Objective: A working group (WG) of the Japanese Society of Nuclear Cardiology (JSNC) determined Japanese normal databases of myocardial perfusion single-photon emission computed tomography (SPECT) on semi-conductor gamma camera (D-SPECT), and the aim of this study was to validate its clinical utility. Materials and methods: The normal myocardial perfusion SPECT (MPS) databases of Japanese patients in the 201Tl stress/redistribution protocol (201Tl protocol), 99mTc stress/rest or rest/stress protocol (99mTc protocol), and rest 99mTc/stress 201Tl simultaneous acquisition dual-isotope protocol (SDI protocol) were created by JSNC WG. The WG collected clinical cases for the 201Tl protocol (male/female [m/f], 8/8), 99mTc protocol (m/f, 9/7), and SDI protocol (m/f, 10/10) from WG participating hospitals. Four WG members read those clinical cases on a 17-segment and 5-point scale (0-4). Using the most frequent values as the score for each segment, weighted κ values were calculated with the scores obtained from quantitative perfusion software (QPS). Results: Weighted κ values were as follows; 201Tl stress/female, 0.77; 201Tl rest/female, 0.74; 201Tl stress/male, 0.81; 201Tl rest/male, 0.68; 99mTc stress/female, 0.77; 99mTc rest/female, 0.62; 99mTc stress/male, 0.77; 99mTc rest/male, 0.75; SDI stress/female, 0.87; SDI rest/female, 0.82; SDI stress/male, 0.87; SDI rest/male, 0.85. Conclusions: The diagnostic accuracy of Japanese MPS normal databases on D-SPECT were comparable with nuclear cardiology expert reading and further clinical applications are expected.
{"title":"Clinical Validation of Japanese Normal Myocardial Perfusion Imaging Databases Using Semi-conductor Gamma Camera (D-SPECT): Japanese Society of Nuclear Cardiology Working Group Reports.","authors":"Naoya Matsumoto, Shonosuke Sugai, Yasuyuki Suzuki, Nobuo Iguchi, Mamoru Nanasato, Keisuke Kiso, Yasuyo Taniguchi, Tatsuya Yoneyama, Koichi Okuda, Kenichi Nakajima","doi":"10.17996/anc.22-00163","DOIUrl":"https://doi.org/10.17996/anc.22-00163","url":null,"abstract":"<p><p><i>Objective</i>: A working group (WG) of the Japanese Society of Nuclear Cardiology (JSNC) determined Japanese normal databases of myocardial perfusion single-photon emission computed tomography (SPECT) on semi-conductor gamma camera (D-SPECT), and the aim of this study was to validate its clinical utility. <i>Materials and methods</i>: The normal myocardial perfusion SPECT (MPS) databases of Japanese patients in the <sup>201</sup>Tl stress/redistribution protocol (<sup>201</sup>Tl protocol), <sup>99m</sup>Tc stress/rest or rest/stress protocol (<sup>99m</sup>Tc protocol), and rest <sup>99m</sup>Tc/stress <sup>201</sup>Tl simultaneous acquisition dual-isotope protocol (SDI protocol) were created by JSNC WG. The WG collected clinical cases for the <sup>201</sup>Tl protocol (male/female [m/f], 8/8), <sup>99m</sup>Tc protocol (m/f, 9/7), and SDI protocol (m/f, 10/10) from WG participating hospitals. Four WG members read those clinical cases on a 17-segment and 5-point scale (0-4). Using the most frequent values as the score for each segment, weighted κ values were calculated with the scores obtained from quantitative perfusion software (QPS). <i>Results</i>: Weighted κ values were as follows; <sup>201</sup>Tl stress/female, 0.77; <sup>201</sup>Tl rest/female, 0.74; <sup>201</sup>Tl stress/male, 0.81; <sup>201</sup>Tl rest/male, 0.68; <sup>99m</sup>Tc stress/female, 0.77; <sup>99m</sup>Tc rest/female, 0.62; <sup>99m</sup>Tc stress/male, 0.77; <sup>99m</sup>Tc rest/male, 0.75; SDI stress/female, 0.87; SDI rest/female, 0.82; SDI stress/male, 0.87; SDI rest/male, 0.85. <i>Conclusions</i>: The diagnostic accuracy of Japanese MPS normal databases on D-SPECT were comparable with nuclear cardiology expert reading and further clinical applications are expected.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749750/pdf/8_36.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10413127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Although 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been widely utilized to assess the extent of inflammation, the association between the extent and severity of atherosclerosis and 18F-FDG uptake on PET remains unexamined. The current study aimed to investigate whether aortic calcium (AC) scores were associated with increased aortic uptake of 18F-FDG on PET. Methods: A total of 167 consecutive patients with suspected lung cancer but unproven malignancy who underwent non-contrast-enhanced computed tomography (CT) and 18F-FDG PET/CT were enrolled. The average standardized uptake values in the ascending aorta were used to calculate the target-to-background ratio (Mean TBR). The total (thoracic and abdominal) AC scores were measured on non-contrast-enhanced chest and abdominal CT using the Agatston method, and were categorized into three groups (0, 1-399, and ≥400). The relationship between total AC scores and 18F-FDG uptake in the ascending aorta was assessed using multivariate linear regression analysis. Results: In total, 68.26% were male, and a mean age was 67.10±14.70 years. Mean TBR values increased progressively with total AC score 0, 1-399, and ≥400 (1.01±0.07, 1.08±0.09, and 1.11±0.11, respectively; p<0.00001). Multivariate linear regression analysis revealed that increased total AC scores of 1-399 (β=0.06, 95% CI: 0.01-0.11, p=0.02) and ≥400 (β=0.11, 95% CI: 0.06-0.16, p<0.001) were significantly associated with higher Mean TBR. Conclusions: The current study demonstrated that total AC scores were associated with Mean TBR. Patients with a greater extent and severity of aortic calcifications may possess increased atherosclerotic inflammatory activity as measured by 18F-FDG PET/CT.
{"title":"Relationship Between <sup>18</sup>F-fluorodeoxyglucose Uptake on Positron Emission Tomography and Aortic Calcification.","authors":"Yuriko Okamura, Rine Nakanishi, Hidenobu Hashimoto, Sunao Mizumura, Sakae Homma, Takanori Ikeda","doi":"10.17996/anc.22-00160","DOIUrl":"https://doi.org/10.17996/anc.22-00160","url":null,"abstract":"<p><p><i>Introduction</i>: Although <sup>18</sup>F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been widely utilized to assess the extent of inflammation, the association between the extent and severity of atherosclerosis and <sup>18</sup>F-FDG uptake on PET remains unexamined. The current study aimed to investigate whether aortic calcium (AC) scores were associated with increased aortic uptake of <sup>18</sup>F-FDG on PET. <i>Methods</i>: A total of 167 consecutive patients with suspected lung cancer but unproven malignancy who underwent non-contrast-enhanced computed tomography (CT) and <sup>18</sup>F-FDG PET/CT were enrolled. The average standardized uptake values in the ascending aorta were used to calculate the target-to-background ratio (Mean TBR). The total (thoracic and abdominal) AC scores were measured on non-contrast-enhanced chest and abdominal CT using the Agatston method, and were categorized into three groups (0, 1-399, and ≥400). The relationship between total AC scores and <sup>18</sup>F-FDG uptake in the ascending aorta was assessed using multivariate linear regression analysis. <i>Results</i>: In total, 68.26% were male, and a mean age was 67.10±14.70 years. Mean TBR values increased progressively with total AC score 0, 1-399, and ≥400 (1.01±0.07, 1.08±0.09, and 1.11±0.11, respectively; p<0.00001). Multivariate linear regression analysis revealed that increased total AC scores of 1-399 (<i>β</i>=0.06, 95% CI: 0.01-0.11, p=0.02) and ≥400 (<i>β</i>=0.11, 95% CI: 0.06-0.16, p<0.001) were significantly associated with higher Mean TBR. <i>Conclusions</i>: The current study demonstrated that total AC scores were associated with Mean TBR. Patients with a greater extent and severity of aortic calcifications may possess increased atherosclerotic inflammatory activity as measured by <sup>18</sup>F-FDG PET/CT.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749753/pdf/8_57.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Merrill Stewart, Sangeeta Shah, Richard Milani, Daniel Morin, Robert Bober
Background: Resting myocardial blood flow (rMBF) within regions of myocardial scar as measured by positron emission tomography (PET) has not yet been assessed with the radiotracer Rubidium82 (Rb82) or correlated with scar thickness. Cardiac magnetic resonance imaging (cMRI) offers high spatial resolution and identifies myocardial scar with late gadolinium enhancement (LGE). Using Rb82 PET, we sought to characterize rMBF in regions of myocardial scar of varying thicknesses determined by cMRI. Methods/Results: Patients with a history of myocardial infarction, a resting Rb82 PET study and a cMRI were identified. On cMRI, regions of infarction, defined as >50% LGE with akinesis, were sub-categorized as 50-75% LGE or >75% LGE, corresponding with increasing transmural scar thickness. PET zones of infarct based on size and %LGE by cMRI were quantified for mean and minimum rMBF. Mean rMBF (cc/min/g) in infarct zones with >75% LGE was 0.32±0.07 with a minimum rMBF of 0.19±0.03. In infarct zones with 50-75% LGE, rMBF was 0.45±0.14 (50-75% vs. >75%, p=0.002). Conclusions: We identified rMBF within cMRI confirmed regions of myocardial scar of varying thicknesses. rMBF has an inverse relationship with the extent of LGE on cMRI, with the most severe regions (>75% LGE) having mean and minimal rMBF (cc/min/g) of 0.32±0.07 and 0.19±0.03, respectively.
{"title":"Quantification of Resting Myocardial Blood Flow Using Rubidum<sup>82</sup> Positron Emission Tomography in Regions with MRI-Confirmed Myocardial Scar.","authors":"Merrill Stewart, Sangeeta Shah, Richard Milani, Daniel Morin, Robert Bober","doi":"10.17996/anc.21-00137","DOIUrl":"https://doi.org/10.17996/anc.21-00137","url":null,"abstract":"<p><p><i>Background</i>: Resting myocardial blood flow (rMBF) within regions of myocardial scar as measured by positron emission tomography (PET) has not yet been assessed with the radiotracer Rubidium<sup>82</sup> (Rb<sup>82</sup>) or correlated with scar thickness. Cardiac magnetic resonance imaging (cMRI) offers high spatial resolution and identifies myocardial scar with late gadolinium enhancement (LGE). Using Rb<sup>82</sup> PET, we sought to characterize rMBF in regions of myocardial scar of varying thicknesses determined by cMRI. <i>Methods/Results</i>: Patients with a history of myocardial infarction, a resting Rb<sup>82</sup> PET study and a cMRI were identified. On cMRI, regions of infarction, defined as >50% LGE with akinesis, were sub-categorized as 50-75% LGE or >75% LGE, corresponding with increasing transmural scar thickness. PET zones of infarct based on size and %LGE by cMRI were quantified for mean and minimum rMBF. Mean rMBF (cc/min/g) in infarct zones with >75% LGE was 0.32±0.07 with a minimum rMBF of 0.19±0.03. In infarct zones with 50-75% LGE, rMBF was 0.45±0.14 (50-75% vs. >75%, p=0.002). <i>Conclusions</i>: We identified rMBF within cMRI confirmed regions of myocardial scar of varying thicknesses. rMBF has an inverse relationship with the extent of LGE on cMRI, with the most severe regions (>75% LGE) having mean and minimal rMBF (cc/min/g) of 0.32±0.07 and 0.19±0.03, respectively.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754780/pdf/8_7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10413122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Smoothing in 99mTc myocardial perfusion single-photon emission computed tomography (SPECT) often increases myocardial artifacts due to subdiaphragmatic activity near the heart. To reduce these artifacts, we developed a new process flow, masking on unsmoothed images (MUS), that includes the extraction of the myocardium by masking before smoothing. Methods: This study evaluated the relationships between matrix sizes and distances to the subdiaphragmatic activity using the MUS method compared to conventional methods using a combination of image reconstruction methods (filtered back-projection [FBP] and ordered subset expectation maximization [OSEM]) with or without corrections (attenuation [AC], scatter [SC], and resolution recovery [RR]) using a myocardial phantom. The results were compared for two matrix sizes (pixel sizes) (128×128 [3.3 mm] and 64×64 [6.6 mm]); four subdiaphragmatic activity distances (5, 10, 15, and 20 mm); and three reconstruction methods (FBP without correction; OSEM with RR; and OSEM with AC, SC, and RR). Results: In the conventional method, increasing distance resulted in interference with myocardial perfusion SPECT evaluation however, the artifacts were less apparent when the MUS method was applied. The images converted to 64×64 did not show the same effect as the 128×128 images, even when RR was used. The MUS method was useful for acquisition at 128×128, along with the use of RR in the reconstruction process. Conclusion: MUS mitigated the effects of subdiaphragmatic activity on myocardial perfusion SPECT, particularly combined with 128×128 acquisitions and iterative reconstruction with RR.
{"title":"A Novel Method to Suppress the Effect of Subdiaphragmatic Activity in <sup>99m</sup>Tc Myocardial Perfusion SPECT and Evaluation of Its Usefulness Using a Myocardial Phantom.","authors":"Atsushi Komuro, Satomi Teraoka, Yasushi Ishikawa, Masanori Tsuboko, Mika Tanno, Kouichi Ishimori, Kazuo Funaki, Jiro Izumida, Tomiyoshi Saito","doi":"10.17996/anc.22-00154","DOIUrl":"https://doi.org/10.17996/anc.22-00154","url":null,"abstract":"<p><p><i>Background</i>: Smoothing in <sup>99m</sup>Tc myocardial perfusion single-photon emission computed tomography (SPECT) often increases myocardial artifacts due to subdiaphragmatic activity near the heart. To reduce these artifacts, we developed a new process flow, masking on unsmoothed images (MUS), that includes the extraction of the myocardium by masking before smoothing. <i>Methods</i>: This study evaluated the relationships between matrix sizes and distances to the subdiaphragmatic activity using the MUS method compared to conventional methods using a combination of image reconstruction methods (filtered back-projection [FBP] and ordered subset expectation maximization [OSEM]) with or without corrections (attenuation [AC], scatter [SC], and resolution recovery [RR]) using a myocardial phantom. The results were compared for two matrix sizes (pixel sizes) (128×128 [3.3 mm] and 64×64 [6.6 mm]); four subdiaphragmatic activity distances (5, 10, 15, and 20 mm); and three reconstruction methods (FBP without correction; OSEM with RR; and OSEM with AC, SC, and RR). <i>Results</i>: In the conventional method, increasing distance resulted in interference with myocardial perfusion SPECT evaluation however, the artifacts were less apparent when the MUS method was applied. The images converted to 64×64 did not show the same effect as the 128×128 images, even when RR was used. The MUS method was useful for acquisition at 128×128, along with the use of RR in the reconstruction process. <i>Conclusion</i>: MUS mitigated the effects of subdiaphragmatic activity on myocardial perfusion SPECT, particularly combined with 128×128 acquisitions and iterative reconstruction with RR.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749759/pdf/8_30.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10413124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Gateway to a Bright Future","authors":"N. Iguchi","doi":"10.17996/anc.22-002","DOIUrl":"https://doi.org/10.17996/anc.22-002","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77227464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gated myocardial perfusion single-photon emission computed tomography (SPECT) has been used to non-invasively evaluate the left ventricular (LV) volume and function. This study aimed to measure the normal and range values for heart risk view-function (HRV-F) software using the Japanese Society of Nuclear Medicine Working Group (JSNM-WG) normal database and clarify the characteristics of the normal database. Methods:We used 206 myocardial perfusion short-axis images from the normal database. Ejection fraction (EF), end-systolic volume (ESV), end-diastolic volume (EDV), peak filling rate (PFR), 1/3 mean filling rate (MFR), time to PFR (TTPF), and TTPF divided by RR interval (TPFR/RR) were calculated. Phase parameters of 95% histogram bandwidth and standard deviation were also computed using the phase analysis. The relationships among phase parameters, LV volumes, and body surface area (BSA) were evaluated in the age group of ≤65 years. Results: Higher EF was observed in females than in males (p<0.0001). EDV and ESV were significantly higher in males than in females (p<0.0001). Additionally, PFR and 1/3 MFR significantly differed between sexes (p≤0.075). Phase parameters were higher in males than in females, and higher at stress than at rest. All diastolic parameters showed no significant differences between sexes in any age group, whereas differences have remained in phase values. Phase parameters were weakly correlated with EDV (r=0.31), ESV (r=0.43), and BSA (r=0.27), respectively. Conclusions: Mean normal and range values of the normal database were determined using the HRV-F software. The normal and range values can help diagnose gated SPECT data in patients with cardiac diseases.
