Browsing by Author "Bertagna, Francesco (25632102900)"

Background: Transient post-ischemic LV dysfunction due to myocardial stunning in patients with coronary artery disease can be missed by conventional gated SPECT (GSPECT) acquisitions. The aim of this IAEA-sponsored multi-center study was to determine whether early post-exercise imaging is more likely to detect stunning than conventional without adversely affecting image quality or perfusion information.; Methods and Results: Patients undergoing exercise/rest GSPECT were enrolled in this international multicenter study. Post-exercise studies were acquired at 15 ± 5 minutes after radiotracer injection (Stress-1) and repeated at 60 ± 15 minutes (Stress-2). Rest studies (R) were acquired at 60 minutes post injection. A core laboratory quantitatively assessed perfusion pattern and LV blinded to the acquisition time. Ischemia was defined as summed stress score (SDS) ≥4, and stunning was defined as the difference between rest and post-stress LVEF (Δ-LVEF). In the 229 patients enrolled into the study, both image quality and perfusion information were similar between Stress-1 and Stress-2. Post-stress LVEF was associated with both ischemia and time of acquisition, with a significant correlation between SDS and Δ-LVEF, which was stronger at Stress-1 than Stress-2 in the ischemic compared to the non-ischemic population (r = 0.23 vs 0.08, P = 0.10).; Conclusions: Early post-exercise imaging is feasible, and can potentially improve the detection of post-ischemic stunning without compromising image quality and perfusion data © 2014, American Society of Nuclear Cardiology.

Rationale and Objectives: To provide an updated evidence-based review of the literature on the role of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) or PET/computed tomography (PET/CT) in patients with sarcoidosis. Materials and Methods: A comprehensive literature search of PubMed/MEDLINE, Scopus, and Embase databases was conducted to find relevant published articles on FDG-PET or PET/CT in patients with sarcoidosis. Only those studies that satisfied all the following criteria were included: (1) FDG-PET or PET/CT performed in patients with histologically confirmed sarcoidosis, (2) sample size of at least 10 patients, and (3) whole-body PET studies performed. Information was collected concerning basic study, patient characteristics, and technical aspects. The main findings of the articles included have been described. Results: Reviewing titles and abstracts, 21 articles were selected. The role of FDG-PET or PET/CT was analyzed in assessing disease extent and activity and in treatment response evaluation. Comparison with other tracers had also been investigated. Recent studies evaluated the influence of these methods in the clinical management and their role as predictive tools in patients with sarcoidosis. Conclusions: FDG-PET and PET/CT seem to be useful in staging, evaluating disease activity, and monitoring treatment response in patients with sarcoidosis. PET appears to have higher diagnostic accuracy compared to Gallium-67-citrate scintigraphy. Conversely, there is not enough evidence about the use of other PET tracers in patients with sarcoidosis. FDG-PET and PET/CT seem to have a role as predictive tools and may influence the clinical management in patients with sarcoidosis, but more studies are needed in this regard. © 2014 AUR.