Nuclear cardiology

Section editor: Eli V. Gelfand, M.D. (Beth Israel Deaconess Medical Center, Harvard Medical School) [1]

General overview of Nuclear Cardiology

• Basic physical principles of single-photon emission computed tomography (SPECT)
• Basic physical principles of positron emission tomography (PET)
• Commonly used radiopharmaceuticals
• Selecting appropriate candidates for myocardial perfusion imaging
• Standard exercise stress protocols
• Standard pharmacologic stress protocols
• Imaging protocols
• Combining myocardial perfusion imaging with coronary CT
• Radionuclide angiography
• Molecular imaging and related novel technologies

Clinical use of stress myocardial perfusion imaging (MPI)

• ACCF/ASNC appropriateness criteria for SPECT-MPI (2005)
• ACC/AHA guidelines for cardiac radionuclide imaging (2003)

Coronary Disease

• Assessment of patients presenting with chest pain to the Emergency Department
• Detection of CAD
• Management, risk assessment and prognosis of patients with chronic CAD
• Detection of acute MI
• Risk assessment of patients following ST-elevation MI
• Risk assessment of patients following non-ST elevation acute coronary syndrome

Heart Failure

• Assessment of LV systolic function
• Assessment of etiology of heart failure
• Detection of CAD in patients with heart failure
• Determination of myocardial viability

Specific patient populations

• Patients with an “uninterpretable” resting ECG
• Elderly patients
• Asymptomatic patients with diabetes
• Patients following up after a coronary calcium screening
• Patients before and after coronary revascularization
• Patients undergoing elective noncardiac surgery

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