Incidental scan findings in cardiac amyloid scintigraphy.

When interpreting amyloid scintigraphy the nuclear cardiology physician should be aware of incidental image findings that may interfere with scan interpretation and may be of potential clinical significance. As for other nuclear cardiac imaging it is important to inspect the entire field of view of the planar and SPECT images. Correlation with the patient's history and physical examination is crucial in interpretation of these incidental findings.

Correction to: Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC.

The above position statement originally published containing errors in the author metadata; specifically, the Expert Content Reviewers-Andrew Einstein, Raymond Russell and James R. Corbett-were tagged as full authors of the paper. The article metadata has now been corrected to remove Drs. Einstein, Russell and Corbett from the author line, and the PubMed record has been updated accordingly.

Comparisons and contrasts in the practice of nuclear cardiology in the United States and Japan.

There are interesting differences between the practice of Nuclear Cardiology in Japan and that in the United States and associated unique challenges. Differences in patient body habitus and the perceived importance of limiting patient radiation dose have resulted in different radiopharmaceutical and imaging protocol preferences. Governmental approval and reimbursement policies for various radiopharmaceuticals have promulgated adoption of different clinical applications. Both countries have experienced a significant decline in the number of nuclear cardiology studies performed, in part due to decreased governmental funding and reimbursement and to the emergence of competing modalities. Whereas precertification and test substitution have impacted negatively on the sustainability and growth of nuclear cardiology in the United States, in Japan those deterrents have not yet been encountered. Instead, communication barriers between nuclear medicine physicians and referring cardiologists are cited as a more significant barrier.

Traditional gamma cameras are preferred.

Although the new solid-state dedicated cardiac cameras provide excellent spatial and energy resolution and allow for markedly reduced SPECT acquisition times and/or injected radiopharmaceutical activity, they have some distinct disadvantages compared to traditional sodium iodide SPECT cameras. They are expensive. Attenuation correction is not available. Cardio-focused collimation, advantageous to increase depth-dependent resolution and myocardial count density, accentuates diaphragmatic attