Journal of Nuclear Cardiology最新文献

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ASNC research awards: Advancing the future of nuclear cardiology ASNC研究奖：推进核心脏病学的未来

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.nuclcard.2025.102511

Panithaya Chareonthaitawee MD, MASNC

引用次数: 0

Integrating perfusion with AI–derived coronary calcium on CT attenuation scans to improve selection of low-risk studies for stress-only SPECT myocardial perfusion imaging 整合灌注与人工智能衍生冠状动脉钙化在CT衰减扫描，以改善低风险研究的选择，仅压力SPECT MPI。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-11-01 DOI: 10.1016/j.nuclcard.2025.102482

Robert J.H. Miller MD , Orit Barrett MD, PhD , Aakash Shanbhag MSc , Alan Rozanski MD , Damini Dey PhD , Mark Lemley BSc , Serge D. Van Kriekinge PhD , Paul B. Kavanagh MSc , Attila Feher MD, PhD , Edward J. Miller MD , Andrew J. Einstein MD, PhD , Terrence D. Ruddy MD , Timothy Bateman MD , Philip A. Kaufmann MD , Joanna X. Liang MPH , Daniel S. Berman MD , Piotr J. Slomka PhD

Background

In many contemporary laboratories, a completely normal stress perfusion single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) is required for rest imaging cancelation. We hypothesized that an artificial intelligence (AI)–derived coronary artery calcium (CAC) score of 0 from computed tomography attenuation correction (CTAC) scans obtained during hybrid SPECT/CT may identify additional patients at a low risk of major adverse cardiovascular events (MACEs) who could be selected for stress-only imaging.

Methods

Patients without known coronary artery disease who underwent SPECT/CT MPI and had stress total perfusion deficit (TPD) <5% were included. Stress TPD was categorized as no abnormality (stress TPD: 0%) or minimal abnormality (stress TPD: 1%-4%). CAC was automatically quantified from the CTAC scans. We evaluated associations with MACEs.

Results

In total, 6884 patients (49.4% males and median age: 63 years) were included. Of these, 9.7% experienced MACE (15% non-fatal myocardial infarction, 2.7% unstable angina, 38.5% coronary revascularization and 43.8% deaths). Compared to patients with TPD 0%, those with TPD 1%-4% and CAC 0 had lower MACE risk (hazard ratio [HR]: 0.58; 95% confidence interval [CI]: 0.45-0.76), while those with TPD 1%%-4% and CAC score>0 had a higher MACE risk (HR: 1.90; 95% CI: 1.56-2.30). Compared to canceling rest scans only in patients with normal perfusion (TPD 0%), by canceling rest scans in patients with CAC 0, more than twice as many rest scans (55% vs 25%) could potentially be canceled.

Conclusion

Using an AI-derived CAC of 0 on CT scans with hybrid SPECT/CT in patients with a stress TPD <5% can double the proportion of patients in whom stress-only procedures could be safely performed.

背景：在许多现代实验室中，需要完全正常的应力灌注SPECT-MPI来消除静止成像。我们假设，在混合SPECT/CT期间获得的计算机断层扫描衰减校正（CTAC）扫描中，人工智能（AI）衍生的CAC评分为0，可能会识别出其他低风险的MACE患者，可以选择他们进行应激成像。方法和结果：没有已知冠状动脉疾病的患者行SPECT/CT MPI且有应激性总灌注缺陷（TPD） 0的MACE风险较高（HR 1.90; 95%CI 1.56-2.30）。与仅在灌注正常（TPD为0%）的患者中取消休息扫描相比，通过取消CAC 0患者的休息扫描，可以取消的休息扫描次数（55%对25%）超过两倍。结论：在应激性TPD患者的CT扫描中使用ai衍生的CAC 0进行SPECT/CT混合扫描

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引用次数: 0

Improving prognostic risk assessment of cardiovascular events with machine learning: An evaluation using positron emission tomography myocardial perfusion imaging. 用机器学习改善心血管事件的预后风险评估：PET心肌灌注成像的评估。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-30 DOI: 10.1016/j.nuclcard.2025.102539

Fares Alahdab, Radwa El Shawi, Ahmed Ibrahim Ahmed, Mahmoud Al Rifai, Mouaz Al-Mallah

Background: Machine learning (ML) holds potential for improving risk assessment in patients with suspected or confirmed coronary artery disease (CAD). However, certain approaches offer greater benefit than others for this task, particularly to capture non-linearity between variables as well as case-by-case explainability.

Methods: We included consecutive patients who underwent clinically indicated positron emission tomography (PET) imaging. Using automated machine learning (AutoML) and unseen data for performance testing, clinical and PET variables were used to train the predictive models. A logistic regression (LR) and a deep feed-forward neural network (DNN) were trained on the same data for comparison. Major adverse cardiovascular events (MACEs) included death, myocardial infarction, or coronary revascularization >90 days after imaging.

Results: We included 8,357 patients (80% for development and 20% held out for testing), 46.3% females, with a mean (standard deviation) age of 67.2 (11.7) years. The median (interquartile range) myocardial flow reserve (MFR) was 2.1 (1.6 to 2.6). After an average follow-up of 589 days, a total of 852 patients (10.2%) experienced MACEs. The AutoML achieved an area under the receiver operator curve of .82 (95% confidence interval: .79 to .85) versus .79 (.76 to .82) and .76 (.73 to .80) for the LR and the DNN models, respectively. Model explainability showed that MFR topped the list of most impactful features, followed by total perfusion defects, serum creatinine, and diastolic blood pressure.

Conclusions: An AutoML model integrating clinical and PET data discriminated MACE risk in CAD more accurately than LR or DNN models and provides interpretable patient-level explanations that can inform personalized care.

背景：机器学习（ML）具有改善疑似或确诊冠状动脉疾病（CAD）患者风险评估的潜力。然而，对于这项任务，某些方法比其他方法提供了更大的好处，特别是在捕获变量之间的非线性以及个案可解释性方面。方法：我们纳入了连续接受临床指示的正电子发射断层扫描（PET）成像的患者。使用自动机器学习（AutoML）和未见过的数据进行性能测试，使用临床和PET变量来训练预测模型。在相同的数据上训练逻辑回归（LR）和深度前馈神经网络（DNN）进行比较。主要不良心血管事件（MACE）包括死亡、心肌梗死或冠状动脉血运重建术后90天。结果：我们纳入8357例患者（80%用于发展，20%用于检测），46.3%为女性，平均（SD）年龄为67.2（11.7）岁。心肌血流储备（MFR）中位值（IQR）为2.1（1.6 ~ 2.6）。平均随访589天，共有852例患者（10.2%）经历了MACE。对于LR和DNN模型，AutoML的AUROC分别为0.82 （95% CI 0.79至0.85）和0.79（0.76至0.82）和0.76（0.73至0.80）。模型可解释性表明，MFR是影响最大的特征，其次是总灌注缺陷、血清肌酐和舒张压。结论：综合临床和PET数据的AutoML模型比LR或DNN更准确地区分CAD的MACE风险，并提供可解释的患者层面解释，可以为个性化护理提供信息。

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引用次数: 0

Caution in interpreting positron emission tomography-negative fibrosis: Commentary on the diagnostic scope of 13N-ammonia positron emission tomography in nonischemic cardiomyopathies 谨慎解释PET阴性纤维化：13n -氨PET在非缺血性心肌病诊断范围的评论。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102300

Syed Muhammad Ali MBBS, FCPS, Brijesh Sathian PhD, Javed Iqbal RN, MHA, Khair Muhammad

引用次数: 0

The safety and associated complications of cardiac stress testing in select populations 心脏应激试验在特定人群中的安全性和相关并发症。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102298

Sean R. McMahon MD, Ina Lico DO, Etee Patel MD, Olivia Blazek MD, W. Lane Duvall MD

引用次数: 0

Global opportunities in nuclear cardiology: Perspectives on growth in the Middle East, Latin America, and Europe 核心脏病学的全球机遇：中东、拉丁美洲和欧洲的增长前景。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102297

Renee P. Bullock-Palmer MD , Firas Al Badarin MD, MSc , Roxana Campisi MD , Fabien Hyafil MD , Ahmed S. Abuzaid MD, EMHL , Matthew E. Harinstein MD, MBA

引用次数: 0

The REgistry of Flow and Perfusion Imaging for Artificial Intelligence with positron emission tomography (REFINE PET):Rationale and design 人工智能PET血流和灌注成像注册表（REFINE PET）：基本原理和设计。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102449

Giselle Ramirez BS , Mark Lemley BSc , Aakash Shanbhag MSc , Jacek Kwiecinski MD, PhD , Robert J.H. Miller MD , Paul B. Kavanagh MSc , Joanna X. Liang MPH , Damini Dey PhD , Leandro Slipczuk MD, PhD , Mark I. Travin MD , Erick Alexanderson MD , Isabel Carvajal-Juarez MD , René R.S. Packard MD, PhD , Mouaz Al-Mallah MD, MSc, MASNC , Andrew J. Einstein MD, PhD, MASNC , Attila Feher MD, PhD , Wanda Acampa MD, PhD , Stacey Knight PhD , Viet T. Le DMSc, PA-C , Steve Mason PA-C , Piotr J. Slomka PhD, MASNC

Background

The REgistry of Flow and Perfusion Imaging for Artificial Intelligence with positron emission tomography (REFINE PET) was established to collect multicenter PET and associated computed tomography (CT) images, together with clinical data and outcomes, into a comprehensive research resource. REFINE-PET will enable validation and development of both standard and novel cardiac PET/CT processing methods.

Methods

REFINE-PET is a multicenter, international registry that contains both clinical and imaging data. The PET scans were processed using QPET software (Cedars-Sinai Medical Center, Los Angeles, CA), while the CT scans were processed using deep learning (DL) to detect coronary artery calcium (CAC). Patients were followed up for the occurrence of major adverse cardiovascular events (MACE), which include death, myocardial infarction, unstable angina, and late revascularization (>90 days from PET).

Results

The REFINE-PET registry currently contains data for 35595 patients from 14 sites, with additional patient data and sites anticipated. Comprehensive clinical data (including demographics, medical history, and stress test results) were integrated with more than 2100 imaging variables across 34 categories. The registry is poised to address a broad range of clinical questions, supported by correlating invasive angiography (within 6 months of PET myocardial perfusion imaging [MPI]) in 5955 patients and a total of 9278 major adverse cardiovascular events during a median follow-up of 4.2 years.

Conclusions

The REFINE-PET registry leverages the integration of clinical, multimodality imaging, and novel quantitative and AI tools to advance the role of PET/CT MPI in diagnosis and risk stratification.

背景：建立人工智能PET血流和灌注成像注册中心（REFINE PET），收集多中心PET和相关CT图像，以及临床数据和结果，形成一个全面的研究资源。REFINE PET将使标准和新型心脏PET/CT处理方法得到验证和开发。方法：细化PET是一个多中心，国际注册，包括临床和影像学数据。PET扫描使用QPET软件（Cedars-Sinai Medical Center, Los Angeles， CA）处理，而CT扫描使用深度学习（DL）处理以检测冠状动脉钙（CAC）。随访患者主要不良心血管事件（MACE）的发生情况，包括死亡、心肌梗死、不稳定型心绞痛和晚期血运重建术（距PET 90天）。结果：REFINE PET注册表目前包含来自14个站点的35,588名患者的数据，预计还会有更多的患者数据和站点。综合临床数据（包括人口统计、病史和压力测试结果）与42个类别的2200多个影像学变量相结合。在4.2年的中位随访期间，5972名患者的侵入性血管造影（MPI后6个月内）和总共9252例主要不良心血管事件的相关性支持下，该登记处准备解决广泛的临床问题。结论：REFINE PET登记利用临床、多模态成像、新型定量和人工智能工具的整合，提高了PET/CT MPI在诊断和风险分层中的作用。

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引用次数: 0

Positron emission tomography computed tomography versus cadmium zinc telluride single-photon emission computer tomography in myocardial flow quantification: Bridging the gap or replacing a standard? 正电子发射断层扫描计算机断层扫描与镉碲化锌单光子发射计算机断层扫描心肌血流定量：弥合差距或取代标准？

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102443

Wanda Acampa MD, Valeria Cantoni PhD

引用次数: 0

Assessment of liver transplant candidates: What tests De-liver? 肝移植候选者的评估：什么检查去肝？

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102479

Robert C. Hendel MD, MASNC, MACC, FSCCT , Jason D. Stencel MD

引用次数: 0

Preclinical and first-in-human studies of a novel tracer for single-photon emission computed tomography myocardial blood flow quantification 一种用于SPECT心肌血流定量的新型示踪剂的临床前和首次人体研究。

IF 2.7 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Nuclear Cardiology

Pub Date : 2025-10-01 DOI: 10.1016/j.nuclcard.2025.102441

Yufan Gu MD , Ruoxi Sun MD , Wanjie Ren PhD , Xiaoying Xi MD , Kai Han MS , Zongyao Zhang MS , Shuang Liu PhD , Wei Fang MD , Lei Wang MD

Background

This study aimed to develop a dedicated tracer with high first-pass extraction fraction and stable heart retention for single-photon emission computed tomography (SPECT) myocardial perfusion imaging and flow measurement.

Methods

Three ^99mTc-labeled compounds (^99mTc-4BOH, ^99mTc-3BOH, and ^99mTc-2BOH) were evaluated by mouse ex vivo distribution and swine planar imaging studies. ^99mTc-4BOH was identified as a candidate and compared with ^99mTc-Teboroxime and ^99mTc-Sestamibi in swine on cadmium zinc telluride SPECT to study organ uptake and kinetic properties. Head-to-head comparisons of ^99mTc-4BOH with ^99mTc-Sestamibi and ¹³N–NH₃ were performed on two separate pilot cohorts each comprising 10 patients.

Results

The myocardial uptake of ^99mTc-4BOH demonstrated significantly higher levels than ^99mTc-Sestamibi in swine and human, evidenced by higher K₁ values (swine rest: .81 ± .03 mL/g/min vs .43 ± .09 mL/g/min, P < .001; stress: 1.19 ± .26 mL/g/min vs .50 ± .10 mL/g/min, P < .001; human rest: .74 ± .09 mL/g/min vs .38 ± .04 mL/g/min, P < .001; stress 1.42 ± .17 mL/g/min vs .59 ± .07 mL/g/min, P < .001). k₂ values of ^99mTc-4BOH were lower than those of ^99mTc-Teboroxime (rest: .18 ± .03/min vs .26 ± .01/min, P < .001; stress: .26 ± .04/min vs .38 ± .08/min, P < .01), suggesting greater stability than ^99mTc-Teboroxime in the swine. Three- to 8-min data after injection are sufficient to produce high-quality perfusion images that offer clear visualization of the myocardium and minimal interference artifacts due to favorable heart-to-liver ratios of ^99mTc-4BOH. Furthermore, K₁ values from ^99mTc-4BOH SPECT significantly correlated with ¹³N–NH₃ positron emission tomography myocardial blood flow (MBF) (ρ = .83 on per-patient level, P < .001; ρ = .81 on per-vessel level, P < .001).

Conclusions

^99mTc-4BOH exhibited an encouraging pharmacokinetic profile with high and relatively stable cardiac uptake. It constitutes a promising candidate as myocardial perfusion radiotracer for SPECT MBF quantification.

背景：本研究旨在开发一种具有高第一次提取分数和稳定心脏保留的专用示踪剂，用于SPECT心肌灌注成像和血流测量。方法：通过小鼠离体分布和猪平面成像研究，对3种99mtc标记化合物（99mTc-4BOH、99mTc-3BOH和99mTc-2BOH）进行评价。将99mTc-4BOH确定为候选药物，并在镉锌碲化SPECT上与99mtc - teboroxme和99mTc-Sestamibi进行比较，研究其在猪体内的器官摄取和动力学特性。99mTc-4BOH与99mTc-Sestamibi和13N-NH3在两个独立的试点队列中进行了正面比较，每个队列包括10名患者。结果：99mTc-4BOH在猪和人的心肌摄取水平显著高于99mTc-Sestamibi，表现为K1值较高（猪休息：0.81±0.03 mL/g/min vs. 0.43±0.09 mL/g/min）， P2值低于99mtc - teboroxme（猪休息：0.18±0.03 mL/ min vs. 0.26±0.01 /min）， p99mtc - teboroxme在猪的心肌摄取水平。注射后3-8分钟的数据足以产生高质量的灌注图像，心肌清晰可见，由于99mTc-4BOH的有利心/肝比，干扰最小。此外，99mTc-4BOH SPECT的K1值与13N-NH3 PET MBF显著相关（在每个患者水平上ρ=0.83）。结论：99mTc-4BOH表现出令人鼓舞的药代动力学特征，具有高且相对稳定的心脏摄取。它是一种很有前途的候选心肌灌注放射性示踪剂，用于SPECT MBF定量。

{"title":"Preclinical and first-in-human studies of a novel tracer for single-photon emission computed tomography myocardial blood flow quantification","authors":"Yufan Gu MD , Ruoxi Sun MD , Wanjie Ren PhD , Xiaoying Xi MD , Kai Han MS , Zongyao Zhang MS , Shuang Liu PhD , Wei Fang MD , Lei Wang MD","doi":"10.1016/j.nuclcard.2025.102441","DOIUrl":"10.1016/j.nuclcard.2025.102441","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to develop a dedicated tracer with high first-pass extraction fraction and stable heart retention for single-photon emission computed tomography (SPECT) myocardial perfusion imaging and flow measurement.</div></div><div><h3>Methods</h3><div>Three <sup>99m</sup>Tc-labeled compounds (<sup>99m</sup>Tc-4BOH, <sup>99m</sup>Tc-3BOH, and <sup>99m</sup>Tc-2BOH) were evaluated by mouse ex vivo distribution and swine planar imaging studies. <sup>99m</sup>Tc-4BOH was identified as a candidate and compared with <sup>99m</sup>Tc-Teboroxime and <sup>99m</sup>Tc-Sestamibi in swine on cadmium zinc telluride SPECT to study organ uptake and kinetic properties. Head-to-head comparisons of <sup>99m</sup>Tc-4BOH with <sup>99m</sup>Tc-Sestamibi and <sup>13</sup>N–NH<sub>3</sub> were performed on two separate pilot cohorts each comprising 10 patients.</div></div><div><h3>Results</h3><div>The myocardial uptake of <sup>99m</sup>Tc-4BOH demonstrated significantly higher levels than <sup>99m</sup>Tc-Sestamibi in swine and human, evidenced by higher <em>K</em><sub><em>1</em></sub> values (swine rest: .81 ± .03 mL/g/min vs .43 ± .09 mL/g/min, <em>P</em> < .001; stress: 1.19 ± .26 mL/g/min vs .50 ± .10 mL/g/min, <em>P</em> < .001; human rest: .74 ± .09 mL/g/min vs .38 ± .04 mL/g/min, <em>P</em> < .001; stress 1.42 ± .17 mL/g/min vs .59 ± .07 mL/g/min, <em>P</em> < .001). <em>k</em><sub><em>2</em></sub> values of <sup>99m</sup>Tc-4BOH were lower than those of <sup>99m</sup>Tc-Teboroxime (rest: .18 ± .03/min vs .26 ± .01/min, <em>P</em> < .001; stress: .26 ± .04/min vs .38 ± .08/min, <em>P</em> < .01), suggesting greater stability than <sup>99m</sup>Tc-Teboroxime in the swine. Three- to 8-min data after injection are sufficient to produce high-quality perfusion images that offer clear visualization of the myocardium and minimal interference artifacts due to favorable heart-to-liver ratios of <sup>99m</sup>Tc-4BOH. Furthermore, <em>K</em><sub><em>1</em></sub> values from <sup>99m</sup>Tc-4BOH SPECT significantly correlated with <sup>13</sup>N–NH<sub>3</sub> positron emission tomography myocardial blood flow (MBF) (ρ = .83 on per-patient level, <em>P</em> < .001; ρ = .81 on per-vessel level, <em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div><sup>99m</sup>Tc-4BOH exhibited an encouraging pharmacokinetic profile with high and relatively stable cardiac uptake. It constitutes a promising candidate as myocardial perfusion radiotracer for SPECT MBF quantification.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"52 ","pages":"Article 102441"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659461","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}

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