Pub Date : 2025-11-20DOI: 10.1016/j.nuclcard.2025.102564
Roberta Assante, Emilia Zampella, Adriana D'Antonio, Teresa Mannarino, Mariarosaria Panico, Valeria Cantoni, Roberta Green, Pietro Buongiorno, Alberto Cuocolo, Wanda Acampa
{"title":"Improved risk stratification with noninvasive measures of myocardial flow reserve by low-dose dynamic imaging by cadmium-zinc-telluride-single photon emission computerized tomography in patients with suspected or known coronary artery disease.","authors":"Roberta Assante, Emilia Zampella, Adriana D'Antonio, Teresa Mannarino, Mariarosaria Panico, Valeria Cantoni, Roberta Green, Pietro Buongiorno, Alberto Cuocolo, Wanda Acampa","doi":"10.1016/j.nuclcard.2025.102564","DOIUrl":"10.1016/j.nuclcard.2025.102564","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":" ","pages":"102564"},"PeriodicalIF":2.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582261","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102509
Friederike K. Keating MD, FACC, FASNC
{"title":"Plaque, stenosis, and ischemia: A complex relationship","authors":"Friederike K. Keating MD, FACC, FASNC","doi":"10.1016/j.nuclcard.2025.102509","DOIUrl":"10.1016/j.nuclcard.2025.102509","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102509"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532678","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102476
Stephan G. Nekolla PhD FESC , Susan Notohamiprodjo MD
{"title":"On the complexity of myocardial blood flow quantification: A never-ending story?","authors":"Stephan G. Nekolla PhD FESC , Susan Notohamiprodjo MD","doi":"10.1016/j.nuclcard.2025.102476","DOIUrl":"10.1016/j.nuclcard.2025.102476","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102476"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355058","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102473
René R. Sevag Packard MD, PhD , Jamshid Maddahi MD , Matthieu Pelletier-Galarneau MD , Mouaz H. Al-Mallah MD, MSc , Marta Coelho , Sharmila Dorbala MD, MPH , James Galt PhD , Mark Hyun CNMT, NCT, RS, RT (N,R,CT) , Nandakumar Menon MD , Edward J. Miller MD, PhD , Mrinali Shetty MD , Antti Saraste MD, PhD
The Society of Nuclear Medicine and Molecular Imaging (SNMMI), founded in 1954 and headquartered in Reston, Virginia, USA, is a nonprofit scientific and professional organization that promotes the science, technology, and practical application of nuclear medicine and molecular imaging. SNMMI strives to be a leader in unifying, advancing, and optimizing molecular imaging with the ultimate goal of improving human health. With 13,000 members worldwide, SNMMI represents nuclear and molecular imaging professionals, all of whom are committed to the advancement of the field. The European Association of Nuclear Medicine (EANM) is a professional, nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The American College of Nuclear Medicine (ACNM) is a professional organization providing education, training, and advocacy for the most sought-after and trusted experts in nuclear medicine who deliver state-of-the-art and innovative care and service to patients and referring physicians. The ACNM's mission is to foster the highest standards in nuclear medicine consultation and service to referring physicians, hospitals, and the public, and to advance the science of nuclear medicine through a program of continuing professional development emphasizing high standards of nuclear medicine practice. The American Society of Nuclear Cardiology (ASNC) is the international home for nuclear cardiology and the largest professional society devoted exclusively to the field. ASNC membership includes more than 5700 nuclear cardiology professionals from around the world. Founded in 1993, ASNC's mission is to improve cardiovascular outcomes through image-guided patient management. ASNC's official publication is the Journal of Nuclear Cardiology.
The SNMMI/EANM/ACNM will periodically define new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.
Each standard/guideline, representing a policy statement by the SNMMI/EANM/ACNM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, EANM, and ACNM recognize that the safe and effective use of diagnostic nuclear medicine imaging and therapy requires specific training, skills, and techniques, as described in each document. This document was jointly developed with ASNC. ASNC endorses this guideline, and it will be published alongside the Journal of Nuclear Medicine in the Journal of Nuclear Cardiology.
