99. Nuclear and Multimodality Imaging: Coronary Ischemia

CardioNerdAmit Goyalis joined byDr. Erika Hutt(Cleveland Clinic general cardiology fellow),Dr. Aldo Schenone(Brighamand Women’s advanced cardiovascular imaging fellow), andDr. Wael Jaber(Cleveland Cliniccardiovascular imaging staffand co-founder ofCardiac Imaging Agora) to discuss nuclear and complimentary multimodality cardiovascular imaging for the evaluation of coronary ischemia.Show notes were created by Dr. Hussain Khalid(University of Florida general cardiology fellow andCardioNerdsAcademy fellow in House Thomas).To learn more about multimodality cardiovascular imaging, check outCardiac Imaging Agora!

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Show Notes & Take Home Pearls

Five Take Home Pearls

1. We can broadly differentiate non-invasive testing into two different categories—functional and anatomical. Functional tests allow us to delineate the functional consequence of coronary disease rather than directly characterizing the burden of disease. Anatomical tests such as coronary CTA, on the other hand, allow us to directly visualize obstructive epicardial disease.

2. In general PET imaging provides higher quality images than SPECT imaging for a variety of reasons, including a higher “keV” of energy in PET radiotracers

3. If using a SPECT camera, we should use cameras that have attenuation correction. Without attenuation correction, the specificity of a SPECT camera drops to 50-60%.

4. In evaluating ischemic heart disease, cardiac nuclear imaging can provide a wide range of information including myocardial perfusion (rest and stress), ejection fraction assessment (rest and stress),