Cardiology Clinics
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Index
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Source Type: journals
Radiation Dose and Safety in Cardiac Computed Tomography
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This article reviews the existing data regarding biologic hazards of radiation exposure associated with medical diagnostic testing, the methodologies used to estimate radiation exposure and dose, and the measures that can be taken to effectively reduce that exposure. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Thomas C. Gerber, Birgit Kantor, Cynthia H. McCollough Source Type: journals
Recent Technologic Advances in Multi-Detector Row Cardiac CT
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This article discusses these recent technical advances in detail. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Sandra Simon Halliburton Source Type: journals
Left Ventricular Function, Myocardial Perfusion and Viability
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Cardiac computed tomography is now poised to revolutionize the practice of cardiology. Multi-detector row CT (MDCT) has the potential to evaluate cardiac function, myocardial perfusion, and viability. These capabilities, combined with the robust ability of MDCT to noninvasively image the coronary arteries, makes MDCT a comprehensive tool for the evaluation of coronary artery disease and its anatomic and physiologic impact on the myocardium. Recent technologic advances in MDCT technology in regards to detector coverage, and spatial and temporal resolution promise to improve the capabilities of cardiac CT in the assessment o...
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Yasuyuki Kobayashi, Albert C. Lardo, Yasuo Nakajima, Joao A.C. Lima, Richard T. George Source Type: journals
Evaluation of Cardiac Valves Using Multidetector CT
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Cardiac CT is an accurate and reasonable alternative modality for valvular imaging. It is used primarily for the evaluation of coronary artery disease; however, important information regarding valvular anatomy and function can be derived from CT. Calcification is a common CT finding in various valvular abnormalities and carries important diagnostic and prognostic value. In addition, valvular morphology, stenosis, and regurgitation also are detected on contrast enhanced scans, with good correlation with trans-thoracic echocardiography and other techniques. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Juan Gaztanaga, Gonzalo Pizarro, Javier Sanz Source Type: journals
CT Applications in Electrophysiology
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In recent years, extraordinary advances have been made in the management of cardiac arrhythmias. Increasingly complex procedures are being performed, and the breadth of conditions for which invasive arrhythmia therapy is indicated continues to grow. In addition to atrial and ventricular ablation procedures for treating arrhythmias, implantable defibrillators and biventricular pacemakers for cardiac resynchronization therapy have made electrophysiology an important part of heart failure management. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Subodh B. Joshi, Andrew R. Blum, Moussa Mansour, Suhny Abbara Source Type: journals
Evaluation of Coronary Atherosclerotic Plaques
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This article discusses the potential value and limitations of cardiac CT for evaluating coronary atherosclerotic plaque. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Christoph R. Becker, Tobias Saam Source Type: journals
Cardiac CT in Asymptomatic Patients at Risk
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Atherosclerosis is a systemic process that can develop as early as the second or third decade of life. A significant percentage of patients who experience acute coronary syndromes often have non-obstructive coronary artery disease and thus cannot be diagnosed by their symptoms or conventional functional stress testing. It has been proposed that early detection of atherosclerosis would generate novel opportunities for primary prevention through changes in lifestyle or even through drug therapy, especially in patients at high cardiovascular risk. Calcium scoring is a simple, reproducible, and widely available test that has b...
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Paolo Raggi Source Type: journals
Functional Versus Anatomic Imaging in Patients with Suspected Coronary Artery Disease
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This article reviews the relative value of anatomical versus functional imaging and their complementary role in different clinical scenarios. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Leslee J. Shaw, Daniel S. Berman Source Type: journals
Cardiac CT in the Emergency Department
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This article reviews the application of CT for the evaluation of acute chest pain the emergency department. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Kavitha M. Chinnaiyan, Gilbert L. Raff, James A. Goldstein Source Type: journals
The Prognostic Value of Cardiac Computed Tomographic Angiography
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This article reviews current and emerging concepts in the prognostic value of cardiac CT angiography. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Fay Y. Lin, Suzanne E. Zentko, James K. Min Source Type: journals
Diagnostic Accuracy of CT Coronary Angiography
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There is a rich and rapidly growing literature on the diagnostic utility of coronary CT angiography (CTA) and its performance relative to other modalities such as stress testing and invasive coronary angiography. Earlier studies of 16-slice coronary CTA showed wide variability in sensitivity (30%–95%) and some variability in specificity (86%–98%). With 40- and 64-slice coronary CTA, more of the chest is covered with each spin of the gantry, the breath hold is shorter, and there are fewer uninterpretable segments than with 16-slice coronary CTA. The very high negative predictive value is especially helpful in ruling out...
