nonvalvular atrial fibrillation who cannot take anticoagulation therapy. Furthermore, percutaneous mitral valve procedures have shown promising results in high risk patients. These percutaneous procedures require multimodality imaging for preprocedural planning and during the procedure. Computed tomography has emerged as an attractive imaging modality prior to percutaneous procedures given ...
Source: Current Cardiovascular Imaging Reports - August 30, 2014 Category: Radiology Source Type: research

Quantitative Analysis of Aortic Valve Stenosis and Aortic Root Dimensions by Three-Dimensional Echocardiography in Patients Scheduled for Transcutaneous Aortic Valve Implantation
Abstract Accurate assessment of the aortic valve area (AVA) and evaluation of the aortic root are important for clinical decision-making in patients being considered for transcatheter aortic valve implantation (TAVI). Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) provides accurate and reliable quantitative assessment of aortic valve stenosis and the aortic root. We performed two-dimensional transthoracic echocardiography (2D-TTE), real-time 2D transesophageal echocardiography (RT2D-TEE) and RT3D-TEE in 71 consecutive patients referred for TAVI. RT3D-TEE multiplanar reconstruction was use...
Source: Current Cardiovascular Imaging Reports - August 30, 2014 Category: Radiology Source Type: research

Patterns of Opacification in Coronary CT Angiography: Contrast Differences and Gradients
Abstract Iodinated contrast delivery is a key component of coronary computed tomography (CT) angiography. However, the purpose of contrast delivery has been limited to morphology alone. Specifically, iodine opacification of the coronary lumen has been used to separate it from the coronary artery wall and lesions within the coronary arteries. Because contrast is delivered to the coronary arteries according to the coronary blood flow, there is flow information encoded within the contrast opacification which, depending on CT hardware and acquisition protocol, can be recognized in coronary CT angiography. In addition...
Source: Current Cardiovascular Imaging Reports - August 23, 2014 Category: Radiology Source Type: research

Integrating Anatomical and Functional Assessment of Coronary Artery Disease: Can MDCT act as the lone Gatekeeper in the near Future?
Abstract Several multicenter trials have demonstrated the high diagnostic accuracy and clinical efficacy of modern coronary computed tomography angiography (CTA) when utilized to evaluate symptomatic patients with low-to-intermediate pretest probability of coronary artery disease (CAD). However, coronary CTA remains a purely anatomic test and further assessment with invasive coronary angiography or other non-invasive tests are occasionally required, with subsequent inherent risks and costs to patients and healthcare systems. Recently, remarkable advances in multidetector computed tomography technology has signifi...
Source: Current Cardiovascular Imaging Reports - August 19, 2014 Category: Radiology Source Type: research

Development of 3D IVOCT Imaging and Co-Registration of IVOCT and Angiography in the Catheterization Laboratory
Abstract Intravascular optical coherence tomography (IVOCT) has become the imaging modality of choice for the evaluation of coronary artery disease and percutaneous coronary intervention (PCI). Both for clinical practice and research, there is a growing interest in 3-dimensional (3D) visualization, as this gives a more comprehensive and intuitively easier to understand representation, compared with 2-dimensional, cross-sectional images. Integrating 3D-IVOCT with classic X-ray angiographic images offers additional advantages and the prospect of integrating IVOCT in fluoroscopic guidance during PCI. Different vendo...
Source: Current Cardiovascular Imaging Reports - August 13, 2014 Category: Radiology Source Type: research

Molecular Intravascular Imaging Approaches for Atherosclerosis
Abstract Coronary artery disease (CAD) is an inflammatory process that results in buildup of atherosclerosis, typically lipid-rich plaque in the arterial wall. Progressive narrowing of the vessel wall and subsequent plaque rupture can lead to myocardial infarction and death. Recent advances in intravascular fluorescence imaging techniques have provided exciting coronary artery-targeted platforms to further characterize the molecular changes that occur within the vascular wall as a result of atherosclerosis and following coronary stent-induced vascular injury. This review will summarize exciting recent development...
Source: Current Cardiovascular Imaging Reports - August 12, 2014 Category: Radiology Source Type: research

Dual Energy Imaging in Cardiovascular CT: Current Status and Impact on Radiation, Contrast and Accuracy
Abstract Dual-energy computed tomography (DECT) exploits the continuous energy distribution of x-rays to improve differentiation of tissues beyond what is possible with single-energy CT (SECT). DECT often uses smaller volumes of iodinated contrast agent and lower radiation doses than SECT. Clinical applications of DECT in cardiovascular imaging are emerging and include myocardial perfusion imaging, myocardial infarct and viability imaging, coronary plaque characterization, coronary stent assessment, and myocardial iron quantification. In this review, we discuss the available methods for acquiring and processing D...
Source: Current Cardiovascular Imaging Reports - August 10, 2014 Category: Radiology Source Type: research

Elasticity of the Heart, Problems and Potentials
This article discusses the requirements for performing quantitative elastography of the heart, as well as current developments and future perspectives. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - August 3, 2014 Category: Radiology Source Type: research

T1 Mapping for Characterization of Intracellular and Extracellular Myocardial Diseases in Heart Failure
Abstract Heart failure (HF) is a major and growing cause of morbidity and mortality. Despite initial successes, there have been few recent therapeutic advances. A better understanding of HF pathophysiology is needed with renewed focus on the myocardium itself. A new imaging technique is now available that holds promise. T1 mapping is a cardiovascular magnetic resonance (CMR) technique for non-invasive myocardial tissue characterization. T1 alters with disease. Pre-contrast (native) T1 changes with a number of processes such as fibrosis, edema and infiltrations. If a post contrast scan is also done, the extracellu...
Source: Current Cardiovascular Imaging Reports - July 31, 2014 Category: Radiology Source Type: research

Intracoronary Optical Coherence Tomography: Insights from Clinical Research—What Do We Need to Learn?
Abstract Optical coherence tomography (OCT) is a high-resolution technology for imaging of biological tissues that has shown tremendous potential for intracoronary use. Based on near-infrared light rather than ultrasound, catheter-based OCT provides cross-sectional images of the vessel wall and related devices in a histology-like manner. At present, OCT is primarily being used in research to better characterize and understand the pathophysiology of vulnerable plaques and to study the acute and long-term effects of coronary stent implantation. The present review provides the interventional cardiologist with a summ...
Source: Current Cardiovascular Imaging Reports - July 22, 2014 Category: Radiology Source Type: research

Low Radiation Coronary CT
This article provides an overview of radiation issues in CT, the risks of diagnostic-level ionizing radiation, and strategies that can be adopted to minimize exposure to radiation of patients undergoing CCTA. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - July 10, 2014 Category: Radiology Source Type: research

Multimodality Imaging in Ischemic Cardiomyopathy
We present an up-to-date comprehensive overview of multimodality imaging already in clinical use, as well as a combination of techniques with promising or developing applications. (Source: Current Cardiovascular Imaging Reports)
Source: Current Cardiovascular Imaging Reports - July 9, 2014 Category: Radiology Source Type: research

Noncardiac Incidental Findings on Cardiac CT: A Step-by-Step Approach
Abstract Noncardiac incidental findings on cardiac CT are remarkably common and some of these may have a significant impact on patient management. Herein, we present a straightforward and cost-effective step-by-step approach for identifying and reporting noncardiac incidental findings. In Step 1, we discuss the ‘ABCDEFG’ search pattern for systematically reviewing noncardiac organ systems. The most prevalent and clinically significant incidental findings are highlighted with strategies for increasing their conspicuity. In Step 2, the importance of reviewing clinical history and prior imaging studies i...
Source: Current Cardiovascular Imaging Reports - June 24, 2014 Category: Radiology Source Type: research

High Risk Plaque Features on Coronary CT Angiography
Abstract Coronary computed tomography angiography (CCTA) is a non-invasive imaging technique that can detect, characterize and quantify coronary atherosclerotic plaques in routine clinical settings. The distinct morphological features of vulnerable plaques and stable lesions provide an opportunity for CCTA to identify high-risk plaque features and guide stratified therapeutic interventions. Morphological plaque characteristics, such as large plaque volume, positive remodelling, low CT attenuation, spotty calcification and the napkin-ring sign have been linked to elevated risk of acute coronary syndrome. Recent ad...
Source: Current Cardiovascular Imaging Reports - June 17, 2014 Category: Radiology Source Type: research

T1 Mapping in Heart Failure
Abstract The pathophysiology of heart failure is characterized by abnormalities not only of the cardiomyocytes, but also by expansion of the extracellular space. Evolving recognition of these changes, and their important functional consequences, has prompted a search for accurate characterization of the myocardial interstitium. Previously, this has only been possible using histologic analysis; however, T1 mapping with cardiac magnetic resonance imaging has recently provided a noninvasive method to measure expansion of the myocardial interstitium. Literature over the past 6 years suggests T1 mapping could pot...
Source: Current Cardiovascular Imaging Reports - June 17, 2014 Category: Radiology Source Type: research

Cardiac Masses on Cardiac CT: A Review
Abstract Cardiac masses are rare entities that can be broadly categorized as either neoplastic or non-neoplastic. Neoplastic masses include benign and malignant tumors. In the heart, metastatic tumors are more common than primary malignant tumors. Whether incidentally found or diagnosed as a result of patients’ symptoms, cardiac masses can be identified and further characterized by a range of cardiovascular imaging options. While echocardiography remains the first-line imaging modality, cardiac computed tomography (cardiac CT) has become an increasingly utilized modality for the assessment of cardiac masses...
Source: Current Cardiovascular Imaging Reports - June 17, 2014 Category: Radiology Source Type: research

Intra-Cycle Motion Correction in Coronary CT Angiography
Abstract Coronary computed tomography angiography (CCTA) has demonstrated high diagnostic performance for coronary lesions detection. However, coronary artery motion blurring, related to high or variable heart rate (HR) is a common drawback. Recently, a novel intracycle motion-correction (MC) algorithm has been developed. Aim of the present review is to evaluate the published literature regarding the impact of MC algorithm compared with standard reconstruction on diagnostic performance of CCTA and to integrate the published data with our local experience. The 2 single-center published studies showed a significant...
Source: Current Cardiovascular Imaging Reports - June 17, 2014 Category: Radiology Source Type: research