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13.50 Potential utility of quantitative analysis of 82Rb PET in three vessel coronary artery disease
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Abstracts
Journal of Nuclear Cardiology
S a t u r d a y , M a y 5, 2 0 0 1
January/February
13.49
13.51
Significant misindexing for SPECT imaging in MEDLINE. M Shen, N Calabretta. Cardiology Cooper HnspitalAJMDNJ Camden United States of America. Background: In this age o f information explosion, accurate indexing of health information is a critical step in the dissemination o f research study results to physicians so they may be efficiently u'nplementad in clinical practice. Objectives: We sought to study the index of nuclear cardiology literature and its classification and nomenclatures. Results: Specifics o f nuclear cardiology imaging techniques are not reflected in the Medical Subject Headings(MeSH)used to index PubMed. From 1966 to 2000, a total o f 3 3 2 4 citations were retrieved using the MeSH Headings Cardiovascular Diseases (CVD) and Tomography, Emission-Computed, Single-Photon ( S P E C T ) . However, additional 6,585 citations were found using 8 other relevant keywords in combination with CVD. These additional headings were not indexed with the SPECT heading. Conclusions: This study illustrates that up to 64% of papers might be missed by a searcher using only standard headings. This alarming result suggests that further cooperation among international nuclear, cardiology and information organizations is necessary to set standards and to keep pace with changes in both technology and nomenclature in order to assure rapid dissemination o f clinically relevant information. International nuclear, cardiology and information organizations is necessary to set standards and to keep pace with changes in both technology and nomenclature in order to assure rapid dissemination o f clinically relevant information.
Improvement of myocardial glucose utilization by troglitazone in type 2 diabetes is estimated by plasma free fatty acids levels after oral glucose load. K Nakagawa, K Yoshida 1, Y Nakagawa 1, M Fujiwara 1, K Odaka 1, Y Masuda I . Diagnostic Imaging Center Nishidai Clinic Tokyo, IThe 3rd Dept. o f Internal Medicine Chiba University Chiba Japan. Purpose: Previous studies have reported reduced myocardial glucose utilization (MGU) in diabetes, which may contribute to myocardial energy deficiency resulting in the reduced cardiac function. Thiazolidinediones has a potential effect to improve the reduced M G U but it has not been reported in humans. We have measured M G U by F-18 FDG PET with oral glucose loading before and after the treatment by troglitazone in 12 type2 diabetes patients and evaluated if reduced M G U was improved. Biochemical factors that may be affected by the treatment were also evaluated. Results: Out o f 12 patients, 6 showed reduced M G U before the treatment. Initial M G U has no correlation to neither plasma glucose, insulin, flee fatty acids, nor hemoglobin A l c levels examined during the study. After the treatment, M G U tended to improve in all the patients, but not significant. Biochemical examination during the PET study showed significantly decreased free fatty acids (FFA) levels after the treatment. Plasma glucose and insulin levels were also decreased after the treatment, but not significant. The changes of MGU and the changes of FFA levels between the two studies in each patient were well correlated (r=0.780). Conclusion: Reduced myocardial glucose utilization in type 2 diabetes can be improved by the treatment o f troglitazone. And it can be estimated if the plasma free fatty acids levels after the oral glucose loading is reduced after the treatment.
13.52
13.50 Potential utility of quantitative coronary artery disease.
S A T U R D A Y
2001
analysis of 82Rb PET in three vessel
Information transformation and gated SPECT utilization in the US from 1994-99.
R Seth, RA deKemp, TD Ruddy, R Hart, A Kitsikis, M Aung, N Levesque, D Gauthier. E Westerman, RS Beanlands. Cardiology University of Ottawa Heart Institute Ottawa Canada.
M Shen, N Calabretta. Cardiology Cooper HospitalAJMDNJ Camden United States o f America.
