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. 2015 Nov;42(12):1929-40.
doi: 10.1007/s00259-015-3139-x. Epub 2015 Aug 21.

EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

Hein J Verberne  1 , Wanda Acampa  2 , Constantinos Anagnostopoulos  3 , Jim Ballinger  4 , Frank Bengel  5 , Pieter De Bondt  6 , Ronny R Buechel  7 , Alberto Cuocolo  8 , Berthe L F van Eck-Smit  9 , Albert Flotats  10 , Marcus Hacker  11 , Cecilia Hindorf  12 , Philip A Kaufmann  7 , Oliver Lindner  13 , Michael Ljungberg  14 , Markus Lonsdale  15 , Alain Manrique  16 , David Minarik  17 , Arthur J H A Scholte  18 , Riemer H J A Slart  19 , Elin Trägårdh  20 , Tim C de Wit  9 , Birger Hesse  21 ; European Association of Nuclear Medicine (EANM)
Affiliations

EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision

Hein J Verberne et al. Eur J Nucl Med Mol Imaging. 2015 Nov.

Abstract

Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf .

Keywords: Guidelines; Myocardial perfusion imaging; Nuclear medicine; Procedures.

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Figures

Fig. 1
Fig. 1
Selection of stress test modality. Except for patients with left bundle branch block (LBBB) or ventricular paced rhythm, consider combining pharmacological vasodilatory stress with low-level exercise according to the ability of the patient to exercise. In case of pharmacological stress with dobutamine but without adequate heart rate response, consider to add atropine
Fig. 2
Fig. 2
Timeline of regadenoson plus low-level exercise testing. BPM beats per minute
Fig. 3
Fig. 3
Coronary artery territories in a 17-segment model Myocardial perfusion SPECT, coronary computed tomography angiography (CCTA), and fused hybrid SPECT/CCTA of a 43-year-old male patient with presenting symptoms of typical angina. Myocardial perfusion SPECT documents a reversible perfusion defect in short axis and horizontal long axis slices (a) at rest (bottom rows) and stress (top rows). The corresponding polar plots (b) at rest (left plot) and stress (right plot) clearly depict the extent of the ischaemic area in the anterolateral wall. CCTA (c) shows an intermediate stenosis (i.e., 50–70 % luminal narrowing) due to non-calcified plaques in the middle/distal left anterior descending artery at the level of the second diagonal branch bifurcation. Fused hybrid SPECT/CCTA (d) reveals that the anterolateral ischaemia corresponds with the vascular territory of the second diagonal branch, while the stenosis in the left anterior descending artery (LAD) does not cause any ischaemia
See this image and copyright information in PMC

References

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