Molecular Imaging Insight - June 2008 - (Page 6)

Nuclear Medicine (Nov. 2006), deemed multislice CT and SPECT “complementary rather than overlapping” technologies in coronary artery disease detection. The authors concluded that “although a relationship exists between the severity of CAD on multislice CT and myocardial perfusion abnormalities on SPECT, analysis on a regional basis showed only moderate agreement between observed atherosclerosis and abnormal perfusion.” The Study of Myocardial Perfusion and Coronary Anatomy Imaging Roles in CAD (SPARC) multicenter trial currently underway (50 sites; 2,800+ patients enrolled; goal: 3,700) is seeking to define the clinical value of myocardial perfusion (stress SPECT, stress PET), CT coronary angiography (CTA) and combined myocardial perfusion-anatomy (PET/CT) imaging on post-test resource utilization. It also looks to determine the incremental prognostic value of stress SPECT, stress PET, CTA and PET/CT for predicting cardiac death and nonfatal myocardial infarction following a procedure. The Biostructure and Bioimaging Institute of the National Council of Research in Naples, Italy, utilized a literature-based review of different clinical applications of nuclear medicine procedures in cardiology. Their work, published in the Quarterly Journal of Nuclear Medicine (Dec. 2002), advocated specific instances for the utilization of cardiac molecular imaging. “Radionuclide imaging techniques appear to be appropriate in risk assessment, prognosis and evaluation of therapy in patients after myocardial infarction,” the authors wrote. “In patients with unstable angina, radionuclide testing is indicated in the identification of ischemia within the distribution of the ‘culprit’ lesion or in remote areas. Exercise and pharmacological cardiac perfusion imaging are appropriate and useful in the diagnosis and prognosis of chronic coronary artery disease. Nuclear medicine procedures are also useful in the assessment of myocardial viability in patients with left ventricular dysfunction, in the assessment of interventions for the evaluation of patients after percutaneous transluminal coronary angioplasty and coronary artery bypass grafting.” In 2006, Johannes Czernin, MD, and colleagues from the department of molecular and medical pharmacology in the Ahmanson Biological Imaging Clinic/Nuclear Medicine and David Geffen School of Medicine at the University of California, Los Angeles, performed a literature-based evidence review of improvements in cancer staging with PET/CT. Their findings, published in the Journal of Nuclear Medicine (Jan. 2007, supplement), determined that reliable evidence had emerged in support of the notion that PET/CT offers diagnostic advantages over its individual components for the major cancers. “Although the value of PET/CT over PET alone for treatment monitoring has yet to be determined, improvements in the staging and restaging accuracies of PET/CT over PET or CT alone for NOPR Delivers Evidence for Expanded PET Use in Oncology Imaging, cont’d “These data confirm what we have known for some time: molecular imaging is a powerful tool in diagnosing, treating, and monitoring disease and is capable of dramatically changing the course of patient care. For oncologists, we’re getting a much better idea of how to use this technology in patients with cancer.” SNM President Alexander J. McEwan, MD, professor and chair of the department of oncology, faculty of medicine, at the University of Alberta and director of oncologic imaging at Cross Cancer Institute in Edmonton, Canada included. In addition, the NOPR data revealed that for patients with a prePET plan of biopsy, the post-PET plan had a significant impact on care, with these patients avoiding biopsy in about 75 percent of the cases analyzed. NOPR working group co-chair R. Edward Coleman, MD, professor of radiology and chief of the division of nuclear medicine at Duke University School of Medicine in Durham, N.C., and study author, observed, “We were especially surprised by the impact of the PET findings on patients who were originally planned to have a biopsy.” Oncologist, NOPR working group co-chair and study author Anthony F. Shields, MD, professor of medicine and oncology at the Karmanos Cancer Institute at Wayne State University in Detroit and chair of ACRIN’s Oncology Committee said of the research findings, “These results confirm what we suspected from increasing experience with PET. However, we lacked the significant data required to prove the benefit of PET for many uncovered indications. It’s very encouraging that oncologists and other clinicians may have access to the valuable information PET affords for ensuring the best patient care.” “These data confirm what we have known for some time: molecular imaging is a powerful tool in diagnosing, treating, and monitoring disease and is capable of dramatically changing the course of patient care,” commented SNM President Alexander J. McEwan, MD, professor and chair of the department of oncology, Molecular Imaging Insight | June 2008 MolecularImaging.net http://MolecularImaging.net

Table of Contents Feed for the Digital Edition of Molecular Imaging Insight - June 2008

Molecular Imaging Insight - June 2008 Contents NOPR: A Landmark Study Cover Story: Evidence-based Medicine Points to Wider Role for Molecular Imaging in Patient Care NOPR Delivers Evidence for Expanded PET Use in Oncology Imaging The Balancing Act Nuclear Cardiology’s Next Step Molecular Imaging Training Gaining Traction SPECT/CT’s Role in Post-Transplant Infection Imaging Clinical Study Digest : Heart Disease & Metastatic Breast, Gastric and Head & Neck Cancer

Molecular Imaging Insight - June 2008

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