SPECT and PET in ischemic heart failure

Angelidis, George; Giamouzis, Grigorios; Karagiannis, Georgios; Butler, Javed; Tsougos, Ioannis; Valotassiou, Varvara; Giannakoulas, George; Dimakopoulos, Nikolaos; Xanthopoulos, Andrew; Skoularigis, John; Triposkiadis, Filippos; Georgoulias, Panagiotis

doi:10.1007/s10741-017-9594-7

Cited by 25 publications

(18 citation statements)

References 145 publications

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“…The most widespread technique for CAD detection is single-photon emission computed tomography (SPECT), which is a non-invasive nuclear imaging test that uses radioactive traces injected into the blood stream. The test measures ventricular function, myocardial perfusion, viability, and intraventricular synchronism in patients with suspected CAD 11 . However, radiation exposure , attenuation artifact, and poor spatial resolution have limited the clinical utility of SPECT [12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Cost-impact of cardiac magnetic resonance imaging with Fast-SENC compared to SPECT in the diagnosis of coronary artery disease in the U.S

Stojanović

Schneider

Cooper

2019

Journal of Medical Economics

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Aims: The purpose of this study is to assess the economic cost differences and the associated treatment resource changes between the developing coronary artery disease (CAD) diagnostic tool fast strain-encoded cardiac imaging (Fast-SENC) and the current commonly used stress test single-photon emission computed tomography (SPECT). Materials and methods: A "payer perspective" model was created first, consisting of long-term and short-term components that used a hypothetical cohort of patients of average age (60.8 years) presenting with chest pain and suspected CAD to assess cost-impact. A cost impact model was then built that assessed likely savings from a "hospital perspective" from substituting Fast-SENC for a portion of SPECTs assuming an average number of annual SPECT tests performed in US hospitals. Results: In the payer model, using Fast-SENC followed by coronary angiography (CA) and percutaneous coronary intervention (PCI) treatment when necessary is less costly than the SPECT method when considering both direct and indirect costs of testing. Expected costs of the Fast-SENC were between $2,510 and $2,632 per correct diagnosis, while expected costs for the SPECT were between $3,157 and $4,078. Fast-SENC reduced false positives by 50% and false negatives by 86%, generating additional cost savings. The hospital model showed total costs per CAD patient visit of $825 for SPECT and $376 for Fast-SENC. Limitations: Limitations of this study are that clinical data are sourced from other published clinical trials on how CAD diagnostic strategies impact clinical outcome, and that necessary assumptions were made which impact health outcomes. Conclusion: The lower cost, higher sensitivity and specificity rates, and faster, less burdensome process for detecting CAD patients make Fast-SENC a more capable and economically beneficial stress test than SPECT. The payer model and hospital model demonstrate an alignment between payer and provider economics as Fast-SENC provides monetary savings for patients and resource benefits for hospitals. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Cost-impact of cardiac magnetic resonance imaging with Fast-SENC compared to SPECT in the diagnosis of coronary artery disease in the U.S

Stojanović

Schneider

Cooper

2019

Journal of Medical Economics

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“…99m Tc e o FDG-18 F, com sensibilidade e especificidade de 88% e 59%, 83% e 66%, e 93% e 63%, respectivamente (1)(2)(3)(4)(5)(6) . O 201 -Tl é ativamente transportado pela bomba de Na+/K+ ATPase e sua captação requer membrana celular íntegra, ou seja, célula miocárdica viva.…”

Section: Introductionunclassified

“…As áreas que apresentam captação de 201 -Tl, apenas na fase tardia, são as áreas de miocárdio hibernado. O sestamibi99m Tc é captado e retido nas mitocôndrias por transporte passivo, refletindo uma membrana mitocondrial intacta com função íntegra e com isso indicando viabilidade (1)(2)(3)(4)(5)(6) . A imagem metabólica com FDG-18 F baseia-se na utilização da glicose como substrato metabólico pelo miocárdio.…”

Section: Introductionunclassified

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Valor Adicional Da Fluordesoxiglicose Marcada Com Flúor-18 Na Avaliação De Viabilidade Miocárdica

Batista¹,

Joaquim²,

Ferrari³

2017

ACS

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Con lito de interesses:Não Contribuição dos autores: CAB coleta, tabulação, delineamento do estudo e elaboração e redação do manuscrito. AIJ orientação do projeto, delineamento do estudo e elaboração do manuscrito. RJRF orientação do projeto, delineamento do estudo e elaboração do manuscrito. Contato para correspondência: Cristiano Augusto Batista E-mail: batista.cristianoaugusto@gmail. Abstract Introduction:The assessment of myocardial viability in patients presenting coronary artery disease (CAD) and associated ventricular dysfunction is an important tool for selecting patients with ischemic cardiomyopathy who may benefit from myocardial revascularization. Case review: This is a hypertensive patient in regular use of medications and in follow-up at outpatient since 2011. He had an ischemic coronary event in 2013. Cardiac catheterization showed coronary lesions in the left anterior descending artery (LAD) and right coronary artery (RCA), which were treated with stents. The patient began to develop dyspnea on moderate exertion and undergoing myocardial scintigraphy with 99m Tc-sestamibi, which showed ischemia in the left ventricular anterior wall. Echocardiography showed no ventricular dysfunction. He was treated with optimization of medications. However, in the scintigraphic control examination, the ischemic area showed up as persistent hypoperfusion. A new cardiac catheterization showed stent restenosis. For evaluation of myocardial viability, we used a scintigraphy with thallium-201 that showed no tracer uptake in the left anterior descending artery territory. As the patient remained symptomatic, a new attempt of myocardial viability research with 18 F-Fluorodeoxyglucose was performed. This showed a viable left ventricular anterior wall. Conclusion: The report confirms the greater sensitivity of Positron-emission tomography/computed tomography with 18F-Fluorodeoxyglucose in detecting a viable myocardium.Descriptors: Radionuclide Imaging; Myocardial Perfusion Imaging; Thallium; Technetium Tc 99m Sestamibi; Fluorodeoxyglucose F18.

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“…It has been used to diagnose ischemic heart disease based on the idea that there is decreased blood flow in the heart and therefore less signal from the heart would be seen in the images. [48][49][50] With functional brain imaging, information on the cerebral blood flow, brain metabolism and energy use, and localized brain damage can be attained.…”

Section: Tomography (Spect) (1961)mentioning

confidence: 99%

Controlling Water Exchange Kinetics and Improving ParaCEST Imaging

Slack¹

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Generating MR image contrast from exogenous contrast media though chemical exchange saturation transfer (CEST) offers several exciting new possibilities, such as multicolored imaging, the interleaving of pre-and post-contrast images, and the potential to perform ratiometric metabolic imaging. The major limitation of the deployment of CEST imaging is the comparatively high detection limits of exogenous agents and particularly at the low B1 power levels required to meet SAR requirements. The large chemical shifts afforded by paramagnetic (paraCEST) agents permit more rapid exchange kinetics and therefore potentially more effective contrast agents. Despite comparatively large chemical shifts, many Ln 3+ DOTA-tetraamide (DOTAM) chelates traditionally investigated as CEST agents are predicted to have exchange kinetics that are considerably faster than optimal at very low B1 powers. This work explores two methodologies for slowing water exchange kinetics in Ln 3+ DOTAM chelates and improving CEST imaging: structural manipulation and encapsulation. In the first method, rigid Ln 3+ NB-DOTAM chelates with hydrophobic amide substituents was thoroughly studied using NMR spectroscopy techniques in order to assess their ability to produce CEST contrast at low B1 power levels. NMR techniques utilized included 1 H NMR, variable temperature, COSY, and CEST experiments. The phenyl amide substituent in the pseudo-axial position afforded chelates with considerably slow water proton exchange rates and appreciably more CEST contrast than isomeric chelates with the amide substituent in the pseudo-equatorial position. The second method involved characterizing a vesicle system to be used for encapsulating a Ln 3+ DOTAM chelate. The vesicles prepared were analyzed using the following NMR ii techniques: 1 H NMR, T1, shift reagent, and CEST experiments. The vesicle system chosen for study did not afford slow water exchange kinetics to enhance CEST contrast. A second vesicle system was attempted but the vesicle synthesis was difficult, parameters studied were not optimized, and the second system did not exhibit slow water exchange with the limited amount of experiments run and data collected.iii

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SPECT and PET in ischemic heart failure

Cited by 25 publications

References 145 publications

Cost-impact of cardiac magnetic resonance imaging with Fast-SENC compared to SPECT in the diagnosis of coronary artery disease in the U.S

Cost-impact of cardiac magnetic resonance imaging with Fast-SENC compared to SPECT in the diagnosis of coronary artery disease in the U.S

Valor Adicional Da Fluordesoxiglicose Marcada Com Flúor-18 Na Avaliação De Viabilidade Miocárdica

Controlling Water Exchange Kinetics and Improving ParaCEST Imaging

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