Cardiac amyloidosis (CA) is a type of systemic amyloidosis, in which abnormal amyloid fibril is deposited in extracellular space of myocardium. Most common subtypes of CA are amyloidosis of immunoglobulin light chain (AL) and amyloidosis of transthyretin (ATTR). With increase in incidence of CA and development of new drugs, the needs of early and accurate diagnosis of CA are increasing. In CA, bone scan and SPECT/CT have long been used for diagnosis. Currently, bone scan is included in almost all practice guidelines as one of key diagnostic examinations for ATTR CA. In some specific scenarios, bone scan can be used as even a substitute for endomyocardial biopsy. Recently, amyloid-targeting PET that is used for Alzheimer dementia has also been attempted as an imaging method for CA. Although the study results are still insufficient, amyloid-targeting has shown promising potential as an imaging method for CA, particularly in AL. Here, imaging method and clinical application and implication of bone scan, SPECT/CT, and amyloid-targeting PET/CT in CA are reviewed.

PURPOSE: The aim of this study is to investigate the reproducibility of the quantitative assessment of segmental wall motion and systolic thickening provided by an automatic quantitation algorithm. MATERIALS AND METHODS: Tc-99m-MIBI gated myocardial SPECT with dipyridamole stress was performed in 31 patients with known or suspected coronary artery disease (4 with single, 6 with two, 11 with triple vessel disease; ejection fraction 51+/-14%) twice consecutively in the same position. Myocardium was divided into 20 segments. Segmental wall motion and systolic thickening were calculated and expressed in mm and % increase respectively, using AutoQUANTTM software. The reproducibility of this quantitative measurement of wall motion and thickening was tested. RESULTS: Correlations between repeated measurements on consecutive gated SPECT were excellent for wall motion (r=0.95) and systolic thickening (r=0.88). On Bland-Altman analysis, two standard deviation was 2 mm for repeated measurement of segmental wall motion, and 20% for that of systolic thickening. The weighted kappa values of repeated measurements were 0.807 for wall motion and 0.708 for systolic thickening. Sex, perfusion, or segmental location had no influence on reproducibility. CONCLUSION: Segmental wall motion and systolic thickening quantified using AutoQUANTTM software on gated myocardial SPECT offers good reproducibility and is significantly different when the change is more than 2 mm for wall motion and more than 20% for systolic thickening.
Coronary Artery Disease ; Dipyridamole ; Humans ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Tomography, Emission-Computed, Single-Photon*

Atherosclerosis is an inflammatory disease as well as a lipid disorder. Atherosclerotic plaque formed in vessel walls may cause ischemia, and the rupture of vulnerable plaque may result in fatal events, like myocardial infarction or stroke. Because morphological imaging has limitations in diagnosing vulnerable plaque, molecular imaging has been developed, in particular, the use of nuclear imaging probes. Molecular imaging targets various aspects of vulnerable plaque, such as inflammatory cell accumulation, endothelial activation, proteolysis, neoangiogenesis, hypoxia, apoptosis, and calcification. Many preclinical and clinical studies have been conducted with various imaging probes and some of them have exhibited promising results. Despite some limitations in imaging technology, molecular imaging is expected to be used both in the research and clinical fields as imaging instruments become more advanced.
Atherosclerosis/*diagnosis/pathology/radiography ; Endothelial Cells/metabolism ; Humans ; Inflammation/pathology ; Lipoproteins, LDL/metabolism ; Macrophages/immunology/metabolism ; Plaque, Atherosclerotic ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon

Nuclear myocardial perfusion imaging is very effective in the evaluation of patients with suspicious acute coronary syndrome (ACS), for adequate diagnosis and treatment. There have been many clinical evidences to support the efficacy and cost-effectiveness. In addition, many authoritative guidelines support the utility of myocardial perfusion imaging in ACS with an appropriate diagnostic protocol. However, with the development of other cardiac imaging modalities, the choice of modality for the diagnosis of suspicious ACS now depends on the availability of each modality in each institute. Newly developed imaging technologies, especially including molecular imaging, are expected to have great potential not only for diagnosis but also for primary, secondary, and tertiary prevention of ACS.
Acute Coronary Syndrome ; Cardiology ; Humans ; Molecular Imaging ; Myocardial Perfusion Imaging ; Tertiary Prevention

Radioiodine (RI) therapy is one of the key factors for the good prognosis of differentiated thyroid cancers. Currently, most of RI treatments are performed with predetermined fixed dose of RI, whereas strict dose adjustment is made in chemotherapy or external radiotherapy for cancer treatment. Although fixed dose methods have been practically effective in RI therapy hitherto, dose determination with individual radiation dosimetry is theoretically superior to use of empirical fixed dose, for maximization of treatment effect and minimization of adverse events. The theoretical superiority of dosimetry-based dose determination is not yet directly supported by clinical data of real world; however, indirect results support the use of dosimetry-based dose determination in several specific patient groups. In this review, the basis of dosimetry is briefly discussed with regard to necessity and practical methods. Additionally, the efficacy of dosimetry is also discussed through the data of clinical studies so far.
Humans ; Prognosis ; Radiometry ; Thyroid Gland ; Thyroid Neoplasms

Molecular nuclear cardiac imaging has included Tc-99m Annexin imaging to visualize myocardial apoptosis, but is now usually associated with gene therapy and cell-based therapy. Cardiac gene therapy was not successful so far but cardiac reporter gene imaging was made possible using HSV-TK (herpes simplex virus thymidine kinase) and F-18 FHBG (fluoro-hydroxymethylbutyl guanine) or I-124 FIAU (fluoro-deoxyiodo-arabino-furanosyluracil). Gene delivery was performed by needle injection with or without catheter guidance. TK expression did not last longer than 2 weeks in myocardium. Cell-based therapy of ischemic heart or failing heart looks promising, but biodistribution and differentiation of transplanted cells are not known. Reporter genes can be transfected to the stem/progenitor cells and cells containing these genes can be transplanted to the recipients using catheter-based purging or injection. Repeated imaging should be available and if promoter are varied to let express reporter transgenes, cellular (trans) differentiation can be studied. NIS (sodium iodide symporter) or D2R receptor genes are promising in this aspect.
Apoptosis ; Catheters ; Genes, Reporter ; Genetic Therapy ; Heart ; Linear Energy Transfer ; Molecular Imaging ; Myocardium ; Needles ; Thymidine ; Transgenes

No abstract available.
Perfusion*

No abstract available.
Brain* ; Carotid Artery, Internal* ; Carotid Stenosis* ; Humans ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Brain* ; Carotid Artery, Internal* ; Carotid Stenosis* ; Humans ; Tomography, Emission-Computed, Single-Photon*