Skip to main content

Radionuclide Imaging of the Cardiovascular System

  • Conference paper
Imaging and Labelling Techniques in the Critically I11

Part of the book series: Current Concepts in Critical Care ((CRITICAL CARE))

  • 47 Accesses

Abstract

Nuclear cardiology involves the use of radiopharmaceuticals to obtain information about the heart. It differs from the majority of other investigative techniques in that it provides functional information, and although structure can be deduced, spatial resolution is poor and anatomy is not always well demonstrated. This does not limit its value, however, since cardiac function is not easily assessed by other noninvasive techniques. Most district general hospitals are now able to perform nuclear investigations, although not all have a mobile camera to study patients on the intensive care unit, and transfer to the nuclear medicine department may be necessary. Information is usually obtained during dynamic exercise as well as at rest, and although this may not always be possible with sick patients, a knowledge of the wide range of information that can be obtained is important in order to select investigations appropriately.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abouantoun S, Ahnve S, Savvides M, Witztum K, Jensen D, Froelicher V (1984) Can areas of myocardial ischaemia be localised by the exercise electrocardiogram? A correlative study with thallium-201 scintigraphy. Am Heart J 108: 933–941

    Article  CAS  PubMed  Google Scholar 

  • Ahmad M, Dubiel JP, Haiback H (1982) Cold pressor thallium-201 myocardial scintigraphy in the diagnosis of coronary artery disease. Am J Cardiol 50: 1253–1257

    Article  CAS  PubMed  Google Scholar 

  • Albro PC, Gould KL, Westcott RJ, Hamilton GW, Ritchie JL, Williams DL (1978) Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilatation. Ill Clinical trial. Am J Cardiol 42: 751–760

    Article  CAS  PubMed  Google Scholar 

  • Alderson PO (1982) Radionuclide quantification of valvular regurgitation. J Nucl Med 23: 851–855

    CAS  PubMed  Google Scholar 

  • Austin EH, Cobb FR, Coleman RE, Jones RH (1982) Prospective evaluation of radionuclide angiocardiography for the diagnosis of coronary artery disease. Am J Cardiol 50: 1212–1216

    Article  CAS  PubMed  Google Scholar 

  • Bacharach SL et al. (1977) ECG-gated scintillation probe measurement of left ventricular function. J Nucl Med 18: 1176–1173

    CAS  PubMed  Google Scholar 

  • Baker EJ, Ellam SV, Lorber A, Jones ODH, Tynan MJ, Maisey MN (1985) Superiority of radionuclide over oximetrie measurement of left to right shunts. Br Heart J 53: 535–540

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Bateman T, Garcia E, Maddahi J et al. (1983) Clinical evaluation of seven-pinhole tomography for the detection and localization of coronary artery disease: comparison with planar imaging using quantitative analysis of myocardial thallium-201 distribution and washout after exercise. Am Heart J 106: 263–271

    Article  CAS  PubMed  Google Scholar 

  • Becker LC (1980) Diagnosis of coronary artery disease with exercise radionuclide imaging: state of the art. Am J Cardiol 45: 1301–1304

    Article  CAS  PubMed  Google Scholar 

  • Beller GA (1984) Quantitative thallium-201 scintigraphy. Internat J Cardiol 5: 234–239

    Article  CAS  Google Scholar 

  • Berger BC, Watson DD, Taylor GJ et al. (1981) Quantitative thallium-201 exercise scintigraphy for detection of coronary artery disease. J Nucl Med 22: 585–593

    CAS  PubMed  Google Scholar 

  • Berger HJ, Reduto LA, Johnstone DE et al. (1979) Global and regional left ventricular response to bicycle exercise in coronary artery disease. Assessment by quantitative radionuclide angiocardiography. Am J Med 66: 13–21

    Article  CAS  PubMed  Google Scholar 

  • Bodenheimer MM, Banka VS, Fooshee CM, Gillespie JA, Helfant RH (1978) Detection of coronary heart disease using radionuclide determined regional ejection fraction at rest and during handgrip exercise: correlation with coronary arteriography. Circulation 58: 640–648

    Article  CAS  PubMed  Google Scholar 

  • Bodenheimer MM, Banka VS, Fooshee CM, Helfant RH (1979) Comparative sensitivity of the exercise electrocardiogram, thallium imaging and stress radionuclide angiography to detect the presence and severity of coronary heart disease. Circulation 60: 1270–1278

    Article  CAS  PubMed  Google Scholar 

  • Bonow RO, Green MV, Bacharach SL (1984a) Radionuclide angiography during exercise in patients with coronary artery disease: diagnostic, prognostic, and therapeutic implications. Internat J Cardiol 5: 229–233

