Myocardial perfusion SPECT and SPECT/CT in interventional cardiology

Abstract

Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) is an important and widely used non-invasive imaging test for the diagnosis and semiquantification of myocardial ischemia. SPECT data, acquired after a stress test and at rest on a gamma camera, shows left ventricular tracer uptake during stress and at rest. The tracer distributions are proportionate to the relative, regional coronary-flow distributions, respectively. A stress-induced perfusion defect reflects myocardial ischemia, while a permanent defect, unchanged from stress to rest, indicates myocardial infarction. By ECG-gating global and regional left ventricular function can also be assessed. The three most important indications for SPECT in the setting of interventional cardiology include (1) the diagnosis of coronary artery disease in intermediate-risk patients, (2) the assessment of ischemia in patients with prior successful revascularization and recurrence of symptoms, and (3) the diagnosis of acute coronary syndrome in the emergency department. The amount of ischemia is related to the outcome of patients undergoing revascularization. It was observed that patients with an ischemic area of <10% of the left ventricle demonstrated by SPECT benefit from staying on optimal medical therapy, whereas patients with more ischemia on SPECT benefit from revascularization. Guidelines and appropriate use criteria for the indications of SPECT in relation to interventional cardiology have been published by the European Society and American College of Cardiology.Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/ 6463499/Activity.aspx

Sidik Perfusi Miokard SPECT/CT Pada Pasien Dekstrokardia Dengan Dugaan Penyakit Arteri Koroner

“…25 Aplikasi CT pada pemerik saan SPM selain untuk koreksi atenuasi, dapat juga digunakan untuk mendapatkan informasi anatomi dan penilaian skor kalsium pada ar teri koroner. 26,27 Pemeriksaan SPM SPECT/CT meng gunakan protokol standar. Karena terdapat dugaan dekstrokardia pada pasien ini, terjadi perubahan pada gambaran dinding ventrikel.…”

PET Tracers for Imaging Cardiac Function in Cardio-oncology

“…1). Assessment of myocardial perfusion using single photon computed tomography (SPECT) is now routine [34], but the proliferation of cameras for positron emission tomography (PET) as well as probes labeled with shortlived radioisotopes that can be incorporated into substrates or substrate analogues of numerous biological pathways make this technology a viable tool for cardio-oncology [35,36]. In comparison to SPECT imaging, PET imaging benefits from higher count sensitivity, robust attenuation correction, and enhanced anatomical information via hybrid PET/CT and PET/MRI devices [35].…”

Myocardial perfusion imaging in the era of COVID-19: a systematic review

“…Major indications of using myocardial SPECT are diagnosing coronary artery disease (CAD), risk stratification in patients with known CAD or after myocardial infarction or before non-cardiac surgeries, and assessment of intervention and myocardial viability before bypass or percutaneous surgery [ 12 ]. It can also diagnose ACS in emergency departments, assess ischemia in patients who had successful revascularization but had a recurrence of symptoms [ 13 ], and evaluate dyspnea with a possible cardiovascular cause [ 14 ]. MPI can be utilized to assess cardiovascular damage in COVID-19 or, as indicated before the pandemic, for non-COVID patients [ 15 ].…”