Molecular Imaging Insight - March 2008 - (Page 2) from the editor Editorial Advisory Board Diagnosing Heart Disease Diagnosing heart disease in women—the No. 1 cause of death of women across the globe—is sometimes difficult, but molecular PET and SPECT imaging is beginning to contribute to resolving this problem. This is quite necessary as women’s cardiac disease is frequently under-diagnosed—for instance, women who suffer a myocardial infarction are more likely to die from it than men with infarctions. Coronary disease detection using perfusion imaging in women is problematic due to erroneous underestimatenuation artifacts complicate image interpretation. PET/CT’s ability to correct for soft-tissue attenuation, and its excellent spatial and temporal resolution allows it to quantify blood flow in the various regions of the heart in units of ml/g/min. Using this approach, small vessel disease, common in women, can be diagnosed accurately. Quantification of myocardial perfusion, which is possible with PET, but not with SPECT, also provides an advantage for diagnosing multivessel disease. Changes in left ventricular ejection fraction from rest to peak stress, another marker of ischemia, can be measured. With SPECT/CT, appropriate soft-tissue attenuation correction is now possible— reducing the number of false positive findings. High-end CT systems combined with PET or SPECT can be used to assess the coronary morphology non-invasively (CT angiography). For those cardiologists who consider this meaningful, calcium scores also can be obtained. Thus, PET/CT with imaging probes such as 13N-ammonia or 82Rubidium can be used to accurately survey the coronary system in “at-risk” patients, in women who have traditionally been underserved by myocardial perfusion imaging, and in patients with known coronary artery disease. The effects of life-style or drug interventions can be monitored effectively. By providing such comprehensive assessments of cardiac function, PET/CT and SPECT/CT will improve the outcome of patients with heart disease. Johannes Czernin, MD Michael J. Fulham, MD Director, PET Unit, Royal Prince Alfred Hospital, and Clinical Associate Professor, University of Sydney, Australia Rodney J. Hicks, MD, FRACP Professor, Department of Medicine, the University of Melbourne, Director, Centre for Molecular Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia Stig A. Larsson, PhD Profressor, and Head of Department of Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden Homer Macapinlac, MD Chair of Nuclear Medicine, The University of Texas M.D. Anderson Cancer Center, Houston Donald Neumann, MD, PhD Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio Randolph Patterson, MD Director, Cardiovascular Imaging, Emory Crawford Long Hospital and Professor of Medicine, The Emory Clinic, Atlanta, Georgia Ron Petrocelli, MD CMO, Siemens Medical Solutions Molecular Imaging division, Hoffman Estates, Ill. Markus Schweiger, MD Technical University of Munich, Munich, Germany Nagara Tamaki, MD, PhD Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan David W. Townsend, PhD Professor of Medicine and Radiology, and Director of the Cancer Imaging and Tracer Development Program, The University of Tennessee School of Medicine, Knoxville tion of pre-test likelihood. In addition, technical problems such as breast tissue at- Johannes Czernin, MD Professor, Molecular & Medical Pharmacology Director, Nuclear Medicine Clinic, Positron Emission Tomography/Computed Tomography David Geffen School of Medicine at UCLA, Los Angeles, Calif. Molecular Imaging Insight | March 2008 MolecularImaging.net http://MolecularImaging.net
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