    Article  CAS  Google Scholar 

  • Bonow RO, Kent KM, Rosing DR et al. (1984b) Exerciseinduced ischaemia in mildly symptomatic patients with coronary artery disease, and preserved left ventricular function: identification of subgroups at high risk for death during medical therapy. New Engl J Med 311: 1339–1345

    Article  CAS  PubMed  Google Scholar 

  • Borer JS, Bacharach SL, Green MV, Kent KM, Epstein SE, Johnston GS (1977) Real-time radionuclide cineangiography in the noninvasive evaluation of global and regional left ventricular function at rest and during exercise in patients with coronary artery disease. New Engl J Med 296: 839–844

    Article  CAS  PubMed  Google Scholar 

  • Borer JS, Kent KM, Bacharach SL et al. (1979) Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease. Comparison with exercise electrocardiography. Circulation 60: 572–580

    Article  CAS  PubMed  Google Scholar 

  • Brown KA, Boucher CA, Okada RD et al. (1983) Prognostic value of exercise thallium-201 imaging in patients presenting for evaluation of chest pain. J Am Coll Cardiol 1: 994–1001

    Article  CAS  PubMed  Google Scholar 

  • Burdine JA, DePuey EG, Orzan F, Mathur VS, Hall RJ (1979) Scintigraphic, electrocardiographic, and enzymatic diagnosis of perioperative myocardial infarction in patients undergoing myocardial revascularisation. J Nucl Med 20: 711–714

    CAS  PubMed  Google Scholar 

  • Burow RD, Pond M, Schafer AW, Becker L (1979) “Circumferential profiles:” a new method for computer analysis of thallium-201 myocardial perfusion images. J Nucl Med 20:771–777

    CAS  PubMed  Google Scholar 

  • Dymond DS, Elliot AT, Flatman W et al. (1983) The clinical validation of gold-195m: a new short half life radio pharmaceutical for rapid, sequential, first pass angiocardiography in patients. J Am Coll Cardiol 2: 85–92

    Article  CAS  PubMed  Google Scholar 

  • Fioretti P, Brower RW, Simoons ML et al. (1984). Prediction of mortality in hospital survivors of myocardial infarction. Comparison of predischarge exercise testing and radionuclide ventriculography at rest. Br Heart J 52: 292–298

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Francisco DA, Collins SM, Go RT, Ehrhardt JC, Van Kirk OC, Marcus ML (1982) Tomographic thallium-201 myocardial perfusion scintigrams after maximal coronary artery vasodilation with intravenous dipyridamole: comparison of qualitative and quantitative approaches. Circulation 66: 370–379

    Article  CAS  PubMed  Google Scholar 

  • Garcia E, Maddahi J, Berman D, Waxman A (1981) Space/time quantitation of thallium-201 myocardial scintigraphy. J Nucl Med 22: 309–317

    CAS  PubMed  Google Scholar 

  • Goris ML, Briandet PA, Huffer E (1979) Automation and operator independent data processing of cardiac and pulmonary functions: role, methods, and results. In: Di Paolo R, Kahn E (eds) Information processing in medical imaging. Proceedings of the 6th international conference. Paris: INSERM 88: 427–448

    Google Scholar 

  • Gould KL (1978) Noninvasive assessment of coronary stenosis by myocardial perfusion imaging during pharmacologic coronary vasodilatation. I Physiologic basis and experimental validation. Am J Cardiol 41: 267–278

    Article  CAS  PubMed  Google Scholar 

  • Gould KL, Westcott RJ, Albro PC, Hamilton GW (1978) Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilatation. II Clinical methodology and feasibility. Am J Cardiol 41: 279–287

    Google Scholar 

  • Iskandrian AS, Hakki A-H (1985a) Thallium-201 myocardial scintigraphy. Am Heart J 109: 113–129

    Article  CAS  PubMed  Google Scholar 

  • Iskandrian AS, Hakki A-H (1985b) Radionuclide evaluation of exercise left ventricular performance in patients with coronary artery disease. Am Heart J 110: 851–856

    Article  CAS  PubMed  Google Scholar 

  • Iskandrian AS, Hakki A-H, Kane-Marsch S (1985a) Prognostic implications of thallium-201 scintigraphy in patients with suspected or known coronary artery disease. Am Heart J 110: 135–143

    Article  CAS  PubMed  Google Scholar 

  • Iskandrian AS, Hakki A-H, Goel IP, Mundth ED, Kane-Marsch SA, Schenk CL (1985b) The use of rest and exercise radionuclide ventriculography in risk stratification in patients with suspected coronary artery disease. Am Heart J 100: 864–872

