Myocardial perfusion scintigraphy: past, present and future

Abstract

ABSTRACT. During the last two decades, radionuclide myocardial perfusion scintigraphy (MPS) has become established as the main functional cardiac imaging technique for the assessment of ischaemic heart disease (IHD). Despite a growing number of alternative functional imaging techniques, MPS still remains the most widely used technique, with a wealth of literature supporting its usefulness in assessing IHD and predicting prognosis. The technique itself has evolved, making it more reliable and robust, with additional ventricular functional information that further defines the prognosis in these patients. With the advent of hybrid single photon emission with CT and positron emission tomography with CT cameras together with the development of new camera technology that enables faster images with less radiation and better resolution, MPS will remain an essential part of IHD investigation. There are new promising radiopharmacological developments and applications such as radiolabelled fatty acids and metaiodobenzylguanidine. These will widen the scope of nuclear medicine imaging to include patients with cardiac failure and acute chest pain presenting to accident and emergency departments. Nuclear medicine cardiac investigations will continue to have an essential role in the diagnosis, stratification and prognosis of patients with cardiac disease, complementing the new developing cardiac modalities such as CT coronary angiography and MRI.

Current and future trends in multimodality imaging of coronary artery disease

“…The combined use of SPECT and computed tomography provides a better assessment of myocardial perfusion, directly influencing clinical decision-making and prognosis [131,132].…”

The Post-Modern Era: Chronic Disease and the Onslaught of a Sedentary Lifestyle

“…Thallium-201 scintigraphy was first introduced in the late 1980s, although since the early 1990s many investigators have preferred to use technetium, because the images are of better quality and the marker has a shorter radioactive half-life. Despite increasing use of computed tomography and magnetic resonance imaging, in the year 2008 CE, 8.5 million myocardial perfusion scintigrams were performed in the U.S. alone (Vitola et al 2009;Notghi and Low 2011).…”

“…In 2003 CE, Britain recommended cardiac scintigraphy as the "gate-keeper" evaluation for angioplasty candidates (Notghi and Low 2011), although more recent guidelines have advocated an initial stratification of patients based on a scoring of coronary calcification (National Institute for Health and Clinical Excellence 2010).…”

Quantitative iodine-123-metaiodobenzylguanidine (MIBG) SPECT imaging in heart failure with left ventricular systolic dysfunction: Development and validation of automated procedures in conjunction with technetium-99m tetrofosmin myocardial perfusion SPECT

“…This approach was based upon prior studies in subjects with IHF and NIHF that demonstrated differences in regional myocardial perfusion and tissue characteristics using SPECT, PET, and magnetic resonance imaging. [20][21][22][23][24][25] …”