{"title":"Normal and Range Value Evaluations Using Heart Risk View-Function Based on the Japanese Societyof Nuclear Medicine Working Group Database.","authors":"Kosuke Tatsuno, Koichi Okuda, Kenichi Nakajima, Hisahiro Saito, Takayuki Shibutani, Masahisa Onoguchi, Tomoko Takahashi, Takafumi Mochizuki, Naoto Watanabe, Munetaka Matoba","doi":"10.17996/anc.22-00156","DOIUrl":"https://doi.org/10.17996/anc.22-00156","url":null,"abstract":"<p><p><i>Background</i>: Gated myocardial perfusion single-photon emission computed tomography (SPECT) has been used to non-invasively evaluate the left ventricular (LV) volume and function. This study aimed to measure the normal and range values for heart risk view-function (HRV-F) software using the Japanese Society of Nuclear Medicine Working Group (JSNM-WG) normal database and clarify the characteristics of the normal database. <i>Methods</i>:We used 206 myocardial perfusion short-axis images from the normal database. Ejection fraction (EF), end-systolic volume (ESV), end-diastolic volume (EDV), peak filling rate (PFR), 1/3 mean filling rate (MFR), time to PFR (TTPF), and TTPF divided by RR interval (TPFR/RR) were calculated. Phase parameters of 95% histogram bandwidth and standard deviation were also computed using the phase analysis. The relationships among phase parameters, LV volumes, and body surface area (BSA) were evaluated in the age group of ≤65 years. <i>Results</i>: Higher EF was observed in females than in males (<i>p</i><0.0001). EDV and ESV were significantly higher in males than in females (<i>p</i><0.0001). Additionally, PFR and 1/3 MFR significantly differed between sexes (<i>p</i>≤0.075). Phase parameters were higher in males than in females, and higher at stress than at rest. All diastolic parameters showed no significant differences between sexes in any age group, whereas differences have remained in phase values. Phase parameters were weakly correlated with EDV (<i>r</i>=0.31), ESV (<i>r</i>=0.43), and BSA (<i>r</i>=0.27), respectively. <i>Conclusions</i>: Mean normal and range values of the normal database were determined using the HRV-F software. The normal and range values can help diagnose gated SPECT data in patients with cardiac diseases.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749745/pdf/8_51.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiroshi Ohira, Robert deKemp, Yoshito Kadoya, Jennifer Renaud, Duncan J Stewart, Ross A Davies, George Chandy, Vladimir Contreras-Dominguez, Carolyn Pugliese, Rosemary Dunne, Rob Beanlands, Lisa Mielniczuk
Aim: Previous studies have demonstrated increased glucose uptake by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in lung parenchyma in animal models or small pulmonary arterial hypertension (PAH) cohorts. However, it is not well known whether increased FDG uptake in the lung is a unique phenomenon in PAH or whether elevated pulmonary artery pressure (PAP) induces FDG uptake. Methods and results: Nineteen patients with PAH, 8 patients with pulmonary hypertension due to left heart disease (PH-LHD), and 14 age matched control subjects were included. All PH patients underwent right heart catheterization and FDG-PET. The mean standard uptake value (SUV g/mL) of FDG in each lung was obtained and average values of both lungs were calculated as mean lung FDG SUV. The correlation between hemodynamics and mean lung FDG SUV was also analyzed in PH patients. Mean PAP (mPAP) was not significantly different between PAH and PH-LHD (45±11 vs 43±5 mmHg, p=0.51). PAH patients demonstrated significantly increased mean lung FDG SUV compared with PH-LHD and controls (PAH: 0.76±0.26 vs PH-LHD: 0.51±0.12 vs controls: 0.53±0.16, p=0.0025). The mean lung FDG SUV did not correlate with mPAP either in PAH or PH-LHD. Conclusion: PAH is associated with increased lung FDG uptake indicating increased glucose utilization in the lung. This may represent metabolic shift to glycolysis and/or active inflammation in the remodeled pulmonary vasculature, and is observed to a greater extent in PAH than in patients with PH secondary to LHD and control subjects without PH.
目的:先前的研究表明,在动物模型或小肺动脉高压(PAH)队列中,18f -氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)在肺组织中增加了葡萄糖摄取。然而,目前尚不清楚肺中FDG摄取增加是否是PAH的独特现象,或者肺动脉压升高是否会诱导FDG摄取。方法与结果:纳入19例PAH患者,8例左心肺动脉高压(PH-LHD)患者,14例年龄匹配的对照组。所有PH患者均行右心导管和FDG-PET检查。计算各肺中FDG的平均标准摄取值(SUV g/mL),并计算两肺的平均值作为平均肺FDG SUV。还分析了PH患者血流动力学与肺平均FDG SUV的相关性。平均PAP (mPAP)在PAH和PH-LHD之间无显著差异(45±11 vs 43±5 mmHg, p=0.51)。与PH-LHD和对照组相比,PAH患者的平均肺FDG SUV显著增加(PAH: 0.76±0.26 vs PH-LHD: 0.51±0.12 vs对照组:0.53±0.16,p=0.0025)。PAH和PH-LHD患者肺平均FDG SUV与mPAP均无相关性。结论:多环芳烃与肺部FDG摄取增加有关,表明肺部葡萄糖利用增加。这可能代表代谢转变为糖酵解和/或重塑肺血管的活动性炎症,并且在PAH中观察到的程度大于继发于LHD的PH患者和没有PH的对照组。
{"title":"Evaluation of Lung Glucose Uptake with Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Pulmonary Arterial Hypertension and Pulmonary Hypertension Due to Left Heart Disease.","authors":"Hiroshi Ohira, Robert deKemp, Yoshito Kadoya, Jennifer Renaud, Duncan J Stewart, Ross A Davies, George Chandy, Vladimir Contreras-Dominguez, Carolyn Pugliese, Rosemary Dunne, Rob Beanlands, Lisa Mielniczuk","doi":"10.17996/anc.22-00151","DOIUrl":"https://doi.org/10.17996/anc.22-00151","url":null,"abstract":"<p><p><i>Aim</i>: Previous studies have demonstrated increased glucose uptake by <sup>18</sup>F-fluorodeoxyglucose positron emission tomography (FDG-PET) in lung parenchyma in animal models or small pulmonary arterial hypertension (PAH) cohorts. However, it is not well known whether increased FDG uptake in the lung is a unique phenomenon in PAH or whether elevated pulmonary artery pressure (PAP) induces FDG uptake. <i>Methods and results</i>: Nineteen patients with PAH, 8 patients with pulmonary hypertension due to left heart disease (PH-LHD), and 14 age matched control subjects were included. All PH patients underwent right heart catheterization and FDG-PET. The mean standard uptake value (SUV g/mL) of FDG in each lung was obtained and average values of both lungs were calculated as mean lung FDG SUV. The correlation between hemodynamics and mean lung FDG SUV was also analyzed in PH patients. Mean PAP (mPAP) was not significantly different between PAH and PH-LHD (45±11 vs 43±5 mmHg, p=0.51). PAH patients demonstrated significantly increased mean lung FDG SUV compared with PH-LHD and controls (PAH: 0.76±0.26 vs PH-LHD: 0.51±0.12 vs controls: 0.53±0.16, p=0.0025). The mean lung FDG SUV did not correlate with mPAP either in PAH or PH-LHD. <i>Conclusion</i>: PAH is associated with increased lung FDG uptake indicating increased glucose utilization in the lung. This may represent metabolic shift to glycolysis and/or active inflammation in the remodeled pulmonary vasculature, and is observed to a greater extent in PAH than in patients with PH secondary to LHD and control subjects without PH.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749761/pdf/8_21.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial has had a great impact on the management of chronic coronary artery disease (CAD). One of the implications of this trial is the importance of close patient follow-up. To improve patient prognosis, evaluation of the residual extent of ischemia after treatment may be important because several studies have shown a close relationship between residual ischemia and cardiac events. For this assessment, myocardial perfusion single-photon emission computed tomography (MPS) has been utilized and is almost the only modality. Among the participants in the ISCHEMIA