Journal of Nuclear Cardiology

, Volume 24, Issue 1, pp 134–137 | Cite as

Successful innovation: A time for change?

Debate Article


Innovation plays an important role in the advancement of nuclear cardiology, meeting the need for reduced exposure to radiation, and maintaining and improving image quality. As we innovate, it is important to understand the impact of these improvements on the clinical and research knowledge base that has made nuclear cardiology such a powerful clinical tool. The need for comparative studies insuring stability in the clinical applicability of our current guidelines and use of the prognostic power of radionuclide myocardial perfusion imaging in clinical practice is essential for new and innovative techniques. The existing data demonstrating the significant differences that can occur with the innovative techniques is explored. The need for tools to insure comparable data is available as we begin to utilize registries to inform our clinical practice and research will be an important part of the future of nuclear cardiology.


SPECT image processing image reconstruction 


  1. 1.
    Cerqueira MD, Allman KC, Ficaro EP, Hansen CL, Nichols KJ, Thompson RC, et al. Information statement recommendations for reducing radiation exposure in myocardial perfusion imaging. J Nucl Cardiol 2010;17:709. doi: 10.1007/s12350-010-9244-0.CrossRefPubMedGoogle Scholar
  2. 2.
    Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Ben-Haim S. High-speed myocardial perfusion imaging. JACC Cardiovasc Imaging 2008;1:156. doi: 10.1016/j.jcmg.2007.12.004.CrossRefPubMedGoogle Scholar
  3. 3.
    Garcia EV, Faber TL. New trends in camera and software technology in nuclear cardiology. Cardiol Clin 2009;27:227-36. doi: 10.1016/j.ccl.2008.12.002.CrossRefPubMedGoogle Scholar
  4. 4.
    Gilmore B. An investigation of the magnitude and causes of count loss artifacts in SPECT imaging. J Nucl Med 1991;32:1771-6.PubMedGoogle Scholar
  5. 5.
    Forstrom LA, Dunn WL, O’Connor MK, Decklever TD, Hardyman TJ, Howarth DM. Technical pitfalls in image acquisition, processing, and display. Semin Nucl Med 1996;26:278-94.CrossRefPubMedGoogle Scholar
  6. 6.
    Hansen CL. Digital image processing for clinicians, part III: SPECT reconstruction. J Nucl Cardiol 2002;9:542-9.CrossRefPubMedGoogle Scholar
  7. 7.
    Leong LK, Kruger RL, O’Connor MK. A comparison of the uniformity requirements for SPECT image reconstruction using FBP and OSEM techniques. J Nucl Med Technol 2001;29:79-83.PubMedGoogle Scholar
  8. 8.
    Heller G, Mann A, Hendel R. Nuclear cardiology: Technical applications: Technical applications. New York: McGraw-Hill; 2008.Google Scholar
  9. 9.
    DePuey EG. Advances in cardiac processing software. Semin Nucl Med 2014;44:252. doi: 10.1053/j.semnuclmed.2014.04.001.CrossRefGoogle Scholar
  10. 10.
    Bruyant PP. Analytic and iterative reconstruction algorithms in SPECT. J Nucl Med 2002;43:1343-58.PubMedGoogle Scholar
  11. 11.
    Sharir T, Germano G, Waechter PB, Kavanagh PB, Areeda JS, Gerlach J, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. II: validation and diagnostic yield. J Nucl Med 2000;41:720-7.PubMedGoogle Scholar
  12. 12.
    Alenius S, Ruotsalainen U. Bayesian image reconstruction for emission tomography based on median root prior. Eur J Nucl Med 1997;24:258-65.PubMedGoogle Scholar
  13. 13.
    Piccinelli M, Garcia EV. Advances in software for faster procedure and lower radiotracer dose myocardial perfusion imaging. Prog Cardiovasc Dis 2014;57:579-87. doi: 10.1016/j.pcad.2014.12.006.CrossRefPubMedGoogle Scholar
  14. 14.
    DePuey EG. Achievements in nuclear cardiology/CME article advances in SPECT camera software and hardware: Currently available and new on the horizon. J Nucl Cardiol 2012;19:551. doi: 10.1007/s12350-012-9544-7.CrossRefPubMedGoogle Scholar
  15. 15.
    Shaw LJ, Berman DS, Maron DJ, Mancini GJ, Hayes SW, Hartigan PM, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: Results from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial nuclear substudy. Circulation 2008;117:1283-91. doi: 10.1161/CIRCULATIONAHA.107.743963.CrossRefPubMedGoogle Scholar
