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Nuclear Cardiology: Basic and Advanced Concepts in Clinical Practice

✍ Scribed by Cláudio Tinoco Mesquita (editor), Maria Fernanda Rezende (editor)


Publisher
Springer
Year
2021
Tongue
English
Leaves
803
Category
Library

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✦ Synopsis


This book covers relevant concepts in nuclear cardiology, combining imaging techniques and clinical data to do so. Today, nuclear cardiology is a worldwide discipline connected to the broader field of cardiovascular imaging. The combination of clinical aspects (symptoms, medications, previous cardiac procedures), ancillary exams and nuclear images is key to decision-making in clinical practice. Thus, a book on this topic is essential to provide better outcomes for cardiology patients.

The chapters cover a comprehensive range of topics in current cardiology practice, such as ambulatory patients, patients in emergency settings, patients after complex cardiac procedures, and patients during and after the use of cancer therapies that are potentially toxic for the heart (cardio-oncology). As such, multiple clinical scenarios are also presented: patients with suspected coronary disease, patients with heart failure of unknown origin, patients with acute chest pain in the emergencydepartment, patients with suspected pulmonary embolism, patients with complications of the left ventricular assist device, etc. Furthermore, the book describes nuclear cardiology procedures and techniques, discusses the main clinical indications and scenarios for each procedure, presents new technological advances in the field (machine learning and artificial intelligence tools), and mentions the coronavirus disease 2019 (COVID-19) pandemic.

Given its scope, the book offers a valuable guide and videos for various medical professionals, especially cardiologists and nuclear physicians.

✦ Table of Contents


Foreword
Editors’ Personal Note
Preface
Contents
Contributors
Chapter 1: Cardiac PET Procedure: Perfusion, Coronary Flow, Viability, Inflammation, and PET/MR
PET (Positron Emission Tomography) Procedure
Perfusion
Positron Emission Tomography Myocardial Perfusion Imaging
Radiotracers
PET Acquisition
PET Imaging Protocols
Patient Preparation and Protocols
Patient Positioning
Dipyridamole Stress Test Procedure
Adenosine Stress Test Procedure
Image Processing
18Fluorine-Based Perfusion Radiotracers
PET Myocardial Perfusion (Relative Perfusion Images)
Left Ventricular Function with PET
PET Perfusion Image Interpretation
Myocardial Blood Flow (MBF) and Coronary Flow Reserve (CFR) Quantification
Coronary Circulation/Coronary Microcirculation/Coronary Reserve
Absolute Quantification of Myocardial Blood Flow (MBF) and Determination of Coronary Flow Reserve (CFR)
Integrating the Perfusion Images, Functional Images, and Quantitative Parameters: Interpretation
Dosimetry
Myocardial Viability with PET
Glucose Metabolism
18F-FDG-PET Myocardial Viability Protocol
Acquisition Parameters [29]
Interpretation Criteria
Fatty Acid Metabolism and Myocardial Oxygen Consumption
Mitochondrial Membrane Potential
Microvascular Dysfunction in the Context of Myocardial Viability
Cardiovascular Inflammation
Glucose Metabolism
Patient Preparation in Order to Avoid 18F-FDG Physiologic Myocardial Uptake
Dietary Approaches
Important Considerations for Image Interpretation
Imaging Protocol [29]
Interpretation (General)
Infective Endocarditis (More Information in Chap. 26: Nuclear Imaging in the Management of Infective Endocarditis by Jadvar Hossein)
Prosthetic Valve Endocarditis
Interpretation of 18F-FDG-PET/CT Images
Native Valve Endocarditis
Cardiac Implantable Electronic Device (CIED) Infection
Classification
Interpretation
Graft Infection
Cardiac Sarcoidosis
Diagnostic by PET
Hybrid Magnetic Resonance Imaging and Positron Emission Tomography (PET/MR)
Attenuation Correction in PET/MR
Motion Correction
Image Post-processing, Visualization, and Quantification
Cautions for Performing Cardiac PET/MRI Examination Safely
Potential Clinical Indications for Cardiac PET/MRI
PET/MR in Cardiac Sarcoidosis (CS)
PET/MR in Ischemic Cardiomyopathy
References
Chapter 2: SPECT Procedures
Introduction
Functional Tests
Exercise Test
Contraindication [4]
Absolute
Relative
Limitations
Procedure
Indications for Early Completion of the Exercise
Pharmacologic Evidence
Vasodilators
Adenosine
Hemodynamic Effects: What to Expect from Adenosine Infusion
Indications
Contraindications
Absolute
Relative
Preparation for Examination and Procedures
• Reversion of Adverse Effects
Combination of Low-Level Exercise with Adenosine
Regadenoson
Preparation for Examination and Procedures
Combination of Low-Level Exercise with Regadenoson
Dipyridamole
Side Effects: What to Expect from Dipyridamole Infusion
Preparation for Examination and Procedures
Combination of Low-Level Exercise with Dipyridamole
Pharmacological Stress with Synthetic Catecholamines
Side Effects: What to Expect from Dobutamine Infusion
Indications: When to Request Dobutamine
Contraindications
Absolute
Relative
Preparation for Examination and Procedures
Special Populations for Pharmacologic Test
Radiotracers and Protocols
Radiopharmaceuticals
99mTc-sestamibi
Thallium-201
New Perspectives
CZT Cameras
Cardiac Scintigraphy with 123I-MIBG
Mechanism of Action
Indications
Procedures
Dose
Adverse Reactions
Performing the Images
Calculating HMR and WR
References
Chapter 3: Evaluation of Myocardial Blood Flow and Myocardial Flow Reserve by Radionuclide Imaging
PET/CT
Radiopharmaceuticals
15Oxygen-Water
13N-Ammonia
Rubidium-82
Imaging Procedure
Patient
Clinical Application
Future Perspectives
Conclusion
References
Chapter 4: Radiation Protection and Exposure in Nuclear Cardiology
Radiation in Our Routine
Ionizing Radiation
Main Types of Ionizing Radiation
Interaction of Ionizing Radiation with Matter
Dose Quantities in Radiological Protection
Absorbed Dose
Equivalent Dose to Tissue or Organ T
Effective Dose
Radiation Applications in Medicine
Nuclear Medicine
Nuclear Cardiology
Gamma Camera
Positron Emission Tomography (PET)
Radiation Protection
Patient’s Radiation Protection
Occupational Radiation Protection
References
Chapter 5: Non-nuclear Cardiac Imaging Modalities: CT and MRI
Advantage and Assessment of Cardiovascular Structure and Function with CMR
Ischemic Heart Disease and Myocardial Infarction/Scar
Non-ischemic Cardiomyopathies
Hypertrophic Cardiomyopathy
Amyloidosis
Cardiac Sarcoidosis
Iron-Overload Cardiomyopathy
Myocarditis
Chagas Disease
Dilated Cardiomyopathy
Valve Disease
Cardiac Masses and Tumors
Pericardial Disease
Congenital Heart Disease
CMR Safety
Cardiac Computed Tomography (CCT)
Coronary Artery Calcium Scoring
Coronary Computed Tomographic Angiography
Beyond Coronary Stenosis
Functional vs. Anatomic Approach – SCOT-HEART and PROMISE
How Will the ISCHEMIA Trial Affect the Future Application of CCTA?
References
Chapter 6: Coronary Physiology: From Basic Concepts to FFR and iFR
Introduction
Fundamentals of the Coronary Pressure-Flow Relationship
(Patho)Physiological Processes in the Presence of a Stenosis
Introduction of Coronary Physiology in Clinical Practice: Basic Principles, Validation, and Implementation
Fractional Flow Reserve in Stenosis Assessment
Coronary Flow in Stenosis Assessment
Improving Hemodynamic Stenosis Assessment: Combining Pressure and Flow
New Kid on the Block: The Introduction of Instantaneous Wave-Free Ratio in Stenosis Assessment
Clinical Case: How to Deal with iFR-FFR Discordance?
Clinical Case: How to Deal with iFR-FFR Discordance?
Clinical Implications for the Future
Conclusion
References
Chapter 7: Coronary Artery Calcium and Hybrid Imaging in Ischemic Heart Disease
Introduction
Part I: Coronary Artery Calcium Score
Diagnostic Applications of CAC Score with MPI
Prognostic Applications of CAC Score Along with MPI
Part II: Hybrid Cardiac Imaging – SPECT/CT
CT for Myocardial Perfusion Imaging: Attenuation Correction
Integration of MPI with CCTA
Part III: Hybrid Imaging – PET/CT
Instrumentation and Technical Aspects of Hybrid Imaging
Clinical Applications of Hybrid PET/CT
Risk Stratification Derived from Hybrid PET/CT
Radiation Exposure Derived from Hybrid Imaging
Indications and Appropriate Use Criteria for Hybrid Imaging PET/CT
Part IV: Hybrid Imaging with Cardiac PET/MRI
Conclusion
References
Chapter 8: Coronary Blood Flow Reserve and Myocardial Ischemia
Introduction
Understanding the Basic Concepts of Coronary Physiology
Ischemia-Stenosis Relationship
Rationale and Clinical Value of MBF Quantification
MBF Quantification Prognostic Value in Patients with CAD
MBF Quantification Prognostic Value in Patients with Nonischemic Cardiomyopathy
MBF Quantification in a Specific Population: Heart Transplant
Clinical Value of MBF Quantification with SPECT
Understanding the Vasodilators Used in Clinical Practice
PET Instrumentation and Protocol
SPECT Instrumentation and Protocol
Nomenclature and Interpretation
Future Direction
Conclusion
References
Chapter 9: Nuclear Cardiology and Coronavirus Disease 2019 (COVID-19) Pandemic
Coronavirus Disease 2019
Coronavirus Disease 2019 and Cardiovascular Manifestations
Nuclear Cardiology Role in Coronavirus Disease 2019
Best Practices in Nuclear Cardiology During the Coronavirus Disease 2019 Pandemic
References
Chapter 10: Nuclear Imaging in Stable Ischemic Coronary Disease
Introduction
Nuclear Medicine Procedures in Cardiology
Perfusion Index Considerations
Pharmacologicallly Induced Stress
Part 3: Clinical Aspects
Clinical Applications of Myocardial Perfusion Scintigraphy and Positron Emission Tomography
Diagnosis of Coronary Artery Disease
Prognostic Assessment and Risk Stratification
Functional Assessment of Known Anatomical Lesions
Assessment After Myocardial Revascularization Surgery
Evaluation After Percutaneous Revascularization
Therapeutic Monitoring
Evaluation in Acute Coronary Syndromes
Myocardial Viability Investigation
18F-Fluorodeoxyglucose with Positron Emission Tomography
Nuclear Medicine in Special Populations
Multivessel Patients
Diabetic Patients
Women
Elderly Patients
Patients with Chronic Renal Failure
Athletes
Extent Determination of Ischemia and Therapeutic Determination
Part 4: Future Prospects
Part 5: Conclusion
References
Chapter 11: Nuclear Imaging in Acute Coronary Syndromes
Introduction
Acute Chest Pain in Patients Received at the Emergency Department with Normal or Nondiagnostic ECG
Role of Nuclear Cardiology Techniques in the Assessment of Patients with Acute Chest Pain
Non-ST Segment Elevation Acute Coronary Syndromes
ST-Segment Elevation Myocardial Infarction (STEMI)
To Assess Myocardium at Risk, Salvaged Area, and Infarct Size
To Detect Ischemia in the Non-IRA Territories After a Primary PCI in a Patient with Multivessel Disease
Approach of the Guidelines
To Risk Stratify for Sudden Cardiac Death
Takotsubo Syndrome
Diagnosis
Electrocardiogram
Echocardiogram
Cardiac Magnetic Resonance
Nuclear Imaging
Coronary Angiography and Left Ventriculography
References
Chapter 12: Nuclear Techniques Before and After Coronary Revascularization
Introduction
Strengths of Nuclear Cardiology
Nuclear Cardiology Techniques Before Revascularization
Nuclear Cardiology Techniques After Revascularization
Current Appropriate Use Criteria of MPI
MPI Versus CTA to Guide Revascularization
MPI Versus CTA to Detect Restenosis Post Intervention
Conclusions
References
Chapter 13: Physiologic and/or Anatomic Assessment of CAD: Patient-Centered Approach
Introduction
Technologies to Evaluate CHD in a Contemporary Practice of Medicine
Conclusion
References
Chapter 14: Evidence-Based and Nuclear Cardiology
Chronic Coronary Syndromes
Acute Coronary Syndromes
Myocardial Viability
Amyloidosis, Sarcoidosis, Infection, and Neuronal Imaging
Amyloidosis
Infective Endocarditis
Sarcoidosis
Neuronal Imaging
Conclusion
References
Chapter 15: Pathophysiology, Diagnosis, and Management of Heart Failure
Introduction
Pathophysiology
Ventricular Mechanics
Cardiac Remodeling
Reverse Remodeling
Microstructural Changes
Interstitial Fibrosis
Macrostructural Changes
Activation of the Neurohumoral System
Natriuretic Peptides
Immunoinflammatory Activation
Mitochondria
Diagnosis
Treatment
References
Chapter 16: PET and SPECT Evaluation of Viable Dysfunctional Myocardium
Introduction
Viability Concepts
Patient Selection for a Viability Study
Guidelines for Viability Imaging in Heart Failure
SPECT and PET: Radiopharmaceuticals and Protocols
SPECT
Thallium-201
Technetium-99m-Labelled Agents
FDG PET
Other Modalities to Assess Viability
Clinical Evidence for Viability Testing
New Studies: IMAGE-HF; Role of Neurohormonal Imaging; PAREPET; and Application in Chronic Total Occlusion
Conclusion
References
Chapter 17: Bone Tracers for the Diagnosis of Cardiac Amyloidosis
What Is Amyloidosis?
When Should I Suspect of Cardiac Amyloidosis (CA)
The Electrocardiogram
Biomarkers
The Echocardiogram
Magnetic Resonance Imaging (MRI)
Most Common Types of CA
Transthyretin (TTR) Amyloidosis
Mutant Transthyretin (TTRm)
Wild Transthyretin (TTRw)
Light Chain Amyloidosis (AL)
Bone Tracer Scintigraphy
Bone Scintigraphy Protocols for CA
Suggested Diagnostic Sequence
Other Nuclear Medicine Techniques for CA Evaluation
Final Considerations
References
Chapter 18: Adrenergic Nervous System Imaging in HF Management
Introduction
Physiology of Myocardial Innervation
Myocardial Kinetics of mIBG
Physiological and Pathophysiological Distribution of mIBG in the Myocardium
Technique and Radiopharmaceutical
Prognostic Value of Cardiac123I-mIBG in Risk-Stratifying HF Patients
PET Tracers in HF Assessment
Conclusion
References
Chapter 19: Takotsubo Cardiomyopathy and Nuclear Imaging
Definition and Epidemiology
Pathophysiology
Clinical Presentation
Types of Takotsubo Cardiomyopathy
Diagnostic Criteria
Role of Nuclear Cardiology Using 123I-MIBG
Conclusion
References
Chapter 20: PET and SPECT in Inflammatory Diseases: Sarcoidosis, Myocarditis, and Vasculitis
Sarcoidosis
Introduction
Clinical Aspects
Imaging in CS
PET and Single Photon Emission Tomography (SPECT) in CS Evaluation
Diagnosis
Other Radiopharmaceuticals (Beyond FDG)
Follow-Up/Treatment Evaluation
Diagnostic Accuracy
Prognostic Information
Myocarditis
Introduction
Epidemiology
Etiology
The Virus Importance
Noninfectious Causes
Immune Checkpoint Inhibitors (ICI)-Related Myocarditis
Diagnosis
Nuclear Medicine
Gallium-67 Citrate
Other SPECT Radiotracers
Monoclonal Antibodies
Imaging Apoptosis
Myocardial Perfusion Imaging
PET–CT (Cardiac 18F-FDG PET Imaging)
Background
Patient Preparation for Cardiac Inflammation FDG Imaging
Role of FDG PET–CT in Assessing Myocarditis
Cardiac MRI
Background
Integrated PET–MR
Key Points for Cardiac PET–MR
Reduced Radiation Exposure
Motion and Partial Volume Correction
Soft Tissue Contrast
Invited Perspectives: PET–CT/PET–MR with Other Radiotracers
Gallium-68 Tracers
Carbon-11 Tracers
FDG PET–CT in Vasculitis and Polymyalgia Rheumatica
Introduction
Effect of Glucocorticoids in FDG Vascular Uptake
Interpretation Criteria
Diagnostic Accuracy
Disease Activity
FDG PET in Medium- and Small-Sized Vessel Vasculitis
References
Chapter 21: Cardiovascular Risk Stratification Prior to Non-cardiac Surgery
General Issues
Assessing the Surgery Timing
Assessing the Surgery Risk
Assessing the Clinical Cardiovascular Risk
General Methods (Non-stress Imaging) for Non-invasive Perioperative Cardiovascular Risk Assessment
Radionuclide Stress Testing, SPECT MPI to Assess Perioperative Cardiovascular Risk and Some Technical Issues
MPI Diagnostic and Prognostic Value
Technical Issues
Safety of Radionuclide Non-invasive Stress Testing
Radionuclide Stress Testing in Special or Vulnerable Population
Other Images Available for Non-invasive Assessment of Cardiovascular Risk
Role of Images in Guidelines for Cardiovascular Perioperative Risk Assessment
Conclusions
References
Chapter 22: Exercise and Pharmacologic Stress Testing
Introduction
Physiology of Physical Stress
Cardiopulmonary System
Exercise Stress Test
Exercise Stress Test Protocol
Contraindications to Stress Testing
Indications for Termination of Exercise Stress Testing
Absolute
Relative
Preparation for the Exercise Stress Testing
Electrocardiographic Leads for Exercise Stress Testing
Basal Electrocardiography
Stress Protocols
Protocols for Treadmill Test
Ramp Protocol
Bruce Protocol
Radiotracer Injection
Image Protocols
Normal Exercise Electrocardiographic Response
Diagnostic Value of Exercise Stress Testing
Stress Testing Interpretation
Localization of Ischemia by ECG Patterns
ST Elevation Due to Transmural Ischemia
ST Depression in V1
Localization of Proximal or Distal LAD
Pharmacological Stress Testing
Vasodilators
Dipyridamole
Indications for Adenosine and Dipyridamole
Contraindications for Adenosine and Dipyridamole
Drugs That Promote Increased Oxygen Uptake
Dobutamine Indications
Dobutamine Contraindications
Combination of Low-Level Exercise with Dipyridamole Infusion
Hybrid Protocols
Anti-ischemic Effects of Medications
New Agents
Other Inotropic Drugs
Assessment of Pre-test Probability (PTP) and Clinical Likelihood of Coronary Artery Disease
Selecting Appropriate Testing
Incremental Information Derived from Stress Testing Protocols
Bibliography
Chapter 23: Evaluation of Ventricular Function by Nuclear Imaging
Technical Aspects
Imaging Methodology for Gated SPECT
Blood Pool Methods
Imaging Methodology for Gated Positron Emission Tomography (Gated PET)
Clinical Applications
Diagnostic Value of Gated SPECT Functional Assessment
Prognostic Value of Functional Assessment
Left Ventricular Ejection Fraction
Transient Ischemic Dilation
Ventricular Volumes
Regional Wall Motion and Thickening
Diastolic Dysfunction
Prognostic Value of Gated PET MPI Functional Assessment
Bibliography
Chapter 24: 123I-mIBG in the Risk Stratification of Sudden Cardiac Death in Chronic Heart Failure
Chronic Heart Failure
Cardiac Sympathetic Activity
Cardiac 123I-mIBG Scintigraphy
Planar 123I-mIBG Scintigraphy Acquisition and Analysis
SPECT 123I-mIBG Scintigraphy Acquisition and Analysis
Planar 123I-mIBG Scintigraphy as Predictor of Cardiac Morbidity and Mortality in CHF
Planar 123I-mIBG Scintigraphy as Predictor of Arrhythmia in CHF
123I-mIBG Cross-Calibration
123I-mIBG SPECT as Predictor of Cardiac Morbidity and Mortality in CHF
123I-mIBG SPECT as Predictor of Arrhythmia in CHF
Risk Calculation with 123I-mIBG Scintigraphy
Conclusion
References
Chapter 25: Nuclear Image-Guided Methods for Cardiac Resynchronization Therapy
Introduction to CRT
Heart Failure
What Is CRT?
How to Evaluate CRT Outcomes?
Nuclear Imaging to Guide CRT
Myocardial Imaging Techniques
Nuclear Image-Guided Approaches for CRT
Nuclear Imaging to Detect Myocardial Viability
Nuclear Imaging to Detect Mechanical Dyssynchrony
Nuclear Imaging to Detect Wall Thickening
Nuclear Imaging to Guide CRT Patient Selection
Nuclear Imaging to Identify the Optimal LV Lead Position
Nuclear Imaging to Guide LV Lead Placement
Large Multicenter Nuclear Image-Guided Clinical Trials
Application of Artificial Intelligence in Guiding CRT
Challenges and Future of Nuclear Imaging to Guide CRT
References
Chapter 26: Nuclear Imaging in the Management of Infective Endocarditis
Introduction
Radiolabeled Leukocyte Scintigraphy
FDG PET/CT (Include Cardiac Prep)
Comparison of Radiolabeled Leukocyte Scintigraphy and FDG PET/CT
Systematic Review and Meta-Analysis
Summary
References
Chapter 27: PET and SPECT in the Evaluation of Cardiac Implantable Electronic Devices
Introduction
Heart Failure
Cardiac Implantable Electronic Devices
Devices for Rhythm Control
Artificial Pacemaker
Implantable Cardioverter Defibrillator (ICD)
Devices to Support the Heart and Circulation
Left Ventricular Assist Device (LVAD)
Cardiac Device-Related Infection Imaging
Overview
Echocardiography
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Nuclear Cardiology
18F-Fluorodeoxyglucose (FDG) PET/CT
Positron Emission Tomography (PET) Overview
18F-fluorodeoxyglucose (FDG) PET/CT
18F
FDG (Fluorodeoxyglucose)
18F-FDG PET/CT
Administered Dose
Dosimetry
Patient Preparation
Protocol
Image Interpretation
Statistics
Radiolabeled Autologous White Blood Cells (WBCs)
Patient Preparation
Blood Sampling and Radiolabeling
99mTc-Exametazime (HMPAO)-Labeled Leukocytes
Administered Activity
Dosimetry
Indium-111-WBC
Administered Activity
Dosimetry
Radiolabeled Autologous White Blood Cells’ Image Acquisition
Radiolabeled Autologous White Blood Cells’ Image Interpretation