The SNMMI, EANM, ASNC, and ACNM have written and approved these standards/guidelines to promote the use of high-quality nuclear medicine procedures. These standards/guide
{"title":"SNMMI/EANM/ASNC/ACNM procedure standard/practice guideline for 18F-Flurpiridaz PET myocardial perfusion imaging and blood flow quantitation","authors":"René R. Sevag Packard MD, PhD , Jamshid Maddahi MD , Matthieu Pelletier-Galarneau MD , Mouaz H. Al-Mallah MD, MSc , Marta Coelho , Sharmila Dorbala MD, MPH , James Galt PhD , Mark Hyun CNMT, NCT, RS, RT (N,R,CT) , Nandakumar Menon MD , Edward J. Miller MD, PhD , Mrinali Shetty MD , Antti Saraste MD, PhD","doi":"10.1016/j.nuclcard.2025.102473","DOIUrl":"10.1016/j.nuclcard.2025.102473","url":null,"abstract":"<div><div>The Society of Nuclear Medicine and Molecular Imaging (SNMMI), founded in 1954 and headquartered in Reston, Virginia, USA, is a nonprofit scientific and professional organization that promotes the science, technology, and practical application of nuclear medicine and molecular imaging. SNMMI strives to be a leader in unifying, advancing, and optimizing molecular imaging with the ultimate goal of improving human health. With 13,000 members worldwide, SNMMI represents nuclear and molecular imaging professionals, all of whom are committed to the advancement of the field. The European Association of Nuclear Medicine (EANM) is a professional, nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The American College of Nuclear Medicine (ACNM) is a professional organization providing education, training, and advocacy for the most sought-after and trusted experts in nuclear medicine who deliver state-of-the-art and innovative care and service to patients and referring physicians. The ACNM's mission is to foster the highest standards in nuclear medicine consultation and service to referring physicians, hospitals, and the public, and to advance the science of nuclear medicine through a program of continuing professional development emphasizing high standards of nuclear medicine practice. The American Society of Nuclear Cardiology (ASNC) is the international home for nuclear cardiology and the largest professional society devoted exclusively to the field. ASNC membership includes more than 5700 nuclear cardiology professionals from around the world. Founded in 1993, ASNC's mission is to improve cardiovascular outcomes through image-guided patient management. ASNC's official publication is the Journal of Nuclear Cardiology.</div><div>The SNMMI/EANM/ACNM will periodically define new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.</div><div>Each standard/guideline, representing a policy statement by the SNMMI/EANM/ACNM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, EANM, and ACNM recognize that the safe and effective use of diagnostic nuclear medicine imaging and therapy requires specific training, skills, and techniques, as described in each document. This document was jointly developed with ASNC. ASNC endorses this guideline, and it will be published alongside the <em>Journal of Nuclear Medicine</em> in the <em>Journal of Nuclear Cardiology</em>.</div><div>The SNMMI, EANM, ASNC, and ACNM have written and approved these standards/guidelines to promote the use of high-quality nuclear medicine procedures. These standards/guide","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102473"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292466","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102561
Marcelo F. Di Carli MD, MASNC
{"title":"Ending the Either–Or debate: Hybrid imaging and AI redefine CAD evaluation","authors":"Marcelo F. Di Carli MD, MASNC","doi":"10.1016/j.nuclcard.2025.102561","DOIUrl":"10.1016/j.nuclcard.2025.102561","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102561"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532599","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102503
Firas Al Badarin MD, MSc , Rupa Sanghani MD
{"title":"Artificial intelligence–derived calcium score as a gate keeper for stress-only imaging: Glimmers of genius, not quite gold","authors":"Firas Al Badarin MD, MSc , Rupa Sanghani MD","doi":"10.1016/j.nuclcard.2025.102503","DOIUrl":"10.1016/j.nuclcard.2025.102503","url":null,"abstract":"","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102503"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532598","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}
Pub Date : 2025-11-01DOI: 10.1016/j.nuclcard.2025.102470
Tanja Kero MD, PhD , Juhani Knuuti MD, PhD , Sarah Bär MD, PhD , Jeroen J. Bax MD, PhD , Antti Saraste MD, PhD, FESC , Teemu Maaniitty MD, PhD
Background
It is unclear whether coronary artery stenosis, plaque burden, and composition differ between major epicardial arteries supplying ischemic myocardial territories.
Methods
We studied 837 symptomatic patients undergoing coronary computed tomography angiography (CTA) and 15O-water positron emission tomography (PET) myocardial perfusion imaging for suspected obstructive coronary artery disease. Coronary CTA was analyzed using artificial intelligence-guided quantitative computed tomography (AI-QCT) to assess stenosis and atherosclerotic plaque characteristics. Myocardial ischemia was defined by regional PET perfusion in the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) territories.
Results
Among arteries supplying ischemic territories, the LAD exhibited significantly higher stenosis and both absolute and normalized plaque volumes compared to LCX and RCA (P < .001 for all). Multivariable logistic regression showed diameter stenosis (P = .001-.015), percent atheroma volume (PAV; P < .001), and percent noncalcified plaque volume (NCPV) (P = .001-.017) were associated with ischemia across all three arteries. Percent calcified plaque volume (CPV) was associated with ischemia only in the RCA (P = .001).
