Journal of Nuclear Cardiology最新文献

英文中文

Observations from early use of [¹⁸F]flurpiridaz in routine clinical practice. 早期氟吡达在常规临床实践中的应用观察[18F]。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-21 DOI: 10.1016/j.nuclcard.2026.102641

Marjolein E Hol, Arthur J A T Braat

引用次数: 0

Diagnostic Performance of F-18 Flurpiridaz in Women: A Sub-study of the Aurora Phase 3 Trial. F-18氟吡达在女性中的诊断性能：Aurora 3期试验的一项亚研究。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-21 DOI: 10.1016/j.nuclcard.2026.102640

Stephen J Horgan, Gary V Heller, Jamshid Maddahi, Timothy M Bateman, Jeroen J Bax, Rob S B Beanlands, Daniel S Berman, Ernest V Garcia, Edward Somer, Nagara Tamaki, David Thompson, James E Udelson

Background: A recent phase 3 study of the PET perfusion tracer F-18 flurpiridaz (flurpiridaz) met the primary efficacy endpoint for the detection of CAD, demonstrating statistically higher sensitivity, non-inferior specificity compared to Tc-99m-tetrofosmin/sestamibi SPECT (Tc99m-SPECT) in the general population. This study reports a pre-specified subgroup analysis examining the diagnostic accuracy of flurpiridaz in women.

Methods: Patients with suspected CAD underwent rest-stress flurpiridaz PET and Tc99m-SPECT before invasive coronary angiography in the US, Canada and Europe. The primary endpoint was sensitivity and specificity by 2 expert readers (majority rule between 3 blinded readers) for the diagnosis of significant CAD defined as a stenosis ≥50%. Secondary endpoints included comparison of the diagnostic performance of flurpiridaz PET and Tc99m-SPECT.

Results: 188 women were included in the subgroup analysis. Flurpiridaz met the pre-specified primary endpoint of sensitivity [82.9% (95% CI: 71.4, 94.4),p=0.0014] and specificity [72.8% (95%CI: 65.6, 80),p=0.0008]. Flurpiridaz sensitivity was significantly higher than Tc99m-SPECT [82.9% vs.65.9%, difference: 17.1% (-1.5%, 35.6%),p=0.0448] and specificity was non-inferior [72.8% vs. 66%, difference:6.8% (-3.4%, 17.0%) p=0.0004]. Diagnostic certainty was significantly higher for women undergoing flurpiridaz PET compared to Tc99m-SPECT (82.4% v 48.9%). PET perfusion image quality was better than Tc99m-SPECT for rest and pharmacological stress images (p<0.0001). The summed difference score was significantly higher for flurpiridaz (5.3 v 3.5). Radiation exposure was significantly lower for flurpiridaz than same day rest/stress Tc99m-SPECT (6.2 v 11.2 mSv).

Conclusions: This pre-specified secondary analysis of the ARORA study in women, demonstrates high diagnostic accuracy of flurpiridaz PET to detect obstructive CAD. In women, the diagnostic performance of flurpiridaz PET for detection of CAD was significantly higher than with 99mTc-SPECT.

背景：最近的一项PET灌注显影剂F-18 flurpiridaz （flurpiridaz）的3期研究达到了检测CAD的主要疗效终点，与Tc-99m-tetrofosmin/sestamibi SPECT （Tc99m-SPECT）相比，在普通人群中显示出统计学上更高的敏感性和非低特异性。本研究报告了一个预先指定的亚组分析，检查氟吡嗪在女性中的诊断准确性。方法：美国、加拿大和欧洲疑似冠心病患者在有创冠状动脉造影前行静息应激氟吡达PET和Tc99m-SPECT。主要终点是2位专家读者（3位盲法读者之间的多数规则）对狭窄≥50%的显著CAD诊断的敏感性和特异性。次要终点包括氟吡达PET和Tc99m-SPECT诊断性能的比较。结果：188名女性被纳入亚组分析。氟吡达符合预先设定的主要终点：敏感性[82.9% (95%CI: 71.4, 94.4),p=0.0014]和特异性[72.8% (95%CI: 65.6, 80),p=0.0008]。氟吡达敏感性显著高于Tc99m-SPECT[82.9%比65.9%，差异为17.1% (-1.5%,35.6%),p=0.0448]，特异性不差[72.8%比66%，差异为6.8% (-3.4%,17.0%)p=0.0004]。与Tc99m-SPECT相比，接受氟吡嗪PET治疗的女性诊断确定性明显更高（82.4% vs 48.9%）。PET灌注图像质量优于Tc99m-SPECT休息和药物应激图像(pp结论：这项预先指定的ARORA女性研究的二次分析表明，氟吡嗪PET检测阻塞性CAD的诊断准确性很高。在女性中，氟吡达PET检测CAD的诊断性能明显高于99mTc-SPECT。

{"title":"Diagnostic Performance of F-18 Flurpiridaz in Women: A Sub-study of the Aurora Phase 3 Trial.","authors":"Stephen J Horgan, Gary V Heller, Jamshid Maddahi, Timothy M Bateman, Jeroen J Bax, Rob S B Beanlands, Daniel S Berman, Ernest V Garcia, Edward Somer, Nagara Tamaki, David Thompson, James E Udelson","doi":"10.1016/j.nuclcard.2026.102640","DOIUrl":"https://doi.org/10.1016/j.nuclcard.2026.102640","url":null,"abstract":"<p><strong>Background: </strong>A recent phase 3 study of the PET perfusion tracer F-18 flurpiridaz (flurpiridaz) met the primary efficacy endpoint for the detection of CAD, demonstrating statistically higher sensitivity, non-inferior specificity compared to Tc-99m-tetrofosmin/sestamibi SPECT (Tc99m-SPECT) in the general population. This study reports a pre-specified subgroup analysis examining the diagnostic accuracy of flurpiridaz in women.</p><p><strong>Methods: </strong>Patients with suspected CAD underwent rest-stress flurpiridaz PET and Tc99m-SPECT before invasive coronary angiography in the US, Canada and Europe. The primary endpoint was sensitivity and specificity by 2 expert readers (majority rule between 3 blinded readers) for the diagnosis of significant CAD defined as a stenosis ≥50%. Secondary endpoints included comparison of the diagnostic performance of flurpiridaz PET and Tc99m-SPECT.</p><p><strong>Results: </strong>188 women were included in the subgroup analysis. Flurpiridaz met the pre-specified primary endpoint of sensitivity [82.9% (95% CI: 71.4, 94.4),p=0.0014] and specificity [72.8% (95%CI: 65.6, 80),p=0.0008]. Flurpiridaz sensitivity was significantly higher than Tc99m-SPECT [82.9% vs.65.9%, difference: 17.1% (-1.5%, 35.6%),p=0.0448] and specificity was non-inferior [72.8% vs. 66%, difference:6.8% (-3.4%, 17.0%) p=0.0004]. Diagnostic certainty was significantly higher for women undergoing flurpiridaz PET compared to Tc99m-SPECT (82.4% v 48.9%). PET perfusion image quality was better than Tc99m-SPECT for rest and pharmacological stress images (p<0.0001). The summed difference score was significantly higher for flurpiridaz (5.3 v 3.5). Radiation exposure was significantly lower for flurpiridaz than same day rest/stress Tc99m-SPECT (6.2 v 11.2 mSv).</p><p><strong>Conclusions: </strong>This pre-specified secondary analysis of the ARORA study in women, demonstrates high diagnostic accuracy of flurpiridaz PET to detect obstructive CAD. In women, the diagnostic performance of flurpiridaz PET for detection of CAD was significantly higher than with 99mTc-SPECT.</p>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102640"},"PeriodicalIF":2.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Systematic differences in myocardial blood flow and flow reserve quantification using Rubidium-82 and [15O]H2O positron emission tomography: Implications for prognostic cut-offs 使用铷-82和[15O]H2O PET定量心肌血流和血流储备的系统差异：对预后截止值的影响。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102533

Jacob H Søby MD , Jesper Mortensen MD , Laust D Rasmussen MD, PhD , Lars P Tolbod MS, PhD , Simon Winther MD, PhD, DMSc , Morten Böttcher MD, PhD

Background

While Rubidium-82 (⁸²Rb) positron emission tomography (PET) myocardial perfusion imaging (MPI) has a well-established myocardial flow reserve (MFR) cut-off of <2 for prognosis, no consensus exists for [¹⁵O]H₂O PET.

Methods

Forty-four patients referred for routine ⁸²Rb PET MPI underwent same-day [¹⁵O]H₂O PET MPI. Myocardial blood flow (MBF) and MFR measurements corrected for nonlinear ⁸²Rb extraction were compared. Additionally, a pooled analysis including five similar studies was conducted.

Results

Global MBF was higher at rest (relative difference 26%, 95% confidence interval [CI]: 21–31) and lower at stress (relative difference −17%, 95% CI: -24 to −10) measured by ⁸²Rb vs [¹⁵O]H₂O PET. Global MFR was lower measured by ⁸²Rb vs [¹⁵O]H₂O PET (relative difference −42%, 95% CI: -48% to −37%). The directions of the observed biases were confirmed in the pooled analysis. Correction for nonlinear ⁸²Rb extraction with the equation by Prior et al. compared to Lortie et al. demonstrated better agreement of stress MBF between the tracers. Applying the relative differences of MFR, the prognostic cut-off for MFR of 2 using ⁸²Rb PET corresponds to an MFR using [¹⁵O]H₂O PET of 3.1 (95% CI: 2.9-3.3) in the present study and 2.5 (95% CI: 2.4-2.6) in the pooled analysis.

Conclusions

⁸²Rb PET overestimates global MBF at rest, underestimates global MBF at stress, and underestimates global MFR compared with [¹⁵O]H₂O PET, despite correction for nonlinear extraction. Validation of prognostic cut-off values for [¹⁵O]H₂O PET is needed, and caution should be taken in directly comparing MBF and MFR obtained by these two tracers.

背景：而铷-82 (82Rb) PET心肌灌注成像（MPI）具有完善的心肌血流储备（MFR）截止值为15O]H2O PET。方法与结果：44例例行82Rb PET MPI患者同日行[15O]H2O PET MPI。比较非线性82Rb提取校正后的心肌血流量（MBF）和MFR测量值。此外，还进行了包括五项类似研究在内的汇总分析。与[15O]H2O PET相比，82Rb测量的整体MBF在休息时较高（相对差值26%，95% CI 21-31），在应激时较低（相对差值-17%，95% CI -24至-10）。与[15O]H2O PET相比，82Rb测量的总体MFR较低（相对差异为-42%，95% CI为-48至-37%）。观察到的偏倚方向在合并分析中得到了证实。与Lortie等人相比，Prior等人用方程对非线性82Rb提取进行了校正，结果表明示踪剂之间的应力MBF一致性更好。应用MFR的相对差异，在本研究中，使用82Rb PET的MFR为2的预后临界值对应于使用[15O]H2O PET的MFR为3.1 (95% CI 2.9-3.3)，在合并分析中为2.5 （95% CI 2.4-2.6）。结论：尽管对非线性提取进行了校正，但与[15O]H2O PET相比，82Rb PET高估了静止状态下的整体MBF，低估了应力状态下的整体MBF，低估了整体MFR。需要验证[15O]H2O PET的预后临界值，并且在直接比较这两种示踪剂获得的MBF和MFR时应谨慎。

{"title":"Systematic differences in myocardial blood flow and flow reserve quantification using Rubidium-82 and [15O]H2O positron emission tomography: Implications for prognostic cut-offs","authors":"Jacob H Søby MD , Jesper Mortensen MD , Laust D Rasmussen MD, PhD , Lars P Tolbod MS, PhD , Simon Winther MD, PhD, DMSc , Morten Böttcher MD, PhD","doi":"10.1016/j.nuclcard.2025.102533","DOIUrl":"10.1016/j.nuclcard.2025.102533","url":null,"abstract":"<div><h3>Background</h3><div>While Rubidium-82 (<sup>82</sup>Rb) positron emission tomography (PET) myocardial perfusion imaging (MPI) has a well-established myocardial flow reserve (MFR) cut-off of <2 for prognosis, no consensus exists for [<sup>15</sup>O]H<sub>2</sub>O PET.</div></div><div><h3>Methods</h3><div>Forty-four patients referred for routine <sup>82</sup>Rb PET MPI underwent same-day [<sup>15</sup>O]H<sub>2</sub>O PET MPI. Myocardial blood flow (MBF) and MFR measurements corrected for nonlinear <sup>82</sup>Rb extraction were compared. Additionally, a pooled analysis including five similar studies was conducted.</div></div><div><h3>Results</h3><div>Global MBF was higher at rest (relative difference 26%, 95% confidence interval [CI]: 21–31) and lower at stress (relative difference −17%, 95% CI: -24 to −10) measured by <sup>82</sup>Rb vs [<sup>15</sup>O]H<sub>2</sub>O PET. Global MFR was lower measured by <sup>82</sup>Rb vs [<sup>15</sup>O]H<sub>2</sub>O PET (relative difference −42%, 95% CI: -48% to −37%). The directions of the observed biases were confirmed in the pooled analysis. Correction for nonlinear <sup>82</sup>Rb extraction with the equation by Prior et al. compared to Lortie et al. demonstrated better agreement of stress MBF between the tracers. Applying the relative differences of MFR, the prognostic cut-off for MFR of 2 using <sup>82</sup>Rb PET corresponds to an MFR using [<sup>15</sup>O]H<sub>2</sub>O PET of 3.1 (95% CI: 2.9-3.3) in the present study and 2.5 (95% CI: 2.4-2.6) in the pooled analysis.</div></div><div><h3>Conclusions</h3><div><sup>82</sup>Rb PET overestimates global MBF at rest, underestimates global MBF at stress, and underestimates global MFR compared with [<sup>15</sup>O]H<sub>2</sub>O PET, despite correction for nonlinear extraction. Validation of prognostic cut-off values for [<sup>15</sup>O]H<sub>2</sub>O PET is needed, and caution should be taken in directly comparing MBF and MFR obtained by these two tracers.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"55 ","pages":"Article 102533"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of hemoglobin concentration on quantitative cardiac perfusion measurements 血红蛋白浓度对心脏灌注定量测量的影响。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102537

Patrik Svanström MD , Tanja Kero MD, PhD , Christian L. Polte MD, PhD, MSc , Jonathan Sigfridsson MSc , Kai M. Eggers MD, PhD , Nina Johnston MD, PhD , Alexander Brandt MD, MSc , Hendrik J. Harms PhD , Mark Lubberink PhD , Jens Sörensen MD, PhD

Background

Anemia is a prognostic factor in chronic coronary syndromes (CCS), but its impact on quantitative myocardial perfusion and potential sex differences remains unclear. We investigated whether hemoglobin concentration (Hb) independently affects resting and stress myocardial blood flow (MBF) or myocardial flow reserve (MFR).

Methods

This retrospective study included patients with known or clinically suspected CCS who underwent cardiac ¹⁵O-water positron emission tomography (PET) and had available Hb data. PET parameters included resting and stress MBF, MFR, and forward stroke volume index (FSVi), calculated by dividing cardiac index derived from the indicator dilution technique by heart rate. Multivariable regression and mediation analyses were performed to determine the independent influence of Hb.

Results

We included 675 consecutive patients (45% female, age 66 ± 11 years, Hb 139 ± 14 g/L, 13% anemic). Heart rate, FSVi, Hb, sex, and systolic blood pressure (SBP) explained two-thirds of the variation in resting MBF (adjusted R² = .66). In mediation analysis, the association between Hb and resting MBF was mainly direct, with partial mediation by FSVi only in females, and no mediation by heart rate or SBP. Hb was not associated with stress MBF in any sex (P ≥ .17). Anemia was associated with a higher proportion of low MFR (<2.5) despite normal stress MBF (20.9% vs. 9.3%, P = .004).

Conclusions

Hemoglobin concentration affects resting myocardial blood flow but not stress MBF, indicating stress MBF may serve as a more robust and reliable measure of maximal coronary flow capacity than MFR, particularly in patients with anemia.

背景：贫血是慢性冠状动脉综合征（CCS）的预后因素，但其对定量心肌灌注的影响和潜在的性别差异尚不清楚。我们研究了血红蛋白浓度（Hb）是否独立影响静息和应激心肌血流量（MBF）或心肌血流储备（MFR）。方法：这项回顾性研究纳入了已知或临床疑似CCS的患者，这些患者接受了心脏15O-water PET检查，并有可用的Hb数据。PET参数包括静息和应激MBF、MFR和前搏容量指数（FSVi），由指标稀释技术得出的心脏指数除以心率计算得到。采用多变量回归和中介分析来确定Hb的独立影响。结果：我们纳入了675例连续患者（45%为女性，年龄66±11岁，Hb 139±14 g/L， 13%贫血）。心率、FSVi、Hb、性别和收缩压（SBP）解释了静息MBF变化的三分之二（校正R2=0.66）。在中介分析中，Hb与静息MBF之间的关系主要是直接的，FSVi仅在女性中有部分中介作用，而心率和收缩压没有中介作用。Hb与应激性MBF无相关性（P≥0.17）。贫血与低MFR比例较高相关(结论：血红蛋白浓度影响静息心肌血流量，但不影响应激MBF，表明应激MBF可能比MFR更可靠，更可靠地衡量最大冠状动脉血流能力，特别是在贫血患者中。

{"title":"Impact of hemoglobin concentration on quantitative cardiac perfusion measurements","authors":"Patrik Svanström MD , Tanja Kero MD, PhD , Christian L. Polte MD, PhD, MSc , Jonathan Sigfridsson MSc , Kai M. Eggers MD, PhD , Nina Johnston MD, PhD , Alexander Brandt MD, MSc , Hendrik J. Harms PhD , Mark Lubberink PhD , Jens Sörensen MD, PhD","doi":"10.1016/j.nuclcard.2025.102537","DOIUrl":"10.1016/j.nuclcard.2025.102537","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is a prognostic factor in chronic coronary syndromes (CCS), but its impact on quantitative myocardial perfusion and potential sex differences remains unclear. We investigated whether hemoglobin concentration (Hb) independently affects resting and stress myocardial blood flow (MBF) or myocardial flow reserve (MFR).</div></div><div><h3>Methods</h3><div>This retrospective study included patients with known or clinically suspected CCS who underwent cardiac <sup>15</sup>O-water positron emission tomography (PET) and had available Hb data. PET parameters included resting and stress MBF, MFR, and forward stroke volume index (FSVi), calculated by dividing cardiac index derived from the indicator dilution technique by heart rate. Multivariable regression and mediation analyses were performed to determine the independent influence of Hb.</div></div><div><h3>Results</h3><div>We included 675 consecutive patients (45% female, age 66 ± 11 years, Hb 139 ± 14 g/L, 13% anemic). Heart rate, FSVi, Hb, sex, and systolic blood pressure (SBP) explained two-thirds of the variation in resting MBF (adjusted <em>R</em><sup>2</sup> = .66). In mediation analysis, the association between Hb and resting MBF was mainly direct, with partial mediation by FSVi only in females, and no mediation by heart rate or SBP. Hb was not associated with stress MBF in any sex (<em>P</em> ≥ .17). Anemia was associated with a higher proportion of low MFR (<2.5) despite normal stress MBF (20.9% vs. 9.3%, <em>P</em> = .004).</div></div><div><h3>Conclusions</h3><div>Hemoglobin concentration affects resting myocardial blood flow but not stress MBF, indicating stress MBF may serve as a more robust and reliable measure of maximal coronary flow capacity than MFR, particularly in patients with anemia.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"55 ","pages":"Article 102537"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unusual intrathoracic uptake of 99mTc-tetrofosmin on myocardial perfusion imaging 胸腔内99mtc -四氟磷摄取异常对心肌灌注成像的影响。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102198

Azusa Shimabukuro MD, Tadao Aikawa MD, PhD, Shinichiro Fujimoto MD, PhD, Tohru Minamino MD, PhD

引用次数: 0

How to perform quantification of myocardial blood flow using single-photon emission computed tomography myocardial perfusion imaging 如何使用SPECT MPI进行心肌血流定量

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102534

Ronaldo de Souza Leão Lima MD, PhD , Andrea de Lorenzo MD, PhD , Isabella Caterina Palazzo MD , Claudio Tinoco Mesquita MD, PhD

Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) using SPECT myocardial perfusion imaging (MPI) represents a significant advancement in the field of nuclear cardiology. The introduction of cadmium-zinc-telluride (CZT) solid-state detectors and innovative reconstruction algorithms has enabled dynamic SPECT imaging for MBF quantification. This review provides a guide to performing and interpreting quantitative SPECT MBF measurements in clinical practice. We discuss appropriate patient selection, protocol optimization, technical requirements, and acquisition parameters. Step-by-step approaches to image reconstruction, processing methods, and quantitative analysis are outlined, with emphasis on real-world clinical cases discussion. The review also addresses common technical challenges, potential pitfalls, and practical solutions for implementing this technology in routine clinical care. This article aims to facilitate wider adoption of SPECT MBF quantification as a valuable tool for diagnosing coronary artery disease and assessing coronary microvascular function.

利用SPECT心肌灌注成像（MPI）量化心肌血流（MBF）和心肌血流储备（MFR）是核心脏病学领域的一项重大进展。碲化镉锌（CZT）固态探测器的引入和创新的重建算法使MBF量化的动态SPECT成像成为可能。这篇综述提供了在临床实践中执行和解释定量SPECT MBF测量的指南。我们讨论适当的患者选择、方案优化、技术要求和获取参数。一步一步的方法图像重建，处理方法和定量分析概述，强调现实世界的临床病例讨论。该综述还讨论了在常规临床护理中实施该技术的常见技术挑战、潜在缺陷和实际解决方案。本文旨在促进SPECT MBF定量作为诊断冠状动脉疾病和评估冠状动脉微血管功能的有价值的工具的广泛采用。

{"title":"How to perform quantification of myocardial blood flow using single-photon emission computed tomography myocardial perfusion imaging","authors":"Ronaldo de Souza Leão Lima MD, PhD , Andrea de Lorenzo MD, PhD , Isabella Caterina Palazzo MD , Claudio Tinoco Mesquita MD, PhD","doi":"10.1016/j.nuclcard.2025.102534","DOIUrl":"10.1016/j.nuclcard.2025.102534","url":null,"abstract":"<div><div>Quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) using SPECT myocardial perfusion imaging (MPI) represents a significant advancement in the field of nuclear cardiology. The introduction of cadmium-zinc-telluride (CZT) solid-state detectors and innovative reconstruction algorithms has enabled dynamic SPECT imaging for MBF quantification. This review provides a guide to performing and interpreting quantitative SPECT MBF measurements in clinical practice. We discuss appropriate patient selection, protocol optimization, technical requirements, and acquisition parameters. Step-by-step approaches to image reconstruction, processing methods, and quantitative analysis are outlined, with emphasis on real-world clinical cases discussion. The review also addresses common technical challenges, potential pitfalls, and practical solutions for implementing this technology in routine clinical care. This article aims to facilitate wider adoption of SPECT MBF quantification as a valuable tool for diagnosing coronary artery disease and assessing coronary microvascular function.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"55 ","pages":"Article 102534"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High flow but feeling low—reporting myocardial perfusion imaging in patients with anemia 贫血患者高血流但感觉低报告的心肌灌注显像

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102575

Valtteri Uusitalo MD, PhD

引用次数: 0

Cardiac stress-to-rest ratio on single-photon emission computed tomography myocardial perfusion imaging: Bet, check, or fold? 单光子发射计算机断层心肌灌注成像的心脏应力-休息比：下注，检查，还是折叠？

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102585

Fabien Hyafil MD, PhD , Nidaa Mikail MD

引用次数: 0

Beyond flow reserve: Comparative prognostic value of myocardial blood flow reserve, peak stress myocardial blood flow, and blood flow reserve corrected for resting rate pressure product in patients undergoing positron emission tomography myocardial perfusion imaging 超血流储备：心肌血流储备、峰值应激心肌血流、静息率压积校正心肌血流储备在PET心肌灌注显像患者中的预后价值比较

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102540

Mirza S. Khan MD, MS , Timothy M. Bateman MD , James A. Case PhD , Brett W. Sperry MD

Background

Global myocardial blood flow reserve (MBFR) demonstrates diagnostic and prognostic value beyond visual perfusion defect assessment. However, high resting rate-pressure product (RPP) can influence MBFR interpretation. Data are mixed regarding the importance of further stratifying MBFR by peak stress MBF or RPP-corrected MBFR (cMBFR) values.

Methods

This retrospective study consisted of consecutive patients referred for positron emission tomography myocardial perfusion imaging (PET MPI) at Saint Luke’s Health System (2010–2016). Patients were categorized based on impaired or preserved levels of MBFR (<2 vs ≥ 2), cMBFR (<2 vs ≥ 2), and peak stress MBF (<1.7 vs ≥ 1.7 mL/min/g). All-cause mortality across groups was assessed using Kaplan-Meier and log-rank tests, with goodness-of-fit assessed using likelihood ratio tests.

Results

Of 13,632 consecutive patients referred for PET MPI, the median age was 70 (IQR: 61–77) years, 50.2 % were female, and the median follow-up was 8.3 years. Over the study period, 30.6 % of patients died; 73.5 % of whom had MBFR<2. Preserved MBFR was associated with the most favorable prognosis, regardless of cMBFR or peak stress MBF. Those with MBFR <2 and impairment of either peak stress MBF or cMBFR had the poorest prognosis. In those with MBFR<2, normal peak stress MBF identified a group with intermediate prognosis slightly better than the presence of preserved cMBFR (P = .012 vs .064, respectively).

Conclusions

In this large cohort, normal MBFR predicted favorable outcomes independent of cMBFR or peak stress MBF. Inclusion of peak stress MBF beyond MBFR and traditional risk factors improved model fit compared to cMBFR and helped to risk stratify patients with impaired MBFR.

总体心肌血流储备（MBFR）在视觉灌注缺陷评估之外具有诊断和预后价值。然而，高静息率压积（RPP）会影响MBFR的解释。关于通过峰值应力MBF或rpp校正的MBFR （cMBFR）值进一步分层MBFR的重要性，数据是混合的。方法：本回顾性研究包括2010-2016年在圣卢克卫生系统进行正电子发射断层扫描心肌灌注成像（PET MPI）的连续患者。患者根据MBFR受损或保留水平进行分类(结果：13632例连续转介PET MPI的患者中位年龄为70 （IQR 61-77）岁，50.2%为女性，中位随访时间为8.3年。在研究期间，30.6%的患者死亡；结论：在这个大的队列中，正常的MBFR预示着良好的结果，与cMBFR或峰值应激MBF无关。与cMBFR相比，纳入峰值应激MBF和传统危险因素可改善模型拟合，并有助于对MBFR受损患者进行风险分层。

{"title":"Beyond flow reserve: Comparative prognostic value of myocardial blood flow reserve, peak stress myocardial blood flow, and blood flow reserve corrected for resting rate pressure product in patients undergoing positron emission tomography myocardial perfusion imaging","authors":"Mirza S. Khan MD, MS , Timothy M. Bateman MD , James A. Case PhD , Brett W. Sperry MD","doi":"10.1016/j.nuclcard.2025.102540","DOIUrl":"10.1016/j.nuclcard.2025.102540","url":null,"abstract":"<div><h3>Background</h3><div>Global myocardial blood flow reserve (MBFR) demonstrates diagnostic and prognostic value beyond visual perfusion defect assessment. However, high resting rate-pressure product (RPP) can influence MBFR interpretation. Data are mixed regarding the importance of further stratifying MBFR by peak stress MBF or RPP-corrected MBFR (cMBFR) values.</div></div><div><h3>Methods</h3><div>This retrospective study consisted of consecutive patients referred for positron emission tomography myocardial perfusion imaging (PET MPI) at Saint Luke’s Health System (2010–2016). Patients were categorized based on impaired or preserved levels of MBFR (<2 vs ≥ 2), cMBFR (<2 vs ≥ 2), and peak stress MBF (<1.7 vs ≥ 1.7 mL/min/g). All-cause mortality across groups was assessed using Kaplan-Meier and log-rank tests, with goodness-of-fit assessed using likelihood ratio tests.</div></div><div><h3>Results</h3><div>Of 13,632 consecutive patients referred for PET MPI, the median age was 70 (IQR: 61–77) years, 50.2 % were female, and the median follow-up was 8.3 years. Over the study period, 30.6 % of patients died; 73.5 % of whom had MBFR<2. Preserved MBFR was associated with the most favorable prognosis, regardless of cMBFR or peak stress MBF. Those with MBFR <2 and impairment of either peak stress MBF or cMBFR had the poorest prognosis. In those with MBFR<2, normal peak stress MBF identified a group with intermediate prognosis slightly better than the presence of preserved cMBFR (<em>P</em> = .012 vs .064, respectively).</div></div><div><h3>Conclusions</h3><div>In this large cohort, normal MBFR predicted favorable outcomes independent of cMBFR or peak stress MBF. Inclusion of peak stress MBF beyond MBFR and traditional risk factors improved model fit compared to cMBFR and helped to risk stratify patients with impaired MBFR.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"55 ","pages":"Article 102540"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nuclear cardiology is exciting in 2026: Let's innovate together! 2026年的核心学令人兴奋：让我们一起创新！

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2026-01-01 DOI: 10.1016/j.nuclcard.2025.102589

Jamieson M. Bourque MD, MHS, FASNC

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of Nuclear Cardiology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