PET Scan Imaging Techniques

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What is the most frequently used coronary function imaging test in the UK and worldwide?

Magnetic Resonance Imaging (MRI)

Myocardial perfusion scintigraphy (MPS) (correct)

Computed Tomography (CT)

Echocardiography

What is the goal of this review?

To consider the expanding role of radionuclide imaging in cardiac imaging (correct)

To compare the strengths of different imaging techniques

To discuss the risks of MPS PET

To introduce a new cardiac imaging technique

What is the outcome of the second phase III trial of the MPS PET tracer?

Ongoing and promising (correct)

Completed and published

Not yet started

Discontinued due to safety concerns

What is a strength of radionuclide-based techniques in cardiac imaging?

Ability to provide quantification of myocardial perfusion in absolute terms Signup and view all the answers

What is a limitation of MPS PET?

Inability to quantify myocardial perfusion in absolute terms Signup and view all the answers

What is a potential application of radionuclide imaging in cardiac imaging?

Imaging myocardial inflammation or infection Signup and view all the answers

What did the echocardiography and CT scans reveal about the aortic root?

It appeared thickened Signup and view all the answers

What was unclear about the infection?

Whether it was on the valve and/or the ICD Signup and view all the answers

What does the figure show?

An initial FDG PET fused with CT in the coronal plane Signup and view all the answers

What is the function of the ICD?

To regulate heart rhythm Signup and view all the answers

What did the initial FDG PET-CT scan show?

Abnormal activity related to the valve and aortic root Signup and view all the answers

What did the subsequent PET-CT scan show?

Extension of the infection into the soft tissue Signup and view all the answers

What was confirmed on CT to be an abscess?

An abscess in the soft tissue around the left main coronary artery Signup and view all the answers

What cannot be excluded as a possibility?

Myocarditis Signup and view all the answers

What is the potential source of 18F-fluorodeoxyglucose accumulation in arterial atheroma?

Inflammatory macrophages Signup and view all the answers

Why is imaging FDG by PET in small coronary arteries challenging?

Because of the rapid movement of coronary arteries Signup and view all the answers

What is the advantage of using sodium 18F-fluoride and 68Ga-dotatate over FDG?

They do not require dietary manipulation Signup and view all the answers

What is the current direction of National Institute for Health and Care Excellence (NICE) guidance?

Towards anatomical assessment Signup and view all the answers

What is the target of 68Ga-dotatate?

Pro-inflammatory macrophages Signup and view all the answers

What was the main finding of the ISCHEMIA trial?

Initial medical therapy is as effective as routine coronary angiography Signup and view all the answers

What is the potential clinical role of 68Ga-dotatate and sodium 18F-fluoride?

Identifying inflammatory macrophages in atherosclerotic plaque Signup and view all the answers

What was a limitation of the ISCHEMIA trial?

It only included patients with mild symptoms Signup and view all the answers

Why is dietary manipulation necessary when using FDG?

To suppress physiological myocardial activity Signup and view all the answers

Why was the specificity of stress echocardiography in women low?

Because it is not good at detecting anatomically significant coronary stenosis Signup and view all the answers

What is the topic of assessment that has been developing for many years?

Myocardial viability and hibernation Signup and view all the answers

What is unclear about the ISCHEMIA trial results?

Whether the results apply to patients with more significant disease Signup and view all the answers

What is 68Ga-dotatate also a marker of?

Myocardial inflammation after myocardial infarction Signup and view all the answers

What was a trend observed in the ISCHEMIA trial?

Towards improved outcome in patients with more severe ischaemia Signup and view all the answers

What was a drawback of the routine invasive group in the ISCHEMIA trial?

It had a higher event rate due to intervention-related complications Signup and view all the answers

What was the initial benefit of the routine invasive group in the ISCHEMIA trial?

An early symptomatic benefit Signup and view all the answers

What is the characteristic of MRI in imaging amyloidosis?

It is unable to distinguish between AL and TTR amyloidosis Signup and view all the answers

What is the main purpose of bone-seeking tracers in amyloidosis?

To image the distribution of amyloid in TTR amyloidosis Signup and view all the answers

What is the name of the radionuclide tracers used to image the distribution of amyloid?

Both A and B Signup and view all the answers

What is the significance of intense activity (grades 2 and 3) in diphosphonate or pyrophosphate imaging?

It perfectly distinguishes between AL and TTR cardiac amyloidosis Signup and view all the answers

What is the main advantage of nuclear cardiology in imaging amyloidosis?

It provides the most common imaging test of myocardial perfusion Signup and view all the answers

What is the importance of Perugini et al's study in diphosphonate or pyrophosphate imaging?

It described a system of grading myocardial activity by comparison with bone Signup and view all the answers

What is the limitation of MRI in imaging cardiac amyloidosis?

It cannot distinguish between AL and TTR cardiac amyloidosis Signup and view all the answers

What is the significance of 3,3-diphosphonopropano-1,2-dicarboxylic acid in imaging amyloidosis?

It is a bone-seeking tracer used for TTR amyloidosis Signup and view all the answers