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Clinical applications of radionuclide imaging in the evaluation and management of patients with congenital heart disease

  • CME ARTICLE
  • Review Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Non-invasive testing of children with congenital heart disease (CHD) began in the 1950s with the introduction of radionuclide studies to assess shunt fractions, pulmonary blood flow, and ventricular contractile function. Echocardiography and cardiac magnetic resonance imaging have since replaced radionuclide imaging in many of these roles. Concurrently, percutaneous and surgical repairs of complex CHD evolved, creating new roles for radionuclide imaging. In this paper on applications of radionuclide imaging in CHD, we review the multiple mechanisms for myocardial ischemia in CHD. We critically compare optimal radionuclide imaging techniques to other imaging modalities for assessing ischemia in CHD. We present the current role of nuclear imaging for assessing viability and pulmonary blood flow. We highlight the value added by advances in dedicated cardiac SPECT scanners, novel reconstruction software, and cardiac PET in performing low-dose radionuclide imaging in CHD. Finally, we discuss the emerging clinical indications for radionuclide imaging in CHD including coronary flow reserve assessment and evaluation of cardiovascular prosthesis and device infections.

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Abbreviations

CHD:

Congenital heart disease

CMR:

Cardiac magnetic resonance

CAD:

Coronary artery disease

TGA:

Transposition of the great arteries

ALCAPA:

Anomalous left coronary artery from the pulmonary artery

RCA:

Right coronary artery

MPI:

Myocardial perfusion imaging

VSD:

Ventricular septal defect

CFR:

Coronary flow reserve

CIED:

Cardiovascular implantable electronic device

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Disclosures

Dr. Dorbala was supported by National Heart Lung and Blood Institute grants K23HL092299.

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Authors and Affiliations

  1. The Philadelphia Adult Congenital Heart Disease Program. A Joint Program of Penn Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Sara L. Partington MD

  2. Boston Adult Congenital Heart Disease and Pulmonary Hypertension program, A Joint Program of Brigham and Women′s Hospital and the Boston Children′s Hospital, Boston, MA, USA

    Anne Marie Valente MD & Michael Landzberg MD

  3. Division of Nuclear Medicine, Department of Radiology, Boston Children’s Hospital, Boston, MA, USA

    Frederick Grant MD

  4. Noninvasive Cardiovascular Imaging Program, Departments of Radiology and Medicine (Cardiology), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women’s Hospital, 70 Francis Street, Shapiro 5th Floor, Room 128, Boston, MA, 02115, USA

    Marcelo F. Di Carli MD & Sharmila Dorbala MBBS, MPH, FACC

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  1. Sara L. Partington MD
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  2. Anne Marie Valente MD
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  3. Michael Landzberg MD
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  4. Frederick Grant MD
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  5. Marcelo F. Di Carli MD
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  6. Sharmila Dorbala MBBS, MPH, FACC
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Correspondence to Sharmila Dorbala MBBS, MPH, FACC.

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Partington, S.L., Valente, A.M., Landzberg, M. et al. Clinical applications of radionuclide imaging in the evaluation and management of patients with congenital heart disease. J. Nucl. Cardiol. 23, 45–63 (2016). https://doi.org/10.1007/s12350-015-0185-5

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