Statistics
Gallium-67 Citrate
Radiopharmaceutical
Administered Dose
Dosimetry
Patient Preparation
Contraindications
Image Acquisition
Image Interpretation
Cardiac Sympathetic Nervous System
Adrenergic Cardiac Imaging
123I-mIBG (I-123 Metaiodobenzylguanidine)
Cardiac 123I-mIBG Indications
Patient Preparation
Radiotracer Administration
Adverse Reactions
Radiation Exposure
Imaging Technique
Heart-to-Mediastinum Ratio (HMR)
Washout Rate
Image Interpretation
Risk Stratification/Prognosis
Use of Cardiac Adrenergic Imaging to Guide Therapy
Dual Cardiac Adrenergic/Perfusion Imaging
Cardiac Autonomic Imaging with PET Tracers
11C-hydroxy-ephedrine (HED)
Procedure
Image Interpretation and Clinical Use
References
Chapter 28: The Clinical Aspects of Heart Damage by Chemotherapy and Radiotherapy
Introduction
Cancer Treatment History
Epidemiology
Cardio-oncology
Clinical Cardiotoxicity Manifestations
Ventricular Dysfunction and Heart Failure
Hypertension
Thromboembolic Disease
Coronary Disease
Cardiac Arrhythmias and Conduction Disorders
Immune Checkpoint Inhibitor Injuries
Pulmonary Hypertension
Cardiovascular Injuries Secondary to Radiotherapy
Conclusions
References
Chapter 29: Nuclear Medicine Tools for Cardiac Damage Diagnosis in Oncology
Introduction
LVEF Evaluation (MUGA and Gated SEPCT)
Specific Evaluations
Cardiac Sympathetic Evaluation
123I-mIBG scintigraphy
PET Tracers
Apoptosis and Necrosis
HER2 Receptors
Myocardial Perfusion and Blood Flow (SPECT and PET)
Fat Acid Metabolism and Other Evaluations by PET
Mitochondrial Function (99mTc-MIBI)
Myocardial Metabolism and Inflammation (18FDG)
Conclusions
References
Chapter 30: Acute Coronary Syndrome Evaluation with Nuclear Medicine in the Emergency Setting
Background
Coronary Risk Stratification Tests
Exercise Test
Stress Echocardiogram
Magnetic Resonance
Computed Tomography
Myocardial Perfusion Scintigraphy
Acute Myocardial Perfusion Imaging
Rest and Stress Myocardial Perfusion
Positron Emission Tomography
Algorithm for Acute Chest Pain Evaluation
References
Chapter 31: Diagnosis of Pulmonary Embolism
Introduction
Imaging Studies in PE Diagnosis
Accuracy of V/Q Scintigraphy and CTPA
Clinical Indications of V/Q Scintigraphy
Methodology of V/Q Scintigraphy
Ventilation Phase
Perfusion Phase
Pediatric
Pregnancy
V/Q Scintigraphy Interpretation
Future Perspectives and New Trends
Conclusion
References
Chapter 32: Deep Learning and Artificial Intelligence in Nuclear Cardiology
Introduction
How Images Can Be Transformed in Numbers?
Artificial Neural Network (ANN)
Other Machine Learning Algorithms
Will Machine Learning Replace the Nuclear Cardiologist?
AI Applications in Nuclear Cardiology
Conclusions
References
Chapter 33: Programmes of the International Atomic Energy Agency for Nuclear Cardiology and Quality Management
Introduction
Challenges Associated With the Introduction of Newer Technologies
Diagnostic Efficacy and Cost-Effectiveness
The Programme in Human Health of the IAEA to Support Nuclear Cardiology
Human Resources Capacity Building
Economic Evidence on the Use of Nuclear Cardiology
Managing Quality in Nuclear Cardiology and Nuclear Medicine in General (IAEA QUANUM Programme)
References
Index


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