By D. R. Elmaleh, E. E. van der Wall, E. Livni (auth.), E. E. van der Wall (eds.)
F.J.Th. WACKERS Metabolic imaging: the way forward for cardiovascular nuclear imaging? when you consider that cardiovascular nuclear imaging emerged as a brand new subspecialty within the mid-1970s, the sphere has undergone an explosive development. Radionuclide strategies turned comfortably well-known as vital new diagnostic aids within the armamentarium of the medical heart specialist. at the start, cardiovascular nuclear imaging thinking about static myocardial imaging utilizing both thallium-201 or technetium-99m-pyrophosphate for diagnosing acute myocardial infarction. presently thereafter, multigated equilibrium radionuclide angiocardiography turned the main customary noninvasive strategy for assessing cardiac functionality. moreover, cognizance and medical program shifted in the direction of using radionuclide suggestions at the side of workout trying out, both with thallium-20 1 myocardial perfusion imaging or technetium-99m left ventricular functionality experiences. the way forward for cardiovascular nuclear imaging seemed fascinating and promising. notwithstanding, round 1980 pessimists estimated the untimely death of cardiovascular nuclear imaging with the creation of electronic subtraction angiography and nuclear magnetic resonance imaging. those doomsayers were confirmed unsuitable: in 1985 cardiovascular nuclear imaging is flourishing and, in lots of facilities, even increasing. even supposing electronic substraction angiography and magnetic resonance imaging supplied beautiful anatomic element, for functional review of sufferers with ischemic middle illness - within the Coronary Care Unit or workout laboratory - nuclear options seemed to be extra practical.
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Extra resources for Noninvasive Imaging of Cardiac Metabolism: Single Photon Scintigraphy, Positron Emission Tomography and Nuclear Magnetic Resonance
Example text
Other reports indicate that the technique has a low level of sensitivity and specificity. Several cases showed diffuse patterns of radionuclide activity and residual blood pool activity, which may be falsely interpreted as myocardial necrosis [173-181]. For differentiating myocardial uptake from persistent blood pool activity, single photon computed tomography with 99mTc_pyp showed some clinical advantages. There was improved detection and localization of myocardial infarction. Several other 99mTc labeled agents such as 99mTc MDP and 99mTc EHDP have been tested and found to localize in zones of acute necrosis.
The metabolic fate of BMHA and palmitic acid was studied in mice. The animals were sacrified 5, 15,30 and 60 min after the injection of 5-10 mCi of either acid. The heart and blood were extracted. The organic phase of the extract was analyzed by TLC for triglycerides (TG), diglycerides (DG), free fatty acids (FFA), monoglycerides (MG) and polar lipids (PL) (Table 5). The distribution of the label between the organic (0), aqueous (A) and insoluble tissue (T) of the heart was measured (Table 6). The data in Tables 5 en 6 show Table 4.
Techniques such as a ratio image of metabolism to perfusion should give an indication of the regional and total myocardial behavior. The association or dissociation of metabolism and flow should be indicative of tissue abnormalities or degree of viability. Therefore the availability of radionuclides such as 123 1 uncontaminated with 1241 is very important to the future of nuclear cardiology and nuclear medicine. Of additional interest is the use of very short half-life radionuclides for first pass studies.