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Divya Kapoor, Randall C. Thompson Source Type: journals
Cardiac CT: Understanding and Adopting a New Diagnostic Modality
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This article reviews the history of this modality, the principles and challenges for its clinical implementation, and provides a preamble to this special issue of Cardiology Clinics. (Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Mario J. Garcia Source Type: journals
Preface
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Patients with known or suspected coronary artery disease who are asymptomatic or who have stable symptoms are often evaluated noninvasively. Functional tests, such as stress electrocardiography, stress echocardiography, or stress nuclear perfusion imaging, detect and quantify the presence of ischemia based on electrical, mechanical, or perfusion abnormalities, indirectly establishing the burden of coronary artery disease. Although these tests have been shown to provide important prognostic information including the prediction of benefit from revascularization, they have limited accuracy for establishing or excluding the di...
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Mario J. Garcia Source Type: journals
Foreword
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The November 2003 issue of Cardiology Clinics was devoted to cardiac computed tomography (CT). In the intervening 6 years tremendous advances in this technology have occurred. We now can legitimately claim that computed tomography angiography (CTA) of the coronary arteries is available. In the evaluation of patients with suspected coronary artery disease, many guidelines consider CTA an alternative to stress testing. In the typical patient with exercise-induced symptoms, stress imaging still makes sense, but there are many other patients in whom CTA may be preferable. For example, we are using it frequently in pre–noncar...
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Authors: Michael H. Crawford Source Type: journals
Forthcoming Issues
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Source Type: journals
Table of Contents
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - September 22, 2009 Category: Cardiology Source Type: journals
Index
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Source Type: journals
The Future Cardiac Catheterization Laboratory
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This article describes the major components in the future cardiac catheterization laboratory to facilitate cardiac interventions for both coronary artery and structural heart diseases. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: S. James Chen, Adam R. Hansgen, John D. Carroll Source Type: journals
Intravascular Ultrasound Registration/Integration with Coronary Angiography
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To exploit fully the imaging data derived from both angiography and intravascular ultrasound (IVUS), combined visualization is needed. Although this visualization has been available in the research environment for the last decade or so, clinical implementation is still pending. Recent improvements in computer hardware and software (algorithms), improved angiography and IVUS technologies, and a total digital imaging workflow could bring integrated IVUS/angiography imaging into the catheter laboratory in the near future. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Nico Bruining, Sebastiaan de Winter, Patrick W. Serruys Source Type: journals
Coronary Computed Tomographic Angiography in the Cardiac Catheterization Laboratory: Current Applications and Future Developments
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This article addresses some of these advances and discusses how cardiac CT and its derived information can be used in the preparation and execution of catheter coronary angiography and percutaneous coronary interventions. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Onno Wink, Harvey S. Hecht, Daniel Ruijters Source Type: journals
Computer Assistance for Solving Imaging Problems
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This article explores the use of computers to assist in these tasks, to create databases for guiding decision making, to provide graphics to assist the physician, and to simulate cardiovascular procedures. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Joel A. Garcia, Babak Movassaghi Source Type: journals
Two and Three-Dimensional Quantitative Coronary Angiography
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Following the development of the first automated methods in the 1980s, quantitative coronary angiography (QCA) has undergone substantial evolution from simplistic computer-assisted methods of visual interpretation of coronary angiograms to recently introduced three-dimensional reconstruction and quantitative analysis algorithms. The ability of QCA to provide objective dimensional assessment of coronary lesions is still useful and has led to its widespread application in both scientific research and clinical practice. Most of the systems available nowadays are based on vessel edge detection algorithms to designate the arter...
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Ioannis Pantos, Efstathios P. Efstathopoulos, Demosthenes G. Katritsis Source Type: journals
Advanced Visibility Enhancement for Stents and Other Devices: Image Processing Aspects
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This article gives an overview of the different methods used for enhanced stent visualization, describes studies that have evaluated these methods, and summarizes results of these methods on other cardiac and non-cardiac devices. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Gert Schoonenberg, Raoul Florent Source Type: journals
Enhanced X-Ray Visualization of Coronary Stents: Clinical Aspects
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Coronary stent under expansion is a major contributor to in-stent restenosis and acute stent thrombosis. StentBoost and IC Stent are advanced x-ray image enhancing techniques that provide improved stent visualization by eliminating motion artifact. These techniques can be useful in the detection of inadequate stent expansion. These motion-corrected x-ray stent (MXS) visualization techniques are more time-efficient compared to intravascular ultrasound (IVUS), require less training of catheterization laboratory personnel, and have lower procedural costs. However, little clinical or outcome data evidence exist for MXS. Though...
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: R. Kevin Rogers, Andrew D. Michaels Source Type: journals
Three-Dimensional Coronary Visualization, Part 2: 3D Reconstruction
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This article gives an overview of reconstruction methods, clinical tools, and present clinical data. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Gert Schoonenberg, Anne Neubauer, Michael Grass Source Type: journals
Three-Dimensional Coronary Visualization, Part 1: Modeling
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This article describes the process and applications associated with producing a 3D model of the coronary arterial tree using only a few standard 2D projection images from a routine coronary angiographic study. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: S. James Chen, Dirk Schäfer Source Type: journals
Technique and Catheters
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This article reviews the current technique of coronary angiography, focusing on the choice of arterial access site; navigation from the arterial access site to the ascending thoracic aorta; cannulation of the native coronary arteries in their normal, variant, and anomalous locations; and cannulation of saphenous vein and arterial graft conduits. The authors conclude that, although no didactic training can substitute for the hands-on apprenticeship obtained during general cardiology and interventional cardiology fellowships, the intellectual elements fundamental to coronary angiography outlined here will result in a more ef...
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Ivan P. Casserly, John C. Messenger Source Type: journals
Advances in Contrast Media and Contrast Injectors
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This article reviews the currently available contrast media used for imaging during coronary angiography and percutaneous intervention. Recent data regarding potential adverse effects of contrast media and strategies to minimize adverse events are discussed. In addition, the authors review the state of the art in automated contrast injection for coronary angiography, including protocols used for performance of rotational coronary angiography and digital subtraction imaging in the catheterization laboratory. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: John C. Messenger, Ivan P. Casserly Source Type: journals
Rotational Coronary Angiography
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This article highlights the techniques, advantages, and disadvantages of each type of rotational angiography currently commercially available. Also included is a discussion of the evolution of rotational angiography, from its initial conception and pilot studies to its latest step forward on the developmental road towards enhanced coronary imaging. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Andrew J.P. Klein, Joel A. Garcia Source Type: journals
Flat Detectors and New Aspects of Radiation Safety
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This article examines the unique radiation hazards of flat detector fluoroscopy and suggests practical steps that clinicians can take to protect themselves and their patients from radiation injury. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: John C. Gurley Source Type: journals
Coronary Angiography: The Need for Improvement and the Barriers to Adoption of New Technology
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Traditional coronary angiography presents a variety of limitations related to image acquisition, content, interpretation, and patient safety. These limitations were first apparent with coronary angiography used as a diagnostic tool and have been further magnified in today's world of percutaneous coronary intervention (PCI), with the frequent use of implantable coronary stents. Improvements are needed to overcome the limitations in using current two-dimensional radiographic imaging for optimizing patient selection, quantifying vessel features, guiding PCI, and assessing PCI results. Barriers to such improvements include the...
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: John D. Carroll, Eugenia P. Carroll, S. James Chen Source Type: journals
Preface
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This issue of Cardiology Clinics brings together contributions from around the world, investigators who are clinical versus imaging science in their orientation, and representatives from academic medical centers and the imaging industry. Each article is written to be accessible to those with a basic knowledge of coronary imaging but also to be stimulating and educational to those who are experts and investigators in medical imaging. (Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: S. James Chen, John D. Carroll Source Type: journals
Foreword
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While most cardiologists are excited about new 64- to 320-slice computed tomography images of the coronary arteries and the promise of magnetic resonance imaging for coronary visualization, the invasive cardiac catheterization laboratory has been evolving as well. Nothing stands still in medicine, and many important clinical issues are moving targets when it comes to research trials. Thus, I was delighted when Drs. Chen and Carroll agreed to guest edit this issue of Cardiology Clinics on the topic of Advances in Coronary Angiography. They have assembled an international group of experts on this topic. The excellent articl...
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Authors: Michael H. Crawford Source Type: journals
Forthcoming Issues
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Source Type: journals
Table of Contents
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - July 5, 2009 Category: Cardiology Source Type: journals
Index
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Source Type: journals
Role of Nuclear Imaging in Regenerative Cardiology
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This article summarizes recent clinical and experimental nuclear imaging studies in cardiac stem cell therapy. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Riikka Lautamäki, Frank M. Bengel Source Type: journals
Radiotracer Imaging of Atherosclerotic Plaque Biology
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This article discusses several radiotracers that can report on high-risk plaque pathophysiology. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Maysoon Elkhawad, James H.F. Rudd Source Type: journals
New Molecular Imaging Targets to Characterize Myocardial Biology
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This article reviews the recent advances in myocardial molecular imaging in the context of the cardiovascular processes of angiogenesis, apoptosis, inflammation, and ventricular remodeling. The focus is on radiotracer-based single photon emission computed tomography and positron emission tomography molecular imaging approaches. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Alan R. Morrison, Albert J. Sinusas Source Type: journals
Cardiac Neuronal Imaging at the Edge of Clinical Application
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Cardiac neuronal innervation plays an important role in normal cardiac function and is adversely affected in the presence of disease. In particular, radiotracer imaging of cardiac sympathetic function has been extensively investigated and not only provides a method of assessing the severity of disease but also has repeatedly been shown to be prognostically useful with a potential for helping to guide patient management. SPECT imaging of myocardial uptake of 123I-mIBG, an analog of the sympathetic neurotransmitter norepinephrine, has been the most studied, but PET neurotracers, such as 11C-HED, are also under investigation....
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Mark I. Travin Source Type: journals
Translation of Myocardial Metabolic Imaging Concepts into the Clinics
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Flexibility in myocardial substrate metabolism for energy production is fundamental to cardiac health. This loss in plasticity or flexibility leads to overdependence on the metabolism of an individual category of substrates, with the predominance in fatty acid metabolism characteristic of diabetic heart disease and the accelerated glucose use associated with pressure-overload left ventricular hypertrophy being prime examples. There is a strong demand for accurate noninvasive imaging approaches of myocardial substrate metabolism that can facilitate the crosstalk between the bench and the bedside, leading to improved patient...
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Adil Bashir, Robert J. Gropler Source Type: journals
Quantification of Myocardial Blood Flow: What is the Clinical Role?
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Quantification of regional myocardial blood flow and of its responses to targeted physiologic and pharmacologic interventions, which is now available with positron emitting tracers of blood flow and positron emission tomography (PET), extends the diagnostic potential of standard myocardial perfusion imaging. These noninvasive flow measurements serve as tools for quantifying functional consequences of epicardial coronary artery disease, as well as of impairments in microcirculatory reactivity that escape detection by standard perfusion imaging. Flow measurements are clinically useful for more comprehensively assessing the e...
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Heinrich R. Schelbert Source Type: journals
Nuclear Imaging in Heart Failure
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Heart failure is becoming the main clinical challenge in cardiology in the twenty-first century and is associated with high morbidity and mortality. Currently, several therapeutic options are available for heart failure patients, including medical therapy, revascularization, advanced cardiac surgery, device therapy, and cardiac transplantation. Future therapies are directed at cell and gene therapy. In this article the role of nuclear imaging in the management of heart failure patients is discussed. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Jeroen J. Bax, Mark M. Boogers, Joanne D. Schuijf Source Type: journals
Hybrid Imaging: Integration of Nuclear Imaging and Cardiac CT
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This article reviews potential clinical applications of hybrid imaging in cardiovascular disease. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Marcelo F. Di Carli Source Type: journals
Cardiac Positron Emission Tomography: Current Clinical Practice
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This article summarizes the main clinical applications of state-of-the art cardiac PET technology. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Lucille Lalonde, Maria Cecilia Ziadi, Rob Beanlands Source Type: journals
New Trends in Camera and Software Technology in Nuclear Cardiology
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This article describes advancements in hardware and software for myocardial perfusion imaging that are becoming commercialized today and their implication in clinical practice. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Ernest V. Garcia, Tracy L. Faber Source Type: journals
Preface: The Changing Face of Nuclear Cardiology
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The field of cardiovascular imaging is changing. On one hand, myocardial perfusion imaging is a well-established clinical technique for the diagnostic and prognostic workup of coronary artery disease. It has been the mainstay of nuclear cardiology for decades. On the other hand, several alternative imaging methodologies for noninvasive functional assessment of ischemic heart disease have emerged, and noninvasive coronary angiography is becoming a clinical reality. As a consequence of the general increase of imaging procedures and associated overall costs, pressure is increasing for individual modalities regarding their cos...
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Frank M. Bengel Source Type: journals
Foreword
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The nuclear technique most frequently used by cardiologists is nuclear perfusion imaging, which is a fairly mature technology. However, mature technologies can be tweaked, as is demonstrated by the first three articles in this issue. The combination of a nuclear camera with CT allows for the attainment of coronary anatomic, cardiac functional, and myocardial perfusion imaging from one piece of equipment. Also, nuclear processing software continues to improve. PET scanning has now entered the mainstream with smaller equipment and the use of rubidium as a tracer. PET/SPECT cameras can now assess perfusion, function, and meta...
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Authors: Michael H. Crawford Source Type: journals
Forthcoming Issues
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(Source: Cardiology Clinics)
Source: Cardiology Clinics - April 20, 2009 Category: Cardiology Source Type: journals