  16. 16.
    O’Keefe JH, Bateman TM, Ligon RW, Case J, Cullom J, Barnhart C, et al. Outcome of medical versus invasive treatment strategies for non-high-risk ischemic heart disease. J Nucl Cardiol 1998;5:28-33.CrossRefPubMedGoogle Scholar
  17. 17.
    Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation 2003;107:2900-7. doi: 10.1161/01.CIR.0000072790.23090.41.CrossRefPubMedGoogle Scholar
  18. 18.
    Hachamovitch R, Rozanski A, Hayes SW, Thomson LE, Germano G, Friedman JD, et al. Predicting therapeutic benefit from myocardial revascularization procedures: Are measurements of both resting left ventricular ejection fraction and stress-induced myocardial ischemia necessary? J Nucl Cardiol 2006;13:768-78. doi: 10.1016/j.nuclcard.2006.08.017.CrossRefPubMedGoogle Scholar
  19. 19.
    Hammermeister KE, DeRouen TA, Dodge HT. Variables predictive of survival in patients with coronary disease. Selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic, and quantitative angiographic evaluations. Circulation 1979;59:421. doi: 10.1161/01.cir.59.3.421.CrossRefPubMedGoogle Scholar
  20. 20.
    White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 1987;76:44. doi: 10.1161/01.cir.76.1.44.CrossRefPubMedGoogle Scholar
  21. 21.
    Hamer AW, Takayama M, Abraham KA, Roche AH, Kerr AR, Williams BF, et al. End-systolic volume and long-term survival after coronary artery bypass graft surgery in patients with impaired left ventricular function. Circulation 1994;90:2899. doi: 10.1161/01.cir.90.6.2899.CrossRefPubMedGoogle Scholar
  22. 22.
    Gebhard C, Fiechter M, Stehli J, Klaeser B, Gaemperli O. Gender- and age-related differences in rest and post-stress left ventricular cardiac function determined by gated SPECT. Int J Cardiovasc Imaging 2014;30:1191. doi: 10.1007/s10554-014-0431-y.CrossRefPubMedGoogle Scholar
  23. 23.
    Véra P, Manrique A, Pontvianne V, Hitzel A, Koning R, Cribier A. Thallium-gated SPECT in patients with major myocardial infarction: Effect of filtering and zooming in comparison with equilibrium radionuclide imaging and left ventriculography. J Nucl Med 1999;40:513-21.PubMedGoogle Scholar
  24. 24.
    Lyra M, Ploussi A. Filtering in SPECT image reconstruction. Int J Biomed Imaging 2011;2011:1. doi: 10.1155/2011/693795.CrossRefGoogle Scholar
  25. 25.
    Standke D, Nowak B, Kaiser H-J, Koch K-C, Buell U. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med 2005;46(8):1256-63.PubMedGoogle Scholar
  26. 26.
    DePuey EG, Bommireddipalli S, Clark J, Thompson L, Srour Y. Wide beam reconstruction “quarter-time” gated myocardial perfusion SPECT functional imaging: A comparison to “‘full-time’” ordered subset expectation maximum. J Nucl Cardiol 2009;16:736. doi: 10.1007/s12350-009-9108-7.CrossRefPubMedGoogle Scholar
  27. 27.
    Miao TL, Kansal V, Wells RG, Ali I, Ruddy TD, Chow BJW. Adopting new gamma cameras and reconstruction algorithms: Do we need to re-establish normal reference values? J Nucl Cardiol 2015. doi: 10.1007/s12350-015-0172-x.PubMedGoogle Scholar
  28. 28.
    Badano LP, Cucchini U, Muraru D, Al Nono O, Sarais C, Iliceto S. Use of three-dimensional speckle tracking to assess left ventricular myocardial mechanics: Inter-vendor consistency and reproducibility of strain measurements. Eur Heart J Cardiovasc Imaging 2012;14:285-93. doi: 10.1093/ehjci/jes184.CrossRefPubMedGoogle Scholar
  29. 29.
    Voigt J-U. Making a black box transparent. Eur Heart J Cardiovasc Imaging 2012;14:201-2. doi: 10.1093/ehjci/jes213.CrossRefPubMedGoogle Scholar
  30. 30.
    Shaw LJ, Wang TY, Mahmarian JJ, Douglas PS, Arrighi JA, Denton EA, et al. Registry. J Nucl Cardiol 2013;20:655-6. doi: 10.1007/s12350-013-9743-x.CrossRefPubMedGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  1. 1.Department of Medicine, Greenville Health SystemUniversity of South Carolina School of Medicine GreenvilleGreenvilleUSA

Personalised recommendations