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Cardio Diabetes Medicine 2017 333

Role of Nuclear Imaging in The Evaluvation

of NonCoronary Artery Disease

Dr. Deepanjan Mitra

Dr. Anirban Mukherjee

AMRI Institute of Nuclear Medicine & PET CT,
AMRI Hospitals, Dhakuria, Kolkata

Abstract: ularity in this field especially in relation to assessment
Nuclear cardiology involves non-invasive assessment of cardiac viability and cardiac infection/ inflamma-
of cardiac perfusion and function using different ra- tion. Cardiac autonomic imaging using 123-iodine
dionuclides. Apart from its common applications in meta-iodo-benzyl-guanidine (MIBG) and cardiac mo-
the assessment of coronary artery disease, the mo- lecular imaging using different radionuclides are also
dality has useful applications in non coronary artery performed routinely in different clinical settings too.
disease patients as well, particularly in the settings of However, most of the radionuclide studies in nuclear
non-ischemic cardiomyopathy and cardiac infection cardiology are applied in patients with coronary ar-
inflammation. Gated myocardial perfusion SPECT tery disease. GMPS is sensitive method in detecting
(GMPS) helps in differentiating ischemic cardiomyop- stress induced ischemia and also provides valuable
athy from non-ischemic cardiomyopathy. Equilibrium information regarding the viability of the myocardi-
radionuclide angiography (ERNA) helps to accurately um. However recently, with advent of different RPs,
evaluate left ventricular ejection fraction (LVEF) and nuclear imaging studies are also performed in set-
thereby determine the treatment modality in heart tings of non-coronary artery disease. In this chap-
failure patients. ERNA has been extensively used to ter, we will briefly discus the indications of different
monitor chemotherapy induced caardiotoxicity too. type sof nuclear cardiology studies in patients with
Phase analysis of ERNA and GMPS are helpful in pre- non-coronary artery disease.
dicting response to Cardiac resynchronisation ther-
apy (CRT). Cardiac autonomic innervations imaging Radionuclide imaging in non-ischemic heart
with 123-Iodine MIBG is helpful in risk stratification failure (HF)
and prognostication in patients with heart failure (HF).
FDG PET-CT has been used for myocardial infection The structural and functional abnormalities of the
and inflammation imaging. Nuclear cardiology thus myocardium in cardiomyopathy can be assessed
provides valuable therapeutic and prognostic infor- by various radionuclide imaging techniques. Radio-
mation in patients with non-coronary artery disease. nuclide imaging addresses several important clinical
questions in HF such as identifying etiology of HF
Introduction: and risk stratification. Newer approaches such as
autonomic innervation imaging, phase analysis for
Nuclear cardiology provides non-invasive assess- synchrony assessment and other molecular imaging
ment of cardiac perfusion, cardiac function and car- techniques continue to expand the applications of
diac infection/ inflammation by use of radionuclides radionuclide imaging in HF.
/ radiopharmaceuticals (RP). Gated myocardial per-
fusion SPECT (GMPS) and equilibrium radionuclide Establishing the etiology:
angiography
Most common etiology of HF is ischemic cardiac dis-
(ERNA) are two most commonly performed studies ease. Thus, it is important to rule out ischemic etiol-
in nuclear cardiology. However with introduction of ogy as a cause of HF. Myocardial perfusion studies
Positron Emission Tomography (PET), Fluorodeoxy- using 201-Thallium, 99m-Techniteum Sestamibi and
glucose (FDG) PET-CT also significantly gaining pop- 99m-Techniteum Tetrofosmin are most commonly

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