Background: Standard perfusion imaging defines disease relative to a maximum in the myocardium. This may underestimate the extent of disease in 3 vessel CAD as the maximum perfusion is below normal. The aim of this study was to determine if PET quantification of Perfusinn Reserve using 82Rb net retention defines a greater extent of disease than 'relative' perfusion at stress in patients with 3VD and may help in risk stratification. Methods: 82Rb retention was quantified as a measure of absolute perhision at rest and with dipyridamole stress using dynamic PET imaging in 18 patients with CAD. Polar maps of 568 sectors were generated and compared to normals. The % of myocarditun with abnortr~l segments (>2 SD below normal) was determined for the standard using stress perfusinn relative to the maximum (STD) and absolute perfusinn reserve (APR). Results: Patients with 3VD served as the primary study population (n= l 1, 66+/- 10, 2 female). As a control, a group of patients with a normal zone (IVD) were also studied (n-7, 66+/-6, 4 female). APR was compared to STD. (*p<0.05) STD APR 3VD (%0abe LV) 42+/-19% 65+/-28%* IVD (% abn LV) 24+/-19% 14+/-14% Absolute retention data also reflected extent and severity of disease on coronary angiography. See figure. The white segments are abnormal. The STD method (left) suggests one abnormal region whereas the APR method (right) is abnormal for the entire myocardinm. Conclusions: Quantification of 82Rb net retention to measure absolute perfusion reserve in the myocardium defines a greater extent of disease than the standard approach in patients with triple vessel disease. More accurate measurement of the extent of CAD should identify more high risk patients for aggressive intervention.
1TM
=,
~13.~
M A Y El
4J.Jh ill
Background: Gated SPECT (GSPECT) imaging is still being underutilizad despite it offers more accurate and comprehensive clinical information as well as more favorable reimbursement than SPECT imaging alone in the US. Objectives: We sought to study the information transformation and the US GSPECT utilization. Methods: SPECT and GSPECT data were collected from T M G from 1994 to 1999. Classification of GSPECT and its publications were searched from the MEDLINE database using OVID. Results: In 1999, 4.2 million SPECT perfusion imaging were performed and 2.5 million were GSPECT in the US. Although GSPECT increased 13 fold from 1994, only 60% SPECT used gated technique. Specifics o f gated imaging techniques are not included in the Medical Subject Headings (MESH) to index OVID for MEDLINE database. Only 108 citations were retrieved using GSPECT as a keywurd combined with cardiovascular disease. Additional 178 citations were found using 8 other relevant keywords in combination with CVD. Conclusion: Currently, up to 62% GSPECT publications might be misregistered without standard MeSH Headings. This signifies the magnitude o f problems in information transformation in nuclear cardiology, which may partially explained the low utilization rate o f GSPECT in the US. In the Interact era of information explosion, standardization and improvement o f information transformation is imperative for nuclear cardiology society to transform study results to clinical practice.
Abstracts
Journal of Nuclear Cardiology
S a t u r d a y , M a y 5, 2 0 0 1
January/February
13.49
13.51
Significant misindexing for SPECT imaging in MEDLINE. M Shen, N Calabretta. Cardiology Cooper HnspitalAJMDNJ Camden United States of America. Background: In this age o f information explosion, accurate indexing of health information is a critical step in the dissemination o f research study results to physicians so they may be efficiently u'nplementad in clinical practice. Objectives: We sought to study the index of nuclear cardiology literature and its classification and nomenclatures. Results: Specifics o f nuclear cardiology imaging techniques are not reflected in the Medical Subject Headings(MeSH)used to index PubMed. From 1966 to 2000, a total o f 3 3 2 4 citations were retrieved using the MeSH Headings Cardiovascular Diseases (CVD) and Tomography, Emission-Computed, Single-Photon ( S P E C T ) . However, additional 6,585 citations were found using 8 other relevant keywords in combination with CVD. These additional headings were not indexed with the SPECT heading. Conclusions: This study illustrates that up to 64% of papers might be missed by a searcher using only standard headings. This alarming result suggests that further cooperation among international nuclear, cardiology and information organizations is necessary to set standards and to keep pace with changes in both technology and nomenclature in order to assure rapid dissemination o f clinically relevant information. International nuclear, cardiology and information organizations is necessary to set standards and to keep pace with changes in both technology and nomenclature in order to assure rapid dissemination o f clinically relevant information.
Improvement of myocardial glucose utilization by troglitazone in type 2 diabetes is estimated by plasma free fatty acids levels after oral glucose load. K Nakagawa, K Yoshida 1, Y Nakagawa 1, M Fujiwara 1, K Odaka 1, Y Masuda I . Diagnostic Imaging Center Nishidai Clinic Tokyo, IThe 3rd Dept. o f Internal Medicine Chiba University Chiba Japan. Purpose: Previous studies have reported reduced myocardial glucose utilization (MGU) in diabetes, which may contribute to myocardial energy deficiency resulting in the reduced cardiac function. Thiazolidinediones has a potential effect to improve the reduced M G U but it has not been reported in humans. We have measured M G U by F-18 FDG PET with oral glucose loading before and after the treatment by troglitazone in 12 type2 diabetes patients and evaluated if reduced M G U was improved. Biochemical factors that may be affected by the treatment were also evaluated. Results: Out o f 12 patients, 6 showed reduced M G U before the treatment. Initial M G U has no correlation to neither plasma glucose, insulin, flee fatty acids, nor hemoglobin A l c levels examined during the study. After the treatment, M G U tended to improve in all the patients, but not significant. Biochemical examination during the PET study showed significantly decreased free fatty acids (FFA) levels after the treatment. Plasma glucose and insulin levels were also decreased after the treatment, but not significant. The changes of MGU and the changes of FFA levels between the two studies in each patient were well correlated (r=0.780). Conclusion: Reduced myocardial glucose utilization in type 2 diabetes can be improved by the treatment o f troglitazone. And it can be estimated if the plasma free fatty acids levels after the oral glucose loading is reduced after the treatment.
13.52
13.50 Potential utility of quantitative coronary artery disease.
S A T U R D A Y
2001
analysis of 82Rb PET in three vessel
Information transformation and gated SPECT utilization in the US from 1994-99.
R Seth, RA deKemp, TD Ruddy, R Hart, A Kitsikis, M Aung, N Levesque, D Gauthier. E Westerman, RS Beanlands. Cardiology University of Ottawa Heart Institute Ottawa Canada.
M Shen, N Calabretta. Cardiology Cooper HospitalAJMDNJ Camden United States o f America.
Background: Standard perfusion imaging defines disease relative to a maximum in the myocardium. This may underestimate the extent of disease in 3 vessel CAD as the maximum perfusion is below normal. The aim of this study was to determine if PET quantification of Perfusinn Reserve using 82Rb net retention defines a greater extent of disease than 'relative' perfusion at stress in patients with 3VD and may help in risk stratification. Methods: 82Rb retention was quantified as a measure of absolute perhision at rest and with dipyridamole stress using dynamic PET imaging in 18 patients with CAD. Polar maps of 568 sectors were generated and compared to normals. The % of myocarditun with abnortr~l segments (>2 SD below normal) was determined for the standard using stress perfusinn relative to the maximum (STD) and absolute perfusinn reserve (APR). Results: Patients with 3VD served as the primary study population (n= l 1, 66+/- 10, 2 female). As a control, a group of patients with a normal zone (IVD) were also studied (n-7, 66+/-6, 4 female). APR was compared to STD. (*p<0.05) STD APR 3VD (%0abe LV) 42+/-19% 65+/-28%* IVD (% abn LV) 24+/-19% 14+/-14% Absolute retention data also reflected extent and severity of disease on coronary angiography. See figure. The white segments are abnormal. The STD method (left) suggests one abnormal region whereas the APR method (right) is abnormal for the entire myocardinm. Conclusions: Quantification of 82Rb net retention to measure absolute perfusion reserve in the myocardium defines a greater extent of disease than the standard approach in patients with triple vessel disease. More accurate measurement of the extent of CAD should identify more high risk patients for aggressive intervention.
1TM
=,
~13.~
M A Y El
4J.Jh ill
Background: Gated SPECT (GSPECT) imaging is still being underutilizad despite it offers more accurate and comprehensive clinical information as well as more favorable reimbursement than SPECT imaging alone in the US. Objectives: We sought to study the information transformation and the US GSPECT utilization. Methods: SPECT and GSPECT data were collected from T M G from 1994 to 1999. Classification of GSPECT and its publications were searched from the MEDLINE database using OVID. Results: In 1999, 4.2 million SPECT perfusion imaging were performed and 2.5 million were GSPECT in the US. Although GSPECT increased 13 fold from 1994, only 60% SPECT used gated technique. Specifics o f gated imaging techniques are not included in the Medical Subject Headings (MESH) to index OVID for MEDLINE database. Only 108 citations were retrieved using GSPECT as a keywurd combined with cardiovascular disease. Additional 178 citations were found using 8 other relevant keywords in combination with CVD. Conclusion: Currently, up to 62% GSPECT publications might be misregistered without standard MeSH Headings. This signifies the magnitude o f problems in information transformation in nuclear cardiology, which may partially explained the low utilization rate o f GSPECT in the US. In the Interact era of information explosion, standardization and improvement o f information transformation is imperative for nuclear cardiology society to transform study results to clinical practice.