Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Diagnosis of Coronary Artery Disease Using Myocardial Perfusion SPECT

심근 SPECT를 이용한 관상동맥질환의 진단

  • Won, Kyoung-Sook (Department of Nuclear Medicine, Keimyung University, School of Medicine) ;
  • Kim, Hae-Won (Department of Nuclear Medicine, Keimyung University, School of Medicine)
  • 원경숙 (계명대학교 동산의료원 핵의학과) ;
  • 김해원 (계명대학교 동산의료원 핵의학과)
  • Published : 2009.06.30
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Abstract

Myocardial perfusion scintigraphy is currently by far the most commonly performed cardiac nuclear study, constituting approximately one third of all nuclear medicine procedure. It plays an important role in the diagnosis, prognosis, risk assessment and management of heart disease. Aim of this review is to describe recent evolution of myocardial perfusion imaging on the focus of diagnosis of coronary artery disease. In addition, current status of other imaging modalities will be reviewed.

Keywords

References

  1. Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999;33:2092-197 https://doi.org/10.1016/S0735-1097(99)00150-3
  2. Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, et al. ACC/ AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging: executive summary-a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/ AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). J Am Coll Cardiol 2003;42:1318-33 https://doi.org/10.1016/j.jacc.2003.08.011
  3. Iskander S, Iskandrian AE. Risk assessment using single-photon emission computed tomographic technetium-99m sestamibi imaging. J Am Coll Cardiol 1998;32:57-62 https://doi.org/10.1016/S0735-1097(98)00177-6
  4. Hacharnovitch R, Berman OS. The use of nuclear cardiology in clinical decision making. Semin Nucl Med 2005;35:62-72 https://doi.org/10.1053/j.semnuclmed.2004.09.005
  5. Hacharnovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43 https://doi.org/10.1161/01.CIR.97.6.535
  6. Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation 2003;107:2900-7 https://doi.org/10.1161/01.CIR.0000072790.23090.41
  7. Nesto RW, Kowalchuk GJ. The ischemic cascade: temporal sequence of hemodynamic, electrocardiographic and symptomatic expressions of ischemia. Am J Cardiol 1987;59:23C-30C https://doi.org/10.1016/0002-9149(87)90192-5
  8. Schuijf JD, Shaw LJ, Wijns W, Lamb HJ, Poldermans D, de Roos A, et al. Cardiac imaging in coronary artery disease: differing modalities. Heart 2005;91:1110-7 https://doi.org/10.1136/hrt.2005.061408
  9. Kapur A, Latus KA, Davies G, et al. A comparison of three radionuclide myocardial perfusion tracers in clinical practice: the ROBUST study. Bur J Nucl Med Mol Imaging 2002;29:1608-16 https://doi.org/10.1007/s00259-002-0998-8
  10. Underwood SR, Anagnostopoulos C, Cerqueira M, Ell PJ, Flint EJ, Harbinson M, et al. Myocardial perfusion scintigraphy: the evidence. Eur J Nucl Med Mol Imaging 2004;31:261-91 https://doi.org/10.1007/s00259-003-1344-5
  11. DePuey EG, Rozanski A. Using gated technetium-99m-sestaruibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med 1995;36:952-5
  12. Smanio PE, Watson DD, Segalla DL, Vinson EL, Smith WH, Beller GA. Value of gating of technetium-99m sestamibi singlephoton emission computed tomographic imaging. J Am Coll Cardiol 1997;30:1687-92 https://doi.org/10.1016/S0735-1097(97)00363-X
  13. Fleischmann S, Koepfli P, Namdar M, Wyss CA, Jenni R, Kaufmann PA. Gated $^{ppm}$Tc-tetrofosmin SPECT for discriminating infarct from artifact in fixed myocardial perfusion defects. J Nucl Med 2004;45:754-75