trial, more than 10% were excluded due to the absence of obstructive CAD. The pathophysiology of ischemia without non-obstructive coronary artery disease (INOCA) is gaining recognition; however, diagnosis is difficult, except for the assessment of myocardial flow reserve (MFR). Myocardial perfusion positron emission tomography (PET) is the most common modality for noninvasive evaluation of MFR; however, its availability in Japan is limited. For a breakthrough in this situation, a novel gamma camera with a cadmium zinc telluride (CZT) semiconductor might be one of the solutions that enables the evaluation of MFR with a commercially available perfusion tracer, similar to PET. Another solution is a novel PET tracer with a longer half-life. Clinical trials with 18F labeled perfusion agents have been initiated in Japan, and in a few years, delivery of this perfusion tracer will result in more frequent and easier assessment of MFR.
{"title":"Post-ISCHEMIA Trial Era: Reconsideration of the Role of Nuclear Cardiology in Patients with Chronic Coronary Artery Disease.","authors":"Keisuke Kiso, Atsuro Masuda, Kentaro Takanami, Tomohiro Kaneta, Kei Takase","doi":"10.17996/anc.22-00168","DOIUrl":"https://doi.org/10.17996/anc.22-00168","url":null,"abstract":"<p><p>The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial has had a great impact on the management of chronic coronary artery disease (CAD). One of the implications of this trial is the importance of close patient follow-up. To improve patient prognosis, evaluation of the residual extent of ischemia after treatment may be important because several studies have shown a close relationship between residual ischemia and cardiac events. For this assessment, myocardial perfusion single-photon emission computed tomography (MPS) has been utilized and is almost the only modality. Among the participants in the ISCHEMIA trial, more than 10% were excluded due to the absence of obstructive CAD. The pathophysiology of ischemia without non-obstructive coronary artery disease (INOCA) is gaining recognition; however, diagnosis is difficult, except for the assessment of myocardial flow reserve (MFR). Myocardial perfusion positron emission tomography (PET) is the most common modality for noninvasive evaluation of MFR; however, its availability in Japan is limited. For a breakthrough in this situation, a novel gamma camera with a cadmium zinc telluride (CZT) semiconductor might be one of the solutions that enables the evaluation of MFR with a commercially available perfusion tracer, similar to PET. Another solution is a novel PET tracer with a longer half-life. Clinical trials with <sup>18</sup>F labeled perfusion agents have been initiated in Japan, and in a few years, delivery of this perfusion tracer will result in more frequent and easier assessment of MFR.</p>","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9749748/pdf/8_86.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10419005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Highlights of the 32nd JSNC Annual Scientific Meeting in Tokyo","authors":"T. Chikamori","doi":"10.17996/anc.22-003","DOIUrl":"https://doi.org/10.17996/anc.22-003","url":null,"abstract":"","PeriodicalId":72228,"journal":{"name":"Annals of nuclear cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91002029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}