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Nuclear Cardiology-Basics PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "NUCLEAR CARDIOLOGY- BASICS” by Dr. THIRUMURTHI.

This medical PowerPoint presentation is about nuclear cardiology, a medical specialty that involves the use of radioactive materials to diagnose and treat heart disease. It is a type of imaging technique that combines nuclear medicine and cardiology to provide detailed images of the heart and its blood vessels.

The most common nuclear cardiology test is the myocardial perfusion imaging (MPI) scan, which uses a small amount of a radioactive substance injected into the patients bloodstream. The radioactive material then travels to the heart, and a special camera is used to take images of the heart as it pumps blood. These images can show areas of the heart that may not be receiving enough blood flow, which can indicate the presence of heart disease.

Another nuclear cardiology test is the positron emission tomography (PET) scan, which also uses a radioactive tracer to produce detailed images of the heart. PET scans are often used to assess the effectiveness of treatments for heart disease and to monitor patients with heart conditions.

Nuclear cardiology is a safe and effective way to diagnose and manage heart disease. However, as with any medical procedure, there are risks associated with the use of radioactive materials. Patients should discuss the benefits and risks of nuclear cardiology with their healthcare provider before undergoing any tests or treatments.

Tags : nuclear cardiology, heart disease, imaging technique, Nuclear Medicine, Nuclear Medicine PowerPoint presentation

Published on : Jun 20, 2023 | Views : 2017 | Downloads : 8

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NUCLEAR CARDIOLOGY- BASICS Dr. THIRUMURTHI CHIEF-NUCLEAR MEDICINE MADRAS MEDICAL MISSION
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Nuclear Medicine Specialty in which a wide range of clinical conditions are investigated using radioactive tracers administered to the patient It is completely different process from X-Ray, CT and MRI scan (these look at the anatomy of the body) To look at the function of the body, Nuclear Medicine uses gamma rays
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Nuclear Medicine Gamma rays are very similar to X-Rays, but the major difference is that the gamma rays are emitted by pharmaceuticals injected into the bloodstream rather than being produced by machines outside the body. Gamma rays are detected by the gamma camera
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Gamma Rays (from Doe Medical Sciences webpage)
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Myocardial Perfusion Imaging Radiopharmaceuticals : 201Thallium Technetium based agents PET * Ammonia
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Technetium based agents 99m Technetium T 1/2 - 6 Hrs Pharmaceuticals : SestaMIBI, Tetrofosmin SestaMIBI: Methoxy Iso Butyl Isonitrile Passive diffusion Uptake proportional to blood flow & no redistribution Good quality images, gating, easy availability & Cost effective
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© Continuing Medical Implementation …...bridging the care gap Exercise stress testing Treadmill or bicycle ergometer Protocols vary - symptom limited Bruce most popular 8 stages Incline and speed increment every 3 minutes Target 85-100% maximum age predicted HR Achieve at least 6 METS for diagnostic accuracy
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MPI Stress Procedure Treadmill Pharmacological stress IV Dobutamine / Adenosine DOBUTAMINE Max.Dosage: 40 ug / kg / min + Inj.Atropine 0.6 mg IV ADENOSINE Dose : 140 ug / kg / min - 6 min
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Indications Screening of IHD Physiological significance of lesions post CAG Post PTCA & post CABG evaluation Risk stratification Myocardial viability detection
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Diagnostic Accuracy 1. O’Rourke RA, et al. Circulation. 2000;102:126-140. 2. Wackers FJ, et al. Nuclear cardiology. In: Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine. 5th ed. Philadelphia, Pa: WB Saunders; 1997. P r e d i c t i v e A c c u r a c y %Sensitivity %Specificity Exercise Stress ECG1 6 7 7 4 6 9 Exercise Stress Echo1 8 5 7 9 8 3 MPI1 8 9 80 8 9 %
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Flow tracers Rb-82 0-15 N-13 Tc-99m MIBI Tl-201
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Metabolic tracer F-18 – fluorodeoxyglucose(FDG) F-18 –BMS 747158 I-123 BMIPP
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Perfusion Metabolism Reversible Stunning Reversible Hibernation Irreversible Scar Dysfunction Condition
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MIBI & FDG 30% OF NO PERFUSION SEGMENT SHOWS FDG UPTAKE
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Influence of Viability Testing on Outcomes With Revascularization 3.2 16 7.7 6.2 0 4 8 12 16 20 Annual Cardiac Death Rate (%) Revasc Med Rx Revasc Med Rx Viable Non-viable -80% p<0.0001 p=NS (Allman, JACC 2002; 39: 1151-1158)
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ACC/AHA Recommendations for the Use of Radionuclide Techniques to Assess Myocardial Viability Class I: Conditions for which there is evidence and/or general agreement that a given procedure or treatment is useful and effective LOE B: Data derived from a single randomized trial, or from nonrandomized studies
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First-Pass Radionuclide Angiography(RNA)
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Indications Coronary artery disease (CAD) Valvular heart disease Congenital heart disease
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Equilibrium Gated Radionuclide Ventriculogram MUGA
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Purpose Examine the function of the pumping chambers of the heart Left ventricle measurements are more accurate than the right because of the heart’s anatomy (gated first-pass study with radionuclides that do not pass the lungs maybe used for the right ventricle)
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BPGS - Blood Pool Gated SPECT Analysis:
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Imaging CTPA is now the recommended initial lung imaging modality for non-massive PE. [B] Patients with a good quality negative CTPA do not require further investigation or treatment for PE. [A] Isotope lung scanning may be considered as the initial imaging investigation providing (a) facilities are available on site, and (b) chest radiograph is normal, and (c) there is no significant symptomatic concurrent cardiopulmonary disease, and (d) standardised reporting criteria are used, and (e) a non-diagnostic result is always followed by further imaging. [B]