  14. Chua T, Kiat H, Germano G, Maurer G, van Train K, Friedman J, et al. Gated technetium-99m sestamibi for simultaneous assessment of stress myocardial perfusion, postexercise regional ventricular function and myocardial viability. Correlation with echocardiography and rest thallium-201 scintigraphy. J Am Coll Cardiol 1994;23:1107-14 https://doi.org/10.1016/0735-1097(94)90598-3
  15. Nichols K, DePuey EG, Krasnow N, Lefkowitz D, Rozanski A. Reliability of enhanced gated SPECT in assessing wall motion of severely hypoperfused myocardium: echocardiographic validation. J Nucl Cardiol 1998;5:387-94 https://doi.org/10.1016/S1071-3581(98)90144-1
  16. Everaert H, Vanhove C, Franken PR. Effects of low-dose dobutamine on left ventricular function in normal subjects as assessed by gated single-photon emission tomography myocardial perfusion studies. Eur J Nucl Med 1999;26:1298-303 https://doi.org/10.1007/s002590050586
  17. Johnson LL, Verdesca SA, Aude WY, Xavier RC, Nott LT, Campanella MW, et al. Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on poststress gated sestamibi tomograms. J Am Coll Cardiol 1997;30:1641-8
  18. DePuey EG, Nichols K, Dobrinsky C. Left ventricular ejection fraction assessed from gated technetium-99m-sestaruibi SPECT. J Nucl Med 1993;34:1871-6
  19. Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138-47
  20. Marie PY, Djaballah W, Franken PR, Vanhove C, Muller MA, Boutley H, et al. OSEM reconstruction, associated with temporal Fourier and depth-dependant resolution recovery filtering, enhances results from sestamibi and $^{201}$Tl 16-interval gated SPECT. J Nucl Med 2005;46:1789-95
  21. Guterberlet M, Mehl S, Froelich M, Hausmann H, Plotkin M, Ruf J, et al. Determination of ventricular volumes in coronary artery disease. Comparison of two gated SPECT analysis tools with MRI. Nuklearmedizin 2006;45:63-73
  22. Sciagra R. The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene. Eur J Nucl Med Mol Imaging 2007;34:1107-22 https://doi.org/10.1007/s00259-007-0405-6
  23. Sharir T, Bacher-Stier C, Dhar S, Lewin HC, Miranda R, Friedman JD, et al. Identification of severe and extensive coronary artery disease by postexercise regional wall motion abnormalities in Tc-99m sestamibi gated single-photon emission computed tomography. Am J Cardiol 2000;86:1171-5 https://doi.org/10.1016/S0002-9149(00)01206-6
  24. Emmett L, Iwanochko RM, Freeman MR, Barolet A, Lee DS, Husain M. Reversible regional wall motion abnormalities on exercise technetium-99m-gated cardiac single photon emission computed tomography predict high-grade angiographic stenoses. J Am Coll Cardiol 2002;39:991-8 https://doi.org/10.1016/S0735-1097(02)01707-2
  25. Mazzanti M, Germano G, Kiat H, Kavanagh PB, Alexanderson E, Friedman JD, et al. Identification of severe and extensive coronary artery disease by automatic measurement of transient ischemic dilatation of the left ventricle in dual-isotope myocardial perfusion SPECT. J Am Coll Cardiol 1996;27:1612-20 https://doi.org/10.1016/0735-1097(96)00052-6
  26. Yamagishi H, Shirai N, Yoshiyama M, Teragaki M, Akioka K, Takeuchi K, et al. Incremental value of left ventricular ejection fraction for detection of multivessel coronary artery disease in exercise 201Tl gated myocardial perfusion imaging. J Nucl Med 2002;43:131-9
  27. Shirai N, Yamagishi H, Yoshiyama M, Teragaki M, Akioka K, Takeuchi K, et al. Incremental value of assessment of regional wall motion for detection of multivessel coronary artery disease in exercise 201Tl gated myocardial perfusion imaging. J Nucl Med 2002;43:443-50
  28. Lima RS, Watson DD, Goode AR, Siadaty MS, Ragosta M, Beller GA, et al. Incremental value of combined perfusion and function over perfusion alone by gated SPECT myocardial perfusion imaging for detection of severe three-vessel coronary artery disease. J Am Coll Cardiol 2003;42:64-70 https://doi.org/10.1016/S0735-1097(03)00562-X
