American society of nuclear cardiology and society of nuclear medicine joint position statement

Despite advancements in technologies, non-uniform soft tissue attenuation still affects the diagnostic accuracy of single photon emission computed tomography (SPECT) myocardial perfusion imaging. A variety of indirect measures have been used to reduce the impact of attenuation, most notably electrocardiography-gated SPECT imaging. However, all available techniques have limitations, making interpretation in the presence of attenuation difficult. The ultimate solution, similar to positron emission tomography imaging, is to use hardware/software algorithms to eliminate attenuation and provide images that are more uniform and easier to interpret. Several attenuation correction solutions are currently available and more will be available soon. The value of these solutions has been varied, particularly with clinical applications. Guidelines and standards clearly are necessary. In recognition of the importance of this issue, the American Society of Nuclear Cardiology and the Society of Nuclear Medicine convened a joint task force to develop a position statement on attenuation correction. It is being published concurrently in the Journal of Nuclear Cardiology and The Journal of Nuclear Medicine, a first for these societies.     

Journal of nuclear cardiology,industry, and the american society of nuclear cardiology

Journal of Nuclear Cardiology -     

Methods and clinical applications in nuclear cardiology: a position statement

Nuclear cardiological procedures have paved the way for non-invasive diagnostics of various partial functions of the heart. Many of these functions cannot be visualised for diagnosis by any other method (e.g. innervation). These techniques supplement morphological diagnosis with regard to treatment planning and monitoring. Furthermore, they possess considerable prognostic relevance, an increasingly important issue in clinical medicine today, not least in view of the cost-benefit ratio. Our current understanding shows that effective, targeted nuclear cardiology diagnosis--in particular for high-risk patients--can contribute toward cost savings while improving the quality of diagnostic and therapeutic measures. In the future, nuclear cardiology will have to withstand mounting competition from other imaging techniques (magnetic resonance imaging, electron beam tomography, multislice computed tomography). The continuing development of these methods increasingly enables measurement of functional aspects of the heart. Nuclear radiology methods will probably develop in the direction of molecular imaging.     

American society of nuclear cardiology position statement on electrocardiographic gating of myocardial perfusion SPECT scintigrams

Conclusion  In heart transplant recipients with isolated focal CAD involving the proximal or mid portion of a vessel, revascularization options exist. However, because of the increased risk of the procedure and uncertain impact on outcome, it probably is important to document evidence of provokable ischemia, especially if the patient is symptom free. Stress myocardial perfusion imaging can document ischemia related to specific coronary artery lesions and may be an important adjunct to decision making in this difficult patient population. One of the most important recent developments in single photon emission computed tomography (SPECT) myocardial perfusion imaging is the ability to acquire these studies in conjunction with electrocardiogrpahic (ECG) gating. A recommendation for incorporating ECG gating as a routine during SPECT cardiac perfusion scintigraphy is appropriate for at least four reasons: there is extensive peer-reviewed literature attesting to its value; the practice is now widespread; practitioners in diverse settings (academia dn private practive) regularly use it; and the hardware and software requirements are widely available. In addition, ASNC-sponsored continuing medical education programs for the past several years have emphasized the added information provided by ECG gating. The purpose of this position statemetn therefore is to formally encourage routine ECG gating along with SPECT myocardial perusion studies, unless technical reasons preclude this. p ]Although the principleis clear-cut, there will need to be more investigations and, ultimately, procedural guidelines to assist in optimizing acquisition and processing parametes in relation to different hardware and radiopharmaceuticals. This is a first step in a new and expanding direction for myocardial perfusion scintigraphy. Timothy M. Bateman, MD President American Society of Nuclear Cardiology     

Advances in cardiac diagnosis: nuclear cardiology

Nuclear cardiology offers an exciting array of techniques to visualize the structure and measure the function of the heart. These techniques include thallium perfusion scanning, isotope angiocardiography, and myocardial infarct scanning. Accurate and clinically relevant diagnostic information is provided by these methods.     

Role of the technologist in nuclear cardiology

Conclusion  It is the responsibility of all technologists to maintain the level of quality and professionalism the field of nuclear cardiology demands. As health care continues to change and become more complex, it is important that we remain an integral part of the diagnostic process. Technologists need to stay informed and actively involved to ensure the institution they are working in is state of the art, allowing the performance of the most upto-date procedures, and that these procedures are performed with the highest level of quality. The ASNC and the editorial staff at the Journal of Nuclear Cardiology support the addition of this Technologist Section to the Journal. It is our goal as coeditors to use these pages to bring valuable information about our field to the technologists who would otherwise not be receiving it and to encourage all technologists practicing nuclear cardiology to be involved in its success. We will strive to bring you the issues that are concerning technologists today in all aspects of nuclear cardiology. We hope that all technologists will be as interested as we are in maintaining the level of professionalism and respect that our predecessors worked so hard to achieve. We welcome your input. If you are a technologist practicing nuclear cardiology and are interested in writing an article, reviewing articles from your peers, or suggesting topics to be covered, we encourage you to contact us through the editorial office of the Journal of Nuclear Cardiology.     

Design and implementation of a nuclear cardiology testing facility in a private-practice cardiology office setting

Nuclear cardiology services increasingly are being provided in private-practice cardiology office settings. Because training programs are hospital based, trainees in nuclear cardiology may find only limited guidance on how to set up a private-practice nuclear laboratory. Furthermore, there is no literature to date advancing “models” for such facilities that might be useful for practice managers. The purpose of this review is to address common issues related to setting up and administering a nuclear cardiology, laboratory in a private-practice cardiology office.     

Advances in nuclear cardiology: Preoperative risk stratification

Summary  Preoperative stress MPI can be used in concert with clinical data to identify low-risk patients who can go on to undergo planned noncardiac surgery. It can also identify high-risk patients, providing an opportunity to ameliorate this risk. Studies suggest that medical and revascularization interventions can reduce the perioperative risk in patients identified as high risk by stress MPI and that early and late outcome is improved when such preoperative testing is used.