Conclusions
The degree of stenosis and atherosclerotic burden are significantly higher in the LAD as compared to LCX and RCA, both in epicardial coronary arteries supplying nonischemic or ischemic myocardial territories. In all the three main coronary arteries, both luminal narrowing and plaque burden are independent predictors of ischemia, where the plaque burden is mainly driven by noncalcified plaque. However, many vessels supplying ischemic territories have a relatively low degree of stenosis and plaque burden, especially in the LCX and RCA, limiting the ability of diameter stenosis and PAV to predict myocardial ischemia.
{"title":"Stenosis degree and plaque burden differ between the major epicardial coronary arteries supplying ischemic territories","authors":"Tanja Kero MD, PhD , Juhani Knuuti MD, PhD , Sarah Bär MD, PhD , Jeroen J. Bax MD, PhD , Antti Saraste MD, PhD, FESC , Teemu Maaniitty MD, PhD","doi":"10.1016/j.nuclcard.2025.102470","DOIUrl":"10.1016/j.nuclcard.2025.102470","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear whether coronary artery stenosis, plaque burden, and composition differ between major epicardial arteries supplying ischemic myocardial territories.</div></div><div><h3>Methods</h3><div>We studied 837 symptomatic patients undergoing coronary computed tomography angiography (CTA) and <sup>15</sup>O-water positron emission tomography (PET) myocardial perfusion imaging for suspected obstructive coronary artery disease. Coronary CTA was analyzed using artificial intelligence-guided quantitative computed tomography (AI-QCT) to assess stenosis and atherosclerotic plaque characteristics. Myocardial ischemia was defined by regional PET perfusion in the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA) territories.</div></div><div><h3>Results</h3><div>Among arteries supplying ischemic territories, the LAD exhibited significantly higher stenosis and both absolute and normalized plaque volumes compared to LCX and RCA (<em>P</em> < .001 for all). Multivariable logistic regression showed diameter stenosis (<em>P</em> = .001-.015), percent atheroma volume (PAV; <em>P</em> < .001), and percent noncalcified plaque volume (NCPV) (<em>P</em> = .001-.017) were associated with ischemia across all three arteries. Percent calcified plaque volume (CPV) was associated with ischemia only in the RCA (<em>P</em> = .001).</div></div><div><h3>Conclusions</h3><div>The degree of stenosis and atherosclerotic burden are significantly higher in the LAD as compared to LCX and RCA, both in epicardial coronary arteries supplying nonischemic or ischemic myocardial territories. In all the three main coronary arteries, both luminal narrowing and plaque burden are independent predictors of ischemia, where the plaque burden is mainly driven by noncalcified plaque. However, many vessels supplying ischemic territories have a relatively low degree of stenosis and plaque burden, especially in the LCX and RCA, limiting the ability of diameter stenosis and PAV to predict myocardial ischemia.</div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102470"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821612","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}
Myocardial perfusion imaging is susceptible to imaging artifacts that may limit its clinical utility. One approach to differentiate true perfusion defects from artifacts involves examining the presence of perfusion abnormalities that align with the typical anatomy of coronary vessels. However, this approach may not be applicable in patients having coronary anomalies. We report a patient with dual LAD exhibiting isolated ischemia of the anteroseptal wall on MPI, resembling artifact typically observed in patients with LBBB. The present case highlights the importance of familiarity with variations in coronary anatomy, like dual LAD, to avoid misinterpretation of atypical perfusion defects observed in MPI.
{"title":"Coronary anatomy matters: Dual LAD presenting as atypical ischemia on myocardial perfusion imaging","authors":"Raza Abbas Mahdi MD , Harpreet Singh MD , Janarthanan Ilangovan MBBS , Neelam Dahiya DM , Bhagwant Rai Mittal MD","doi":"10.1016/j.nuclcard.2025.102205","DOIUrl":"10.1016/j.nuclcard.2025.102205","url":null,"abstract":"<div><div><span><span><span>Myocardial perfusion imaging<span> is susceptible to imaging artifacts that may limit its clinical utility. One approach to differentiate true perfusion defects from artifacts involves examining the presence of perfusion abnormalities that align with the typical anatomy of </span></span>coronary vessels. However, this approach may not be applicable in patients having </span>coronary anomalies. We report a patient with dual LAD exhibiting isolated </span>ischemia<span> of the anteroseptal wall on MPI, resembling artifact typically observed in patients with LBBB. The present case highlights the importance of familiarity with variations in coronary anatomy, like dual LAD, to avoid misinterpretation of atypical perfusion defects observed in MPI.</span></div></div>","PeriodicalId":16476,"journal":{"name":"Journal of Nuclear Cardiology","volume":"53 ","pages":"Article 102205"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811560","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}