Diagnosis, Risk Stratification and Management of Ischemic Heart Disease with Nuclear Cardiology

  • Tanyanan Tanawuttiwat
  • Robert C. HendelEmail author
  • Robert C. Hendel


Single photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging have high degrees of diagnostic accuracy. The sensitivity and specificity of each technique is in the range of 80–95%, with recent studies demonstrating higher accuracy with PET. Advances in technology including new tracers, ECG gating and attenuation correction have further improved nuclear cardiology methods for assessment of suspected coronary artery disease.


Single Photon Emission Compute Tomography Myocardial Perfusion Imaging Nuclear Cardiology Single Photon Emission Compute Tomography Image Suspected Coronary Artery Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Beller GA. First annual Mario S. Verani, MD, Memorial lecture: clinical value of myocardial perfusion imaging in coronary artery disease. J Nucl Cardiol. 2003;10(5):529–42.PubMedCrossRefGoogle Scholar
  2. 2.
    Metz LD, Beattie M, Hom R, Redberg RF, Grady D, Fleischmann KE. The prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography: a meta-analysis. J Am Coll Cardiol. 2007;49(2):227–37.PubMedCrossRefGoogle Scholar
  3. 3.
    Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: results from the Clinical Outcome Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation. 2008;117(10):1283–91.PubMedCrossRefGoogle Scholar
  4. 4.
    Mahmarian JJ, Pratt CM. Risk stratification after acute myocardial infarction: is it time to reassess? Implications from the INSPIRE trial. J Nucl Cardiol. 2007;14(3):282–92.PubMedCrossRefGoogle Scholar
  5. 5.
    Shaw LJ, Narula J. Risk assessment and predictive value of coronary artery disease testing. J Nucl Med. 2009;50(8):1296–306.PubMedCrossRefGoogle Scholar
  6. 6.
    Udelson JE, Beshansky JR, Ballin DS, Feldman JA, Griffith JL, Handler J, Heller GV, Hendel RC, Pope JH, Ruthazer R, Spiegler EJ, Woolard RH, Selker HP. Myocardial perfusion imaging for evaluation and triage of patients with suspected acute cardiac ischemia: a randomized controlled trial. JAMA. 2002;299(21):2693–700.CrossRefGoogle Scholar
  7. 7.
    Shaw LJ, Hachamovitch R, Berman DS, Marwick TH, Lauer MS, Heller GV, Iskandrian AE, Kesler KL, Travin MI, Lewin HC. The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. Economics of Noninvasive Diagnosis (END) Multicenter Study Group. J Am Coll Cardiol. 1999;33(3):661–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Shaw LJ, Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol. 2004;11(2):171–85.PubMedCrossRefGoogle Scholar
  9. 9.
    Machecourt J, Longere P, Fagret D, Vanzetto G, Wolf JE, Polidori C, Comet M, Denis B. Prognostic value of thallium-201 single-photon emission computed tomographic myocardial perfusion imaging according to extent of myocardial defect. Study in 1,926 patients with follow up at 33 months. J Am Coll Cardiol. 1994;23(5):1096–106.PubMedCrossRefGoogle Scholar
  10. 10.
    Sharir T, Germano G, Kavanagh PB, et al. Incremental prognostic value of post-stress left ventricular ejection fraction and volume by gated myocardial perfusion single photon emission computed tomography. Circulation. 1999;100:1035–42.PubMedCrossRefGoogle Scholar
  11. 11.
    Iskandrian AS, Chae SC, Heo J, Stanberry CD, Wasserleben V, Cave V. Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease. J Am Coll Cardiol. 1993;22(3):665–70.PubMedCrossRefGoogle Scholar
  12. 12.
    Berman DS. Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men. Impact of diabetes mellitus on incremental prognostic value and effect on patient management. J Am Coll Cardiol. 2003;41(7):1125–33.PubMedCrossRefGoogle Scholar
  13. 13.
    Uretsky S, Supariwala A, Singh P, Atluri P, Khokhar SS, Koppuravuri HK, Mandeva A, Rozanski A. Impact of weight on long-term survival among patients without known coronary artery disease and a normal stress SPECT MPI. J Nucl Cardiol. 2010;17(3):390–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Hakeem A, Bhaltti S, Dillie KS, Cook JR, Samad Z, Roth-Cline MD, Chang SM. Predictive value of myocardial perfusion single-photon emission computed tomography and the impact of renal function on cardiac death. Circulation. 2008;118(24):2540–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, Pohost GM, Williams KA, American College of Cardiology Foundation Appropriate Use Criteria Task Force; American Society of Nuclear Cardiology; American College of Radiology; American Heart Association; American Society of Echocardiology; Society of Cardiovascular Computed Tomography; Society for Cardiovascular Magnetic Resonance; Society of Nuclear Medicine. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J Am Coll Cardiol. 2009;53(23):2201–29.PubMedCrossRefGoogle Scholar
  16. 16.
    Landesberg G, Mosseri M, Wolf YG, Bocher M, Basevitch A, Rudis E, Izhar U, Anner H, Weissman C, Berlatzky Y. Preoperative thallium scanning, selective coronary revascularization, and long-term survival after major vascular surgery. Circulation. 2003;108(2):177–83.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Tanyanan Tanawuttiwat
    • 1
  • Robert C. Hendel
    • 2
    Email author
  • Robert C. Hendel
    • 3
  1. 1.Cardiovascular DivisionUniversity of Miami Miller School of MedicineMiamiUSA
  2. 2.Cardiac Imaging and Outpatient Services, Cardiovascular Division, Department of MedicineUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Cardiac Care UnitUniversity of Miami HospitalMiamiUSA

Personalised recommendations