Nuclear Cardiology

Nuclear medicine procedures have been widely used for evaluating myocardial blood flow, metabolism and function. In ischemic heart diseases, informations of perfusion and metabolism are very important for the diagnosis and management of patients, as well as coronary anatomy detected by coronary arteriography. The nuclear medicine has also been applied to various types of the primary and secondary cardiomyopathies. The following radiopharmaceuticals are available in Japan at present.

• Myocardial perfusion, ischemia, coronary flow reserve by stress: Tl-201, Tc-99m MIBI, Tc-99m tetrofosmin
• Fatty acid metabolism: I-123 BMIPP (beta-methyl branched fatty acid)
• Sympathetic integrity and function: I-123 MIBG (meta-iodo-benzyl guanidine)
• Injured myocardium: Tc-99m pyrophosphate and In-111 anti-myosin antibody
• Cardiac contraction and hemodynamics: Tc-99m labeled red blood cell
• Inflammation: Ga-67 citrate, In-111 labeled white blood cell

Our research activity includes: (1992-)

the quantification by SPECT, myocardial viability assessment, estimation of right ventricular overload in children with congenital heart diseases, ambulatory monitoring of cardiac function (VEST), metabolic imaging of coronary artery disease, sympathetic imaging and metabolism in hypertrophic cardiomyopathy, etc.

Recently published cardiac works by our colleagues follow.

• A simulation of dynamic SPECT using radiopharmaceutical with rapid clearance. J Nucl Med 1992; 33: 1200-1206
• High-resolution cardiac SPET study using fan-beam collimators in infants. Nucl Med Commun 1992; 13: 604-608
• Application of a continuous ventricular function monitor with miniature cadmium telluride detector to patients with coronary artery bypass grafting. J Nucl Med 1992; 33: 441-447
• Myocardial perfusion imaging and dynamic analysis with technetium-99m tetrofosmin. J Nucl Med 1993; 34: 1478-1484
• 123I-labelled BMIPP fatty acid myocardial scintigraphy in patients with hypertrophic cardiomyopathy: SPECT comparison with stress 201Tl. Nucl Med Commun 1993; 14:181-188
• Regional uptake of iodine-125-metaiodobenzylguanidine in the rat heart. Eur J Nucl Med 1993; 20:1104-1107
• Left ventricular dysfunction during exercise in patients with angina pectoris and angiographically normal coronary arteries (syndrome X). Eur J Nucl Med 1994; 21:98-102
• Decreased 123I-MIBG uptake and increased clearance in various cardiac diseases. Nucl Med Commun 1994; 15: 317-323
• Twenty-four hour quantitative thallium imaging for predicting beneficial revascularization. Eur J Nucl Med 1994; 21: 1212-1217
• Comparison of 99mTc pyrophosphate, 201Tl, perfusion, 123I-labelled methyl-branched fatty acid and sympathetic imaging in acute coronary syndrome. Nucl Med Commun 1995; 16: 494-503
• Comparison of 99mTc-sestamibi and 201Tl-chloride to estimate right ventricular overload in children. Nucl Med Commun 1995; 16: 936-941
• Utility of iodine-123-BMIPP in the diagnosis and follow-up of vasospastic angina. J Nucl Med 1995; 36: 1934-1940
• Impairment of regional fatty acid uptake in relation to wall motion and thallium-201 uptake in ischaemic but viable myocardium: assessment with iodine-123-labelled beta-methyl-branched fatty acid. Eur J Nucl Med 1995; 22: 1385-1392
• Comparison of defect size between thallium-201 and technetium-99m tetrofosmin myocardial single-photon emission computed tomography in patients with single-vessel coronary artery disease. Am J Cardiol 1996; 77: 350-354
• Impaired fatty acid uptake in ischemic but viable myocardium identified by thallium-201 reinjection. Am Heart J 1996; 131: 458-465
• Absent myocardial I-123 BMIPP uptake in a family. Ann Nucl Med 1996; 10:445-448
• Functional imaging of gated Tc-99m tetrofosmin study as a simple method to quantify ventricular wall motion. Ann Nucl Med (in press)
• Others

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