Cardiac nuclear medicine studies

Cardiac nuclear medicine studies play important roles in the diagnosis, clinical decision making and follow-up of various cardiac diseases. Myocardial perfusion scintigraphy provides significant knowledge to define myocardial ischemia and viability in patients with both known and suspected coronary artery disease, and to assess risk stratification and prognostic evaluation as well. Stress-redistribution-reinjection and rest-redistribution Thallium 201 imaging, Tc-99m MIBI GATED SPECT, nitrate or metamizole-induced Tc-99m MIBI studies and cardiac metabolic imaging with positron emission tomography (PET) have an important role in assessment of myocardial viability and serve for clinical decision making. Myocardial perfusion can also be evaluated with the use of PET imaging. Cardiac PET perfusion studies have some important advantages such as better image quality, shorter imaging duration, repeatibility on the same day which make it more preferable for the early detection of coronary artery disease, prognostic evaluation and special patient groups like women, obese or pediatric patients. The most important advantage of PET myocardial perfusion imaging is that it enables the quantitative assessment of myocardial perfusion and it can display coronary vasodilatory reserve which is very useful for the evaluation of endothelial function and smooth muscle relaxation. GATED myocardial perfusion scintigraphy and radionuclide ventriculography studies are used for the evaluation of cardiac contractile function, and provide clinically significant parameters such as ejection fraction, end-systolic and end-diastolic ventricular volumes. Myocardial infarction imaging is mainly used to confirm the diagnosis of suspected myocardial infarction. Myocardial innervation imaging and myocardial fatty acid metabolism imaging are among the promising future nuclear cardiac imaging methods, which are mostly used for experimental purposes currently.