Myocardial perfusion SPECT imaging, a practical guide
UNI-MED (Verlag)
978-3-8374-1263-5 (ISBN)
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The handbook guides you through the field of routine myocardial SPECT and
- covers the physiological basis of perfusion imaging
- includes the appropriate use criteria of myocardial perfusion imaging depicted with flowcharts
- describes the current stress modalities, radiopharma-ceuticals and imaging protocols
- features a comprehensive overview on gated SPECT imaging
- shows the basis and impact of attenuation correction
- provides core information about diagnostic accuracy, risk assessment and prognosis
- reveals the impact of SPECT imaging on treatment decision
- highlights the features of left bundle branch block on imaging
- deals with the value of SPECT imaging in women and diabetics
- includes a checklist for systematic reporting.
1.Introduction12
1.1.Technical and clinical development12
1.2.Myocardial perfusion scintigraphy in Europe13
1.3.Non-invasive imaging in coronary artery disease14
2.Fundamentals of CAD and imaging18
2.1.Coronary artery disease18
2.2.Coronary stenoses and perfusion19
2.3.Principle of myocardial perfusion scintigraphy20
3.Indications for myocardial perfusion scintigraphy24
3.1.Preliminary remarks24
3.2.Imaging procedures in CAD diagnosis24
3.3.Indications on trial – Appropriate Use Criteria27
3.4.Acute coronary syndrome (ACS)31
3.5.Assessment of viability32
4.Performing myocardial perfusion SPECT38
4.1.Preparatory measures38
4.1.1.Instruction and patient information38
4.1.2.Patient preparation38
4.1.3.Before getting started38
4.2.Stress testing39
4.2.1.Exercise stress41
4.2.2.Pharmacological stress43
4.2.2.1.Vasodilators (adenosine and dipyridamole)43
4.2.2.2.Side effects of adenosine and dipyridamole44
4.2.2.3.Digression: Ischaemia under adenosine or dipyridamole46
4.2.2.4.Combining adenosine or dipyridamole with exercise47
4.2.2.5.Catecholamines (dobutamine)47
4.2.2.6.New developments: selective A2a adenosine receptor agonists48
4.3.Radiopharmaceuticals48
4.3.1.Thallium-20149
4.3.2.Tc-99m perfusion radiopharmaceuticals (sestamibi and tetrofosmin)51
4.3.3.Radiation exposure and recommended activities51
4.4.Imaging protocols51
4.4.1.Protocols for Tl-20151
4.4.2.Protocols for Tc-99m perfusion radiopharmaceuticals53
4.4.3.Hybrid protocols54
5.Acquisition technique56
5.1.Ungated SPECT56
5.1.1.Patient positioning56
5.1.2.Camera orbit56
5.1.3.Circular and non-circular orbits56
5.1.4.Pixel size and matrix size57
5.1.5.Step-and-shoot and continuous acquisition57
5.1.6.Number of projections57
5.1.7.Time per projection and total time57
5.2.Gated SPECT57
5.2.1.Basics – systole, diastole and gates57
5.2.2.How does gated SPECT work?57
5.2.3.Short, long and irregular heartbeats58
5.2.4.Acquisition strategies for gated SPECT59
5.2.5.Preparation for gated SPECT61
5.2.6.Gated SPECT acquisition protocols for a dual-head camera61
5.2.6.1.Acquisition protocol with acceptance window and extra files61
5.2.6.2.Acquisition protocol without extra files62
5.2.6.3.Tracking – following the heart rate62
5.2.6.4.Sampling with 8 or 16 gates63
5.2.6.5.Gated SPECT and extrasystoles64
5.2.6.6.Gated SPECT and absolute arrhythmia65
5.2.6.7.Gated SPECT with Tl-201 or Tc-99m radiopharmaceuticals65
5.2.6.8.Gated SPECT: prone or supine position?65
5.3.Attenuation and attenuation correction66
5.3.1.Physical basis66
5.3.2.Absorption problems66
5.3.3.Principle of attenuation correction and artefacts 67
5.3.4.Clinical value of attenuation correction69
6.Processing74
6.1.Raw data check74
6.2.Filtered back projection74
6.3.Iterative reconstruction76
6.4.Reorientation76
6.5.Evaluation of gated SPECT77
6.5.1.Quality control77
6.5.2.Display of results and normal values78
6.5.3.Digression: partial volume effect79
6.5.4.Accuracy of volumes and LVEF80
7.Gated SPECT – why and when?82
7.1.Motivation for gated SPECT82
7.2.Gated rest, gated stress – or both?83
7.3.Impact of gated SPECT on diagnosis85
8.Findings and documentation88
8.1.Image display88
8.2.Polar tomograms88
8.3.Bases of reporting89
8.4.Quantitative perfusion analysis90
8.5.Additional findings92
8.5.1.Transient ischaemic dilatation92
8.5.2.Lung-heart quotient93
9.Diagnostic accuracy of myocardial perfusion SPECT imaging96
9.1.Sensitivity, specificity, likelihood ratios96
9.2.The false-positive myocardial perfusion scan97
10.Risk assessment and prognosis100
10.1.Objective of risk stratification100
10.2.Cardiac risk categories100
10.3.Prognostic value of a normal study100
10.4.Prognostic value of an abnormal study102
10.5.Prognosis in high pretest CAD likelihood102
10.6.Incremental prognostic value of cardiac SPECT imaging103
10.7.Relationsship between ischaemia and infarction104
10.8.Added value of gated SPECT105
10.9.Digression: posttest referral bias in prognostic studies107
11.Myocardial perfusion imaging and treatment decisions110
11.1.Setting the course with the summed difference score110
11.2.Patient management112
12.Special patient groups116
12.1.Diabetes mellitus116
12.1.1.Diagnosis and risk stratification in diabetic patients116
12.1.2.Evaluation of the asymptomatic diabetic patient118
12.2.Women120
12.3.Left-bundle branch block122
13.Key elements of reporting126
14.References130
Index140
| Erscheint lt. Verlag | 10.10.2014 |
|---|---|
| Reihe/Serie | UNI-MED Science |
| Zusatzinfo | 174 illustrations |
| Sprache | englisch |
| Maße | 170 x 240 mm |
| Gewicht | 395 g |
| Einbandart | gebunden |
| Themenwelt | Medizin / Pharmazie ► Medizinische Fachgebiete |
| Schlagworte | Myokardperfusion • Szintigraphie |
| ISBN-10 | 3-8374-1263-6 / 3837412636 |
| ISBN-13 | 978-3-8374-1263-5 / 9783837412635 |
| Zustand | Neuware |
| Informationen gemäß Produktsicherheitsverordnung (GPSR) | |
| Haben Sie eine Frage zum Produkt? |
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