Nuclear Cardiology in Women and Underrepresented Minority Populations

Bullock‐Palmer, Renee P.; Peix, Amalia; Aggarwal, Niti R.

doi:10.1007/s11886-022-01673-w

Cited by 3 publications

(11 citation statements)

References 112 publications

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“…14 Currently, the majority of imaging protocols are developed for the general patient population, and to the best of our knowledge few studies have been conducted on improving medical imaging outcomes specifically focused on patients who may be clinically underrepresented. 31 Our findings thus motivate research on approaches to design optimal patient-specific acquisition and reconstruction protocols for other clinically underrepresented subgroups. This early-stage study has several limitations.…”

Section: Conclusion and Discussionmentioning

confidence: 76%

Can patient-specific acquisition protocol improve performance on defect detection task in myocardial perfusion SPECT?

Choi,

Rahman,

et al. 2024

Medical Imaging 2024: Image Perception, Observer Performance, and Technology Assessment

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Myocardial perfusion imaging using single-photon emission computed tomography (SPECT), or myocardial perfusion SPECT (MPS) is a widely used clinical imaging modality for the diagnosis of coronary artery disease. Current clinical protocols for acquiring and reconstructing MPS images are similar for most patients. However, for patients with outlier anatomical characteristics, such as large breasts, images acquired using conventional protocols are often sub-optimal in quality, leading to degraded diagnostic accuracy. Solutions to improve image quality for these patients outside of increased dose or total acquisition time remain challenging. Thus, there is an important need for new methodologies that can help improve the quality of the acquired images for such patients, in terms of the ability to detect myocardial perfusion defects. One approach to improving this performance is adapting the image acquisition protocol specific to each patient. Studies have shown that in MPS, different projection angles usually contain varying amounts of information for the detection task. However, current clinical protocols spend the same time at each projection angle. In this work, we evaluated whether an acquisition protocol that is optimized for each patient could improve performance on the task of defect detection on reconstructed images for patients with outlier anatomical characteristics. For this study, we first designed and implemented a personalized patient-specific protocol-optimization strategy, which we term precision SPECT (PRESPECT). This strategy integrates the theory of ideal observers with the constraints of tomographic reconstruction to optimize the acquisition time for each projection view, such that performance on the task of detecting myocardial perfusion defects is maximized. We performed a clinically realistic simulation study on patients with outlier anatomies on the task of detecting perfusion defects on various realizations of low-dose scans by an anthropomorphic channelized Hotelling observer. Our results show that using PRESPECT led to improved performance on the defect detection task for the considered patients. These results provide evidence that personalization of MPS acquisition protocol has the potential to improve defect detection performance on reconstructed images by anthropomorphic observers for patients with outlier anatomical characteristics. Thus, our findings motivate further research to design optimal patient-specific acquisition and reconstruction protocols for MPS, as well as developing similar approaches for other medical imaging modalities.

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Section: Conclusion and Discussionmentioning

confidence: 76%

Can patient-specific acquisition protocol improve performance on defect detection task in myocardial perfusion SPECT?

Choi,

Rahman,

et al. 2024

Medical Imaging 2024: Image Perception, Observer Performance, and Technology Assessment

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“…79,142,143 É o estudo de imagem não invasivo mais comumente empregado na avaliação de mulheres com risco intermediário-alto de DIC e sintomas isquêmicos estáveis. 141 Um mesmo exame traz informações sobre a extensão e a gravidade das anormalidades de perfusão, a motilidade das paredes miocárdicas, a FEVE e o sincronismo intraventricular em repouso e após estresse. 79,142,143 O déficit perfusional total e a extensão dos defeitos de perfusão podem ser calculados, sendo parâmetros objetivos da carga isquêmica e do miocárdio em risco, que facilitam a definição de conduta e o acompanhamento terapêutico.…”

Section: Medicina Nuclearunclassified

“…104 As novas gama-câmaras CZT também têm mostrado resultados promissores na avaliação de RFC pela técnica SPECT, sendo uma promessa para maior disponibilidade da avaliação da disfunção microvascular coronariana em regiões onde a técnica PET não está disponível. 141,142 A RFC anormal está também associada à disfunção diastólica. Um estudo recente com 64,7% de mulheres sem DIC obstrutiva mostrou uma associação independente de redução da RFC (definida como < 2) e disfunção diastólica, bem como aumento de eventos cardiovasculares ou ICFEp.…”

Section: Medicina Nuclearunclassified

“…A imagem nuclear consegue avaliar todo o espectro da DIC, desde DIC epicárdica obstrutiva até disfunção microvascular coronariana. 141 Diretrizes nacionais e internacionais enfatizam, na avaliação da DIC, o uso da CPM, que pode ser realizada em todos os pacientes, independentemente de função renal, presença de arritmias, obesidade ou dispositivos intracardíacos. 79 , 142 As técnicas empregadas são SPECT e PET.…”

Section: Diagnóstico Por Imagem Cardiovascular Não Invasivaunclassified

“… 79 , 142 , 143 É o estudo de imagem não invasivo mais comumente empregado na avaliação de mulheres com risco intermediário-alto de DIC e sintomas isquêmicos estáveis. 141 …”

Section: Diagnóstico Por Imagem Cardiovascular Não Invasivaunclassified

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Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

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et al. 2023

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Cardiac Imaging in Women with Ischemic Heart Disease

Peix¹

2023

Life

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Cardiac diseases are the main cause of death for both sexes worldwide. Treatment varies widely according to the sex of a patient, as there are differences in physiopathology, epidemiology, clinical presentation and management. However, women have been largely excluded from research studies in this field. At present, differences are starting to be recognized and more attention is being paid to the identification of female-specific (or emergent) atherosclerotic risk factors. Diagnostic testing also merits attention because cardiac imaging offers important information to help diagnosis and guide cardiac disease management. In this sense, multimodal imaging should be used with the most cost-effective approach, integrating this information into the clinical sphere according to the pretest probability of the disease. In this review, we address sex-specific features of ischemic heart disease that should be considered in the clinical assessment of women, as well as the value of different imaging techniques (including technical and clinical aspects) for management of women with ischemic heart disease, and identify future areas of action concerning ischemic heart disease in women.

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Nuclear Cardiology in Women and Underrepresented Minority Populations

Cited by 3 publications

References 112 publications

Can patient-specific acquisition protocol improve performance on defect detection task in myocardial perfusion SPECT?

Can patient-specific acquisition protocol improve performance on defect detection task in myocardial perfusion SPECT?

Posicionamento sobre Doença Isquêmica do Coração – A Mulher no Centro do Cuidado – 2023

Cardiac Imaging in Women with Ischemic Heart Disease

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