  29. Kaul S, Senior R, Firschke C, Wang XQ, Lindner J, Villanueva FS, et al. Incremental value of cardiac imaging in patients presenting to the emergency department with chest pain and without ST-segment elevation: a multicenter study, Am Heart J 2004; 148: 129-36 https://doi.org/10.1016/j.ahj.2003.12.041
  30. Taillefer R, DePuey EG, Udelson JE, Beller GA, Benjamin C, Gagnon A. Comparison between the end-diastolic images and the summed images of gated 99mTc-sestamibi SPECT perfusion study in detection of coronary artery disease in women, J Nucl Cardiol 1999;6:169-76 https://doi.org/10.1016/S1071-3581(99)90077-6
  31. Smith LDR, Spyer G, Dean JW. Audit of cardiac catheterisation in a district general hospital: implications for training, Heart 1999;81:461-4
  32. Pilote L, Miller DP, Califf RM, Rao JS, Weaver WD, Topol EJ. Determinants of the use of coronary angiography and revascularisation after thrombolysis for acute myocardial infarction. N Engl J Med 1996;17:1198-205 https://doi.org/10.1056/NEJM199610173351606
  33. Mark DB, Naylor CD, Hlatky MA, Califf RM, Topol EJ, Granger CB, et al. Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States. N Engl J Med 1994;331:1130-5 https://doi.org/10.1056/NEJM199410273311706
  34. Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation 1989;80:87-98 https://doi.org/10.1161/01.CIR.80.1.87
  35. Giang TH, Nanz D, Coulden R, Friedrich M, Graves M, Al-Saadi N, et al. Detection of coronary artery disease by magnetic resonance myocardial perfusion imaging with various contrast medium doses: first European multi-centre experience. Eur Heart J 2004;25:1657-65 https://doi.org/10.1016/j.ehj.2004.06.037
  36. Wolff SD, Schwitter J, Coulden R, Friedrich MG, Bluemke DA, Biederman RW, et al. Myocardial first-pass perfusion magnetic resonance imaging: a multicenter dose-ranging study. Circulation 2004; 110:732-7 https://doi.org/10.1161/01.CIR.0000138106.84335.62
  37. Schuijf JD, Bax JJ, Shaw LJ, de Roos A, Lamb HJ, van der Wall EE, et al. Meta-analysis of comparative diagnostic performance of magnetic resonance imaging and multi-slice computed tomography for non-invasive coronary angiography. Am Heart J 2006;151:404-11
  38. Juergens KU, Fischbach R Left ventricular function studied with MDCT. Eur Radiology 2006;16:342-57 https://doi.org/10.1007/s00330-005-2888-5
  39. Leschka S, Alkadhi H, Plass A. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 2005;26:1482-7
  40. Di Carli MF. Hybrid imaging: Integration of nuclear imaging and cardiac CT. Cardiol Clin 2009;27:257-63 https://doi.org/10.1016/j.ccl.2008.12.001
  41. Schuijf JD, Wijns W, Jukema JW, Atsma DE, deRoos A, Lamb HJ, et al. Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol 2006;48:2508-14 https://doi.org/10.1016/j.jacc.2006.05.080
  42. Di Carli MF, Dorbala S, Curillova Z, Kwong RJ, Goldhaber SZ, Rybicki FJ, et al. Relationship between CT coronary angiography and stress perfusion imaging in patients with suspected ischemic heart disease assessed by integrated PET-CT imaging, J Nucl Cardiol 2007;14:799-809 https://doi.org/10.1016/j.nuclcard.2007.07.012
  43. Shaw LJ Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol 2004;11:171-85 https://doi.org/10.1016/j.nuclcard.2003.12.004
  44. Rispler S, Keidar Z, Ghersin E, Roquin A, Soil A, Draque R, et al. Integrated single-photon emission computed tomography and computed tomography coronary angiography for the assessment of hemodynamically significant coronary artery lesions. J Am Coli Cardiol 2007;49: 1059-67 https://doi.org/10.1016/j.jacc.2006.10.069