RT Book, Section
A1 Hendel, Robert C.
A1 Desiderio, Michael C.
A1 Heller, Gary V.
A2 Heller, Gary V.
A2 Hendel, Robert C.
SR Print(0)
ID 1190157355
T1 Nuclear Cardiovascular Imaging in Special Populations
T2 Nuclear Cardiology: Practical Applications, 4e
YR 2022
FD 2022
PB McGraw Hill LLC
PP New York, NY
SN 9781264257201
LK accesscardiology.mhmedical.com/content.aspx?aid=1190157355
RD 2023/12/09
AB KEY  POINTSThere  is  abundant  literature  support  for  nuclear  cardiac  imaging  in  specific  populations,  with  value  for  both  diagnosis  and  risk  stratification.Nuclear  cardiac  imaging  provides  important  diagnostic  and  risk  stratification  data  with  both  single-photon  emission  computed  tomography  (SPECT)  and  positron  emission  tomography  (PET)  myocardial  perfusion  imaging  (MPI),  while  abnormal  myocardial  blood  flow  (MBF)  assessment  identifies  microvascular  disease  with  independent  risk  of  coronary  events.Data  on  MBF  are  increasingly  important  in  specific  populations,  such  as  diabetics  and  women.In  diabetic  patients,  patients  with  normal  exercise  SPECT  carry  a  low  risk  of  coronary  events,  while  those  with  abnormal  MBF  are  at  the  highest  risk  of  events.Overall,  MPI  in  female  patients  provides  similar  diagnostic  and  risk  stratification  data  in  male  patients,  while  MBF  data  provide  further  risk  stratification  especially  in  nonobstructive  disease  states.Renal  failure  patients  are  at  high  risk  for  cardiac  events,  and  myocardial  perfusion  data  provide  important  risk  stratification.In  the  elderly  population,  exercise  testing  alone  does  not  provide  adequate  discrimination  between  normal  and  abnormal  results,  while  SPECT  and  PET  MPI  provide  incremental  prognostic  value.In  obese  patients,  the  use  of  attenuation  correction,  alternate  patient  positioning,  and  altered  radiopharmaceutical  dosing/protocols  is  recommended,  which  will  then  provide  similar  clinical  information  to  that  obtained  in  a  nonobese  population.