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Nuclear cardiology: state of the art.

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Title: Nuclear cardiology: state of the art.
Authors: Schofield, R
Menezes, L
Underwood, SR
Item Type: Journal Article
Abstract: Radionuclide imaging remains an essential component of modern cardiology. There is overlap with the information from other imaging techniques, but no technique is static and new developments have expanded its role. This review focuses on ischaemic heart disease, heart failure, infection and inflammation. Radiopharmaceutical development includes the wider availability of positron emission tomography (PET) tracers such as rubidium-82, which allows myocardial perfusion to be quantified in absolute terms. Compared with alternative techniques, myocardial perfusion scintigraphy PET and single photon emission computed tomography (SPECT) have the advantages of being widely applicable using exercise or pharmacological stress, full coverage of the myocardium and a measure of ischaemic burden, which helps to triage patients between medical therapy and revascularisation. Disadvantages include the availability of expertise in some cardiac centres and the lack of simple SPECT quantification, meaning that global abnormalities can be underestimated. In patients with heart failure, despite the findings of the STICH (Surgical Treatment for Ischemic Heart Failure) trial, there are still data to support the assessment of myocardial hibernation in predicting when abolition of ischaemia might lead to improvement in ventricular function. Imaging of sympathetic innervation is well validated, but simpler markers of prognosis mean that it has not been widely adopted. There are insufficient data to support its use in predicting the need for implanted devices, but non-randomised studies are promising. Other areas where radionuclide imaging is uniquely valuable are detection and monitoring of endocarditis, device infection, myocardial inflammation in sarcoidosis, myocarditis and so on, and reliable detection of deposition in suspected transthyretin-related amyloidosis.
Issue Date: 26-May-2021
Date of Acceptance: 11-Dec-2020
URI: http://hdl.handle.net/10044/1/86465
DOI: 10.1136/heartjnl-2019-315628
ISSN: 1355-6037
Publisher: BMJ Publishing Group
Start Page: 954
End Page: 961
Journal / Book Title: Heart
Volume: 107
Issue: 12
Copyright Statement: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in [insert journal name] following peer review. The definitive copyedited, typeset version Schofield R, Menezes L, Underwood SRNuclear cardiology: state of the artHeart Published Online First: 22 January 2021 is available online at: http://dx.doi.org/10.1136/heartjnl-2019-315628
Keywords: advanced cardiac imaging
cardiac imaging and diagnostics
nuclear cardiac imaging
advanced cardiac imaging
cardiac imaging and diagnostics
nuclear cardiac imaging
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status: Published
Conference Place: England
Online Publication Date: 2021-01-22
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine