Novel Noninvasive Nuclear Medicine Imaging Techniques for Cardiac Inflammation

Kircher, Malte; Lapa, Constantin

doi:10.1007/s12410-017-9400-x

Cited by 38 publications

(20 citation statements)

References 135 publications

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“…As inflammation has been widely established as increasing cardiovascular disease risk [24–26], our finding at least partially explains the pathway of autonomic neuropathy for increasing such risk. More research needs to be performed to validate our result.…”

Section: Discussionmentioning

confidence: 57%

New method of sudomotor function measurement to detect microvascular disease and sweat gland nerve or unmyelinated C fiber dysfunction in adults with retinopathy

Lewis

Atlas

Rasul

et al. 2017

J Diabetes Metab Disord

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BackgroundDiabetes-associated microvascular complications such as retinopathy and neuropathy often lead to end-organ and tissue damage. Impaired skin microcirculation often precedes the detection of other advanced diabetic complications. The ANS-1 system contains a redesigned sympathetic skin response (ANS-1 SSR) device that measures sudomotor function, a photoplethysmography sensor, and a blood pressure device to comprehensively assess cardiac autonomic neuropathy and endothelial dysfunction. The purpose of this study was to determine the relationships between the ANS-1 SSR amplitude measured at the: (a) negative electrode (Nitric Oxide [NO] Sweat Peak) with microvascular diseases and associated vascular blood markers and (b) positive electrode (iSweat Peak) with C fiber function.MethodsAll participants (healthy controls n = 50 and retinopathy patients n = 50) completed the ANS-1 system evaluation and a basic sociodemographic and medical history questionnaire, including a quality of life measure (SF-36). A small sample of blood was drawn to determine levels of homocysteine, blood urea nitrogen (BUN), C-reactive protein (CRP), and fibrinogen. Symptoms of peripheral foot neuropathy were assessed with a scale from 1 (none) to 10 (the worst). We used Spearman rank correlations, independent samples t-tests, and receiver operating characteristic curves to determine the specificity and sensitivity of the NO Sweat Peak as a potential screening marker of retinopathy.ResultsThe ANS-1 System Cardiometabolic Risk Score and all indicators of quality of life on the SF-36, other than Emotional Role Functioning, were significantly worse in the retinopathy patients. The sudomotor response marker NO Sweat Peak had a sensitivity of 88% and a specificity of 68% (Area Under the Curve = 0.81, p < 0.0001) to detect retinopathy. The NO Sweat Peak response marker inversely correlated with BUN (ρ = −0.41, p < 0.0001), homocysteine (ρ = −0.44, p < 0.0001), fibrinogen (ρ = −0.41, p < 0.0001), the Cardiac Autonomic Neuropathy score (ρ = −0.68, p < 0.0001), and the heart rate variability Total Power (ρ = −0.57, p < 0.0001), and it positively correlated with the Photoplethysmography Index (PTGi; ρ = 0.53 p < 0.0001). The ANS-1 system sudomotor response marker iSweat Peak inversely correlated with the severity of symptoms on the peripheral neuropathy scale (ρ = −0.56, p < 0.0001).ConclusionThe results of the study show that this new method of measuring sympathetic skin response should be useful for detecting the earliest manifestations of microvascular disease and symptoms of C fiber dysfunction.

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Section: Discussionmentioning

confidence: 57%

New method of sudomotor function measurement to detect microvascular disease and sweat gland nerve or unmyelinated C fiber dysfunction in adults with retinopathy

Lewis

Atlas

Rasul

et al. 2017

J Diabetes Metab Disord

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“…Another possible reason for the low specificity observed in other studies is that myocardial ischemia and heart failure may also produce focally or heterogeneously increased 18 F-FDG uptake not related to sarcoidosis. 18 F-FDG PET may also visualize acute myocardial inflammation to suggest active myocarditis [ 38 ]. A meta-analysis for pulmonary lesion diagnosis reported that 18 F-FLT showed better results compared with 18 F-FDG in ruling out inflammation-based lesions [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of 18F-FLT and 18F-FDG for detecting cardiac and extra-cardiac thoracic involvement in patients with newly diagnosed sarcoidosis

et al. 2017

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Background 18F-FDG PET has been used in sarcoidosis for diagnosis and determination of the extent of the disease. However, assessing inflammatory lesions in cardiac sarcoidosis using 18F-FDG can be challenging because it accumulates physiologically in normal myocardium. Another radiotracer, 3′-deoxy-3′-18F-fluorothymidine (18F-FLT), has been investigated as a promising PET tracer for evaluating tumor proliferative activity. In contrast to 18F-FDG, 18F-FLT uptake in the normal myocardium is low. The purpose of this retrospective study was to compare the uptake of 18F-FLT and 18F-FDG in the evaluation of cardiac and extra-cardiac thoracic involvement in patients with newly diagnosed sarcoidosis.Data for 20 patients with newly diagnosed sarcoidosis were examined. 18F-FLT and 18F-FDG PET/CT studies had been performed at 1 h after each radiotracer injection. The patients had fasted for at least 18 h before 18F-FDG PET/CT but were given no special dietary instructions regarding the period before 18F-FLT PET/CT. Uptake of 18F-FLT and 18F-FDG was examined visually and semiquantitatively using maximal standardized uptake value (SUVmax).ResultsTwo patients had cardiac sarcoidosis, 7 had extra-cardiac thoracic sarcoidosis, and 11 had both cardiac and extra-cardiac thoracic sarcoidosis. On visual analysis for diagnosis of cardiac sarcoidosis, 4/20 18F-FDG scans were rated as inconclusive because the 18F-FDG pattern was diffuse, whereas no FLT scans were rated as inconclusive. The sensitivity of 18F-FDG PET/CT for detection of cardiac sarcoidosis was 85%; specificity, 100%; and accuracy, 90%. The corresponding values for 18F-FLT PET/CT were 92, 100, and 95%, respectively. Using semiquantitative analysis of cardiac sarcoidosis, the mean 18F-FDG SUVmax was significantly higher than the mean 18F-FLT SUVmax (P < 0.005). Both 18F-FDG and 18F-FLT PET/CT studies detected all 24 extra-cardiac lesions. Using semiquantitative analysis of extra-cardiac sarcoidosis, the mean 18F-FDG SUVmax was significantly higher than the mean 18F-FLT SUVmax (P < 0.001).ConclusionsThe results of this preliminary study suggest that 18F-FLT PET/CT can detect cardiac and extra-cardiac thoracic involvement in patients with newly diagnosed sarcoidosis as well as 18F-FDG PET/CT, although uptake of 18F-FLT in lesions was significantly lower than that of 18F-FDG. However, 18F-FLT PET/CT may be easier to perform since it requires neither prolonged fasting nor a special diet prior to imaging.

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“…It has proven its value in inflammatory conditions such as myocarditis, endocarditis, sarcoidosis, pericarditis, amyloidosis, and implantable electronic device infections. [ 39 ] In suspicion of endocarditis on a prosthetic valve, abnormal activity around the site of implantation detected by18F-FDG PET/CT (If prosthesis was implanted for >3 months) or radiolabeled leucocyte SPECT/CT is considered a major criterion in recent guideline. [ 40 ]…”

Section: Interpretation In the Heart And Vascular Diseasementioning

confidence: 99%

Nuclear investigative techniques and their interpretation in the heart and vascular disease

Ora

Gambhir

2020

Ann Card Anaesth

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Over the last several decades, myocardial perfusion imaging with single photon emission tomography and positron emission tomography has been a mainstay for the evaluation of patients with known or suspected coronary artery disease non-invasively. Technical advances in imaging modalities and radiopharmaceutical have revolutionaries the understanding of pathogenesis and management of various diseases. In this article, we shall discuss the various available imaging nuclear medicine techniques, radiopharmaceutical, and common indications. In the era of “precision medicine,” imaging has to be patient centered. We will briefly review the upcoming areas of nuclear medicine imaging apart from perfusion imaging, such as advances in myocardial blood flow quantitation and molecular imaging.

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Novel Noninvasive Nuclear Medicine Imaging Techniques for Cardiac Inflammation

Cited by 38 publications

References 135 publications

New method of sudomotor function measurement to detect microvascular disease and sweat gland nerve or unmyelinated C fiber dysfunction in adults with retinopathy

New method of sudomotor function measurement to detect microvascular disease and sweat gland nerve or unmyelinated C fiber dysfunction in adults with retinopathy

Comparative evaluation of 18F-FLT and 18F-FDG for detecting cardiac and extra-cardiac thoracic involvement in patients with newly diagnosed sarcoidosis

Nuclear investigative techniques and their interpretation in the heart and vascular disease

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