Choice of imaging techniques

ESC CardioMed ◽  
2018 ◽  
pp. 645-658
Author(s):  
Jeroen J. Bax ◽  
Alexander R. van Rosendael ◽  
Laurens F. Tops ◽  
Nina Ajmone Marsan ◽  
Victoria Delgado
Keyword(s):  
Computed Tomography ◽  
Cardiovascular Disease ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Non Invasive ◽  
Disease States ◽  
Potential Disadvantage ◽  
Artery Disease ◽  
Stable Chest Pain ◽  
Therapeutic Decision Making

Cardiovascular non-invasive imaging has become an important component in the diagnosis and guidance of therapy in patients with cardiovascular disease. Currently, the four main non-invasive imaging techniques are echocardiography, nuclear imaging with single-photon emission computed tomography (SPECT) and positron emission tomography (PET), cardiovascular magnetic resonance (CMR), and multidetector computed tomography (MDCT). Over recent years, each of these modalities has witnessed rapid technological developments. All of the techniques can presently provide integrated cardiac anatomical and functional information, whereas in the past, the techniques could mostly only provide information on just one of these parameters. This has resulted in an increased implementation of cardiovascular imaging in clinical patient management. Consequently, improved diagnosis and therapeutic decision-making has become possible. However, clinicians have become confused about which imaging techniques to use and when, with the potential disadvantage of ‘over-using’ the imaging techniques. When selecting imaging techniques for a particular patient, various issues need to be considered: the cardiovascular disease, the information on that disease that is needed for the clinical management of the patient, and the characteristics of the patient. Frequently, different techniques can provide the required information; it is therefore also important to consider the local availability, expertise, and experience with the imaging techniques. In this chapter, three specific disease states (the patient with stable chest pain with suspected coronary artery disease, the patient with atrial fibrillation, and the patient with chronic heart failure) will be used as examples to illustrate these issues.

Nuclear cardiology

2021 ◽  
pp. 41-45
Author(s):  
Aju P. Pazhenkottil ◽  
Ronny R. Buechel
Keyword(s):  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Nuclear Imaging ◽  
Cardiac Metabolism ◽  
Non Invasive ◽  
Positron Emission ◽  
Invasive Method ◽  
Artery Disease ◽  
Pet Myocardial Perfusion Imaging

Nuclear imaging was first introduced with the development of scintillator cameras by Hal Anger in the early 1960s. Hence, nuclear imaging is one of the oldest non-invasive imaging techniques in cardiology, beside echocardiography. Over the last few decades, nuclear imaging has seen tremendous advances and has generated great interest as a non-invasive method to assess a variety of medical conditions. Aside from 18F-fluorodeoxyglucose positron emission tomography (PET) for patients with oncological disease, the growth of nuclear medicine in recent years has been mainly driven by the increasing use of single-photon emission computed tomography (SPECT) and PET myocardial perfusion imaging studies in patients with known or suspected coronary artery disease. While SPECT as a non-invasive method is widely available, PET has superior spatial and temporal resolution, allowing quantification of radiotracer uptake and thereby contributing important insights into the pathophysiological regulation of myocardial blood flow and cardiac metabolism.

scholarly journals 1173 Additional role of FFRct and stress CT perfusion in the management of patients with stable chest pain compared to cCTA alone

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Baggiano ◽  
M Guglielmo ◽  
G Muscogiuri ◽  
L Fusini ◽  
A Del Torto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Invasive Technique ◽  
Functional Evaluation ◽  
Fractional Flow ◽  
Non Invasive ◽  
Artery Disease ◽  
Stable Chest Pain

Abstract Background Computed tomography-derived fractional flow reserve (FFRCT) and stress computed tomography perfusion (stress-CTP) are new techniques that combine anatomy and functional evaluation to improve assessment of coronary artery disease (CAD) using coronary computed tomography angiography (cCTA). Purpose This study sought to determine the effect of adding FFRCT and stress-CTP to cCTA alone for assessment of lesion severity and patient management of patients referred for chest pain. Methods 289 patients with stable chest pain scheduled for clinically indicated invasive coronary angiography (ICA) plus invasive FFR were evaluated with cCTA, FFRCT, and stress-CTP. Of 289 patients, 147 underwent static stress-CTP, while 142 were evaluated with dynamic stress-CTP. Management plan with optimal medical therapy (OMT) or percutaneous coronary intervention (PCI) for each patient according to results of each non-invasive technique was recorded, and then compared to what effectively applied according to results of reference standard technique (ICA + FFR). The primary endpoints for the study were the correct allocation of patients to OMT or PCI using cCTA, cCTA + FFRCT and cCTA + stress-CTP, and the correct assessment of non-invasive techniques for all three vessels in relation to angiographically and FFR-defined significance. Results Compared to cCTA alone, the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to OMT from 24% to 38% and 44%, respectively, while the addition of FFRCT and stress-CTP to cCTA alone increased the agreement in allocating patients to PCI from 29% to 32% and 36%, respectively. Using ICA + FFR as standard reference, cCTA showed agreement for all three vessels in 56% of patients, while combined approaches of cCTA + FFRCT and cCTA + stress-CTP showed agreement in 66% and 82% of patients, respectively. Conclusions The addition of functional assessment with FFRCT or Stress-CTP to cCTA has a substantial effect on the evaluation of the relevance of coronary artery disease and therefore on the management of patients compared to cCTA alone.

Integration Between Computed Tomography and Nuclear Medicine for Non-invasive Assessment of Coronary Anatomy and Myocardial Perfusion

2009 ◽  
Vol 5 (2) ◽  
pp. 15
Author(s):  
Wanda Acampa ◽  
Mario Petretta ◽  
Carmela Nappi ◽  
Alberto Cuocolo ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Myocardial Perfusion ◽  
Myocardial Blood Flow ◽  
Imaging Techniques ◽  
Emission Computed Tomography ◽  
Coronary Anatomy ◽  
Non Invasive

Many non-invasive imaging techniques are available for the evaluation of patients with known or suspected coronary heart disease. Among these, computed-tomography-based techniques allow the quantification of coronary atherosclerotic calcium and non-invasive imaging of coronary arteries, whereas nuclear cardiology is the most widely used non-invasive approach for the assessment of myocardial perfusion. The available single-photon-emission computed tomography flow agents are characterised by a cardiac uptake proportional to myocardial blood flow. In addition, different positron emission tomography tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. Extensive research is being performed in the development of non-invasive coronary angiography and myocardial perfusion imaging using cardiac magnetic resonance. Finally, new multimodality imaging systems have recently been developed bringing together anatomical and functional information. This article provides a description of the available non-invasive imaging techniques in the assessment of coronary anatomy and myocardial perfusion in patients with known or suspected coronary heart disease.

scholarly journals Cardiac Computed Tomography Radiomics for the Non-Invasive Assessment of Coronary Inflammation

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 879
Author(s):  
Kevin Cheng ◽  
Andrew Lin ◽  
Jeremy Yuvaraj ◽  
Stephen J. Nicholls ◽  
Dennis T.L. Wong
Keyword(s):  
Cardiac Computed Tomography ◽  
Quantitative Information ◽  
Imaging Biomarkers ◽  
Great Promise ◽  
Non Invasive ◽  
Quantitative Image ◽  
Artery Disease ◽  
Therapeutic Decision Making ◽  
Underlying Pathophysiology

Radiomics, via the extraction of quantitative information from conventional radiologic images, can identify imperceptible imaging biomarkers that can advance the characterization of coronary plaques and the surrounding adipose tissue. Such an approach can unravel the underlying pathophysiology of atherosclerosis which has the potential to aid diagnostic, prognostic and, therapeutic decision making. Several studies have demonstrated that radiomic analysis can characterize coronary atherosclerotic plaques with a level of accuracy comparable, if not superior, to current conventional qualitative and quantitative image analysis. While there are many milestones still to be reached before radiomics can be integrated into current clinical practice, such techniques hold great promise for improving the imaging phenotyping of coronary artery disease.

Diagnostic Imaging Techniques

2017 ◽  
Author(s):  
Gerald W. Staton Jr ◽  
Phuong-Anh T. Duong
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Diagnostic Imaging ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Chest Radiographs ◽  
Medical Community ◽  
Multidetector Row Computed Tomography ◽  
Resonance Imaging

Chest imaging techniques are evolving with recent advances in computed tomography, magnetic resonance imaging, and ultrasonography. While conventional radiography remains an important screening tool because of its low relative cost, ease of acquisition, general availability, and familiarity, physicians must understand all techniques so as to provide patients with the most appropriate diagnostic imaging. Consultation with radiologists, use of online clinical decision support, and adherence to national guidelines such as the American College of Radiology Appropriateness Criteria®, can help clinicians make imaging decisions, especially in light of medical imaging risks that are of concern in the medical community and the general population. Choosing appropriate imaging, including whether or not to image, requires careful consideration. This review contains 6 figures, 3 tables, and 6 references. Key Words: Chest Radiographs, Dual-Energy Chest Radiographs, Computed Tomography, High-Resolution Chest Computed Tomography, Multidetector Row Computed Tomography, Computed Tomographic Angiography for Pulmonary Embolism, Magnetic Resonance Imaging, Single-Photon Emission Tomography (SPECT), Ultrasonography 

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