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Stress Protocol and Myocardial Perfusion Imaging Accuracy

  • Cardiac Nuclear Imaging (A Cuocolo and M Petretta, Section Editors)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To evaluate the most recent evolutions in the field of single photon emission computed tomography (SPECT) nuclear cardiac imaging (NCI), particularly regarding the influence of stress protocol specifics on test accuracy.

Recent Findings

The substantial improvement in both software and hardware SPECT settings may allow a drastic redefinition of the acquisition parameters, with a radical reduction of scanning time. Moreover, recent evidence has identified novel (contra)-indications to the different cardiac stressors, defining the categories of patients in which a specific stressor is most appropriate.

Summary

Whilst exercise stress is favoured in the majority of patients submitted to SPECT NCI, in patients with atrial fibrillation or diabetes mellitus, a vasodilator stress may be preferred because of a significantly higher specificity. Moreover, the use of non-perfusion variables, such as post-stress diastolic left ventricular parameters or eccentricity index, is favoured to increase the accuracy of SPECT imaging. Finally, the quantification of myocardial blood flow through dynamic scans with cadmium-zinc-telluride cameras is gaining its way in clinical practice, possibly further increasing NCI accuracy in the most difficult patients.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Fondazione Toscana Gabriele Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy

    Alessia Gimelli

  2. Dipartimento di Patologia Chirurgica, Molecolare e dell’Area Critica, Università di Pisa, Pisa, Italy

    Riccardo Liga

Authors
  1. Alessia Gimelli
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  2. Riccardo Liga
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Correspondence to Alessia Gimelli.

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Alessia Gimelli and Riccardo Liga declare that they have no conflict of interest.

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This article is part of the Topical Collection on Cardiac Nuclear Imaging

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Gimelli, A., Liga, R. Stress Protocol and Myocardial Perfusion Imaging Accuracy. Curr Cardiovasc Imaging Rep 12, 2 (2019). https://doi.org/10.1007/s12410-019-9477-5

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