Impact of coronary artery calcium scanning on coronary risk factors and downstream testing the EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) prospective randomized trial.

Temporal Trends in the Frequency of Inducible Myocardial Ischemia During Cardiac Stress Testing: 1991 to 2009

Preamble……2

I.Introduction……2

II.Goals……2

III.Definitions……3

IV. Common clinical applications……3

V. Qualifications and responsibilities of personnel (in the United States)……3

1. Physicians……3
 1. SPECT/CT cardiac radionuclide imaging……3
 2

https://jnm.snmjournals.org/content/jnumed/54/8/1485.full.pdf

SNMMI/ASNC/SCCT Guideline for Cardiac SPECT/CT and PET/CT 1.0

Glucose metabolic activity expressed as 18F-FDG uptake may be increased in active atherosclerotic plaque. Calcium depositions are often increased in mature atherosclerotic plaque. The purpose of the present study was to assess the patterns of vascular-wall 18 F-FDG uptake and CT calcifications using combined PET/CT. Methods: One hundred twenty-two consecutive patients over the age of 50 (47 women and 75 men; mean age, 66 9 y) undergoing whole-body 18F-FDG PET/CT for tumor assessment were retrospectively evaluated. PET, CT, and PET/CT slices were generated for review. Abnormal vascular findings in major arteries in the chest and abdomen were categorized as PET positive (PET), PET negative (PET), CT positive (CT), or CT negative (CT). The topographic relationship between increased vascular-wall 18F-FDG uptake on PET and the presence of calcifications on CT was assessed on PET/CT fused images, with abnormal sites further classified as PET/CT, PET/CT ,o r PET/CT. The presence of CT calcifications and increased vascular-wall 18 F-FDG uptake was correlated with age, sex, presence of cardiovascular risk factors, and cardiovascular disease. Results: Abnormal findings were identified at 349 sites. CT calcifications (CT) were observed at 320 sites (92%) of 100 patients (82%), more commonly in men (P 0.03), in older patients (P 0.0001), in patients with hypertension (P 0.003) or hyperlipidemia (P 0.04), and in smokers (P 0.008). Increased vascular-wall 18F-FDG uptake (PET) was observed at 52 sites (15%) of 38 patients (31%), more commonly in men (P 0.02), in older patients (P 0.0001), and in patients with hypertension (P 0.02), and was borderline in patients with cardiovascular disease (P 0.057). PET and CT findings correlated in 12 patients, a PET/CT pattern was found in 18 patients, and 8 patients had increased vascular-wall 18F-FDG uptake in sites with and without calcifications (PET/CT ,C T). Twenty-two patients (18%) had a PET/CT pattern. Conclusion: Hybrid PET/CT can be used to identify and to correctly localize vascular-wall 18 F-FDG activity. Increased vascular-wall 18 F-FDG activity was found in 15% of sites and CT calcifications were noted in 92% of sites, with congruent findings in 7%. The clinical significance of the relationship between vascular-wall 18F-FDG uptake and CT calcifications needs to be assessed by further prospective studies with long-term follow up.

https://jnm.snmjournals.org/content/jnumed/45/11/1816.full.pdf

Evaluation of 18F-FDG Uptake and Arterial Wall Calcifications Using 18F-FDG PET/CT

Review Form First Author, Year: ___________________ Ref ID #__________ Abstractor Initials: ___ ___ ___ Primary Inclusion/Exclusion Criteria 1. Relevant to SER topic Yes No Cannot Determine 2. Attempts internal or external validation Yes No Cannot Determine 3. Published in English Yes No Cannot Determine 4. Original research (exclude reviews, editorials, commentaries, letters to editor, etc.) Yes No Cannot Determine 5. Eligible Study types a. Randomized controlled trials b. Controlled clinical trials

Systematic Review of Cardiovascular Disease Risk Assessment Tools

Coronary calcium screening in asymptomatic patients as a guide to risk factor modification and stress myocardial perfusion imaging.

Is 3D-only PET/CT scanner ready to acquire rest/stress Rb-82 myocardial blood flow using the same infusion for clinical images?

Transient ischemic dilation in response to dipyridamole stress with Rubidium-82 myocardial perfusion PET: Quantitative comparison of low-likelihood and CAD populations

26.06—11:20 a.m.: Atherosclerotic Plaque Characterization with Simultaneous Dual-source/Dual-energy Computed Tomography: A Preliminary Phantom Experiment Toward Clinical Utilization

Iain McGhie

Papers

Coronary calcium screening in asymptomatic patients as a guide to risk factor modification and stress myocardial perfusion imaging.

Is 3D-only PET/CT scanner ready to acquire rest/stress Rb-82 myocardial blood flow using the same infusion for clinical images?

Transient ischemic dilation in response to dipyridamole stress with Rubidium-82 myocardial perfusion PET: Quantitative comparison of low-likelihood and CAD populations

26.06—11:20 a.m.: Atherosclerotic Plaque Characterization with Simultaneous Dual-source/Dual-energy Computed Tomography: A Preliminary Phantom Experiment Toward Clinical Utilization