The aim of this text is to review pertinent clinically relevant topics in nuclear cardiology for the clinician referring patients for nuclear cardiology studies, performing and reading nuclear cardiology studies, and for those who are training to do so. The information here is practical, concise and clinically relevant for the day-to-day practice of nuclear cardiology. Topics that are likely to be seen in the daily practice of nuclear cardiology are emphasized.

A case-based format is used with heavy emphasis on illustrations, making this a case-based atlas of nuclear cardiology

Table of contents

Broad Topics (Introductory Topics)
Image Reconstruction and format of a normal study (e.g. normalstudy.ppt slides 4, 31 41)
Nuclear Imaging Protocols (e.g. nuclearimagingprotocols.ppt all slides)
Use cases from stressonly.ppt to illustrate stress utility of stress only (short protocol) for Tc99m agents
Slides 10-18: high pretest prob. With very abnormal stress can go straight to angiogram (note, SPECT not matching polar image)
Slides 1-5: low pretest probability obese with normal high dose stress 1st images
Gated Blood Pool Scan (gbps.ppt, all slides)
Specific Topics
Diagnostic and Prognostic Value of Nuclear Cardiology Studies (diagnosisprognosis.ppt slides 26-33)
Diabetic patient (e.g. diabetic patient.ppt: case with selected slides to illustrate points
Nuclear Cardiology: Perfusion imaging for Pediatric Patients (pediatrics.ppt)
Perfusion imaging: definition on slide 17
Slides 22-33: Kawasaki
Slides 34-55: Myocarditis with L. main disease
Correlation between SPECT and angiogram (perfuscathmismatch.ppt: most slides)
Attenuation and scatter corrected imaging (attencorr.ppt: most slides)
Slides 10-14 low pretest probability in woman with typical breast attenuation
Slides 38-43 intermediate pretest probability in man with typical diaphragm attenuation
Slides 44-54 high pretest probability with normal corrected images and angiogram correlation
Slide 58 alone nicely shows breast shadow on planar image
Attenwicardiomyop.ppt: all slides show nice case of attenuation and scatter correction in patient with known cardiomyopathy and normal coronary arteries by angiogram
Scatterartifact.ppt all slides illustrates how to properly deal with scatter from adjacent tissue
Detecting Severe CAD by Imaging and Non-imaging Findings
Severecad.ppt
TID.ppt
Balancedischemia.ppt
Assessment of Myocardial Viability (viabil2.ppt)
Cardiac PET: Role in Assessment of Myocardial Perfusion, Cardiac Metabolism and Quantification of Coronary Blood Flow
Diagnosing cardiomyopathy:(cardiomyopathy.ppt)
Slides 1-4: cardiomyopathy with concentric LVH and dilatation
Slides 5-10: concentric LVH showing echo correlation
Slides 11- 16: focal hypertrophy (need angiogram still shot or just indicate normal coronaries. Nice echo correlation
Slides 17-21: Cardiomyopathy with CAD
Slides 22-27: Valvular heart disease with eccentric LVH
Slides 28-34: End stage renal disease, concentric LVH by SPECT and MUGA
Common Technical Errors / Pitfalls
Motion artifact (motionartifact.ppt)
Scatter artifact (scatterartifact.ppt can be used here or with category 4)
Artifact due to significant gut uptake of tracer (adjacent to heart) (gutuptake.ppt)
Myocardial perfusion scan done too soon after V/Q scan: mibi vqscan.ppt
Significant heart block during adenosine infusion: adenosineheartblock.ppt
False positive study due to exercising with LBBB: exerciselbbb.ppt
Prinzemetal's Angina / Microvascular Disease (prinzemetal.ppt)
Specific Unusual & Interesting Cases
Primary cardiac lymphoma with infarct avid imaging: infarctavidimaging.ppt
Cardiac Sarcoid: sarcoid2.ppt
Transient decrease in LV function due to ischemia: stresstunning.ppt
Duchenne muscular dystrophy MUGA scan: duchenne.ppt
Cholecystitis diagnosed by myocardial SPECT: cholecystitis.ppt
Diagnosing hiatal hernia during nuclear stress test (hiatalhernia.ppt)
Significant perfusion defect with non-obstructive CAD on angiogram but significant CAD by IVUS: ivuscad.ppt
Dextrocardia: dextrocardia.ppt
RV enlargement by ECG and SPECT study: pulmdisease.ppt