    Article  Google Scholar 

  • Janowitz W, Fester A (1982) Quantification of left ventricular regurgitant fraction by first pass radionuclide angiocardiography. Am J Cardiol 49: 85–92

    Article  CAS  PubMed  Google Scholar 

  • Keyes JW, Leonard PF, Brody SL, Svetkoff DJ, Rogers WL, Luchessi BR (1978) Myocardial infarct quantification in the dog by single photon emission computed tomography. Circulation 58: 227–232

    Article  CAS  PubMed  Google Scholar 

  • Kirsch C-M, Doliwa R, Buell U, Roedler D (1983) Detection of severe coronary heart disease with T1-201: comparison of resting single photon emission tomography with invasive arteriography. J Nucl Med 24: 761–767

    CAS  PubMed  Google Scholar 

  • Laird EE, Rajathurai A, Williams ED, Mittra B, Rankin D (1984) Quantitative analysis of rotating gamma camera thallium-201 scintigrams of myocardium. Nucl Med Commun 5: 577–586

    Article  CAS  PubMed  Google Scholar 

  • Leppo J, Boucher CA, Okada D, Newell JB, Strauss HW, Pohost GM (1982) Serial thallium-201 myocardial imaging after dipyridamole infusion: diagnostic utility in detecting coronary stenoses and relationship to regional wall motion. Circulation 66: 649–656

    Article  CAS  PubMed  Google Scholar 

  • Maddahi J, Garcia EV, Berman DS, Waxman A, Swan HJC, Forrester J (1981) Improved noninvasive assessment of coronary artery disease by quantitative analysis of regional stress myocardial distribution and washout of thallium-201. Circulation 64: 924–935

    Article  CAS  PubMed  Google Scholar 

  • Maltz DL, Treves S (1973) Quantitative radionuclide angiocardiography: determination of Qp/Qs in children. Circulation 47: 1049–1056

    Article  CAS  PubMed  Google Scholar 

  • Meade RC, Bamrah VS, Horgan JD, Ruetz PP, Kronenwetter C, Yeh E-L (1978) Quantitative methods in the evaluation of thallium-201 myocardial perfusion images. J Nucl Med 19: 1175–1178

    CAS  PubMed  Google Scholar 

  • Mueller TM, Marcus ML, Ehrhardt JC, Chandhuri T, Abboud FM (1976) Limitations of thallium-201 myocardial perfusion scintigrams. Circulation 54: 640–646

    Article  CAS  PubMed  Google Scholar 

  • Neilson AP, Morris KG, Murdock R, Bruno FP, Cobb FR (1980) Linear relationship between the distribution of thallium-201 and blood flow in ischaemic and nonischaemic myocardium during exercise. Circulation 61: 797–801

    Article  Google Scholar 

  • Okada RD, Leppo JA, Strauss HW, Boucher CA, Pohost GM (1982) Mechanisms and time course for the disappearance of thallium-201 defects at rest in dogs. Relation of time to peak activity to myocardial blood flow. Am J Cardiol 49: 699–706

    Google Scholar 

  • O’Keefe JC et al. (1983) Comparison of exercise electrocardiography, thallium-201 myocardial imaging and exercise gated blood pool scan in patients with suspected coronary artery disease. Aust NZ J Med 13: 45–50

    Article  Google Scholar 

  • Pavel DG, Zimmer AM, Patterson V (1977) In vivo labelling of red blood cells with 99m-Tc: a new approach to blood pool visualisation. J Nucl Med 18: 305–308

    CAS  PubMed  Google Scholar 

  • Pohost GM, Zir LM, Moore RH, McKusik KA, Guiney TE, Beller GA (1977) Differentiation of transiently ischaemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation 55: 294–302

    Article  CAS  PubMed  Google Scholar 

  • Pryor DB, Harrell FE Jr, Lee KL et al. (1984) Prognostic indicators from radionuclide angiography in medically treated patients with coronary artery disease. Am J Cardiol 53: 18–22

    Article  CAS  PubMed  Google Scholar 

  • Righetti A, O’Rourke RA, Schelbert H et al. (1977) Usefulness of preoperative and postoperative Tc-99m ( Sn) pyrophosphate scans in patients with ischaemic and valvular heart disease. Am J Cardiol 39: 43–49

    Article  CAS  PubMed  Google Scholar 

  • Rigo P, Alderson PO, Robertson RM, Becker LC, Wagner HN Jr (1979) Measurement of aortic and mitral regurgitation by gated cardiac blood pool scans. Circulation 60: 306–312

    Article  CAS  PubMed  Google Scholar 

  • Steele PP, Van Dyke D, Trow RS, Anger HO, Davies H (1974) Simple and safe bedside method for serial measurement of left ventricular ejection fraction, cardiac output, and pulmonary blood volume. Br Heart J 36: 122–131

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Tamaki N, Mukai T, Ishii Y et al. (1981) Clinical evaluation of thallium-201 emission myocardial tomography using a rotating gamma camera: comparison with seven-pinhole tomography. J Nucl Med 22: 849–855

    CAS  PubMed  Google Scholar 

  • Tamaki N, Yonekura Y, Mukai T et al. (1984) Segmental analysis of stress thallium myocardial emission tomography for localisation of coronary artery disease. Eur J Nucl Med 9: 99–105

    Article  CAS  PubMed  Google Scholar 

  • Timmis AD (1985) Probability analysis in the diagnosis of coronary artery disease. Br Med J 291: 1443–1444

    Article  CAS  Google Scholar 

  • Underwood SR, Walton S, Laming PJ, Ell PJ, Swanton RH, Emanuel RW (1983) Differential sensitivity of the Fourier phase and amplitude images in the detection of abnormal anterior and inferior left ventricular wall motion ( Abstract ). Nucl Med Commun 4: 135

    Google Scholar 

  • Underwood SR, Walton S, Ell PJ, Emanuel RW, Swanton RH (1984) Isometric exercise in the detection of coronary artery disease - specific but not sensitive. In: Hoefer R, Bergman H (eds) Radioactive isotopes in clinical medicine and research. Verlag H Egermann, Vienna, 16: 443–450

    Google Scholar 

  • Underwood SR, Klipstein RH, Firmin DN et al. (1986) Magnetic resonance assessment of the accuracy of radionuclide methods for the quantification of valvular regurgitation and atrial shunting. In: Hoefer R, Bergman H (eds) Radioactive isotopes in clinical medicine and research. Verlag H Egermann, Vienna, 17: 299–305

    Google Scholar 

  • Verani MS, Zacca NM, DeBauche TL, Miller RR, Chahine RA (1982) Comparison of cold pressor and exercise radionuclide angiocardiography in coronary artery disease. J Nucl Med 23: 770–776

    CAS  PubMed  Google Scholar 

  • Vogel RA, Kirch DL, LeFree MT, Rainwater JO, Jenson DP, Steele PP (1979) Thallium-201 myocardial perfusion scintigraphy: results of standard and multi-pinhole tomographic techniques. Am J Cardiol 43: 787–793

    Article  CAS  PubMed  Google Scholar 

  • Wahl JM, Hakki AH, Iskandrian AS (1985) Prognostic implications of normal exercise thallium 201 images. Arch Intern Med 145: 253–256

    Article  CAS  PubMed  Google Scholar 

  • Walton S, Jarritt PH, Ell PJ (1980) Improved reproducibility of ejection fraction estimation using the phase image. Use of the technique to determine the heart’s response to isometric exercise. In: Nuklearmedizin. Schattauer Verlag, Stuttgart, 1980; 220–224

    Google Scholar 

  • Walton S, Underwood SR, Ell PJ, Swanton RH, Emanuel RW (1984) Measurement of valvular regurgitation by first pass radionuclide angiocardiography ( Abstract ). Br Heart J 54: 91P

    Google Scholar 

  • Watson DD, Campbell NP, Read EK, Gibson RS, Teates CD, Beller GA (1981) Spatial and temporal quantitation of plane thallium myocardial images. J Nucl Med 22: 577–584

    CAS  PubMed  Google Scholar 

  • Xue QF, Macnee W, Flenley DC, Hannan WJ, Adie CJ, Muir AL (1983) Can right ventricular performance be assessed by equilibrium radionuclide ventriculography? Thorax 38: 486–493

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Yiannikas J, Maclntyre WJ, Underwood DA et al. (1985) Prediction of improvement after ventricular aneurysmectomy using Fourier phase and amplitude analysis of radionuclide cardiac blood pool scans. Am J Cardiol 55: 1308–1312

    Article  CAS  PubMed  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1988 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Underwood, S.R. (1988). Radionuclide Imaging of the Cardiovascular System. In: Kox, W., Boultbee, J., Donaldson, R. (eds) Imaging and Labelling Techniques in the Critically I11. Current Concepts in Critical Care. Springer, London. https://doi.org/10.1007/978-1-4471-1440-6_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-1440-6_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1442-0

  • Online ISBN: 978-1-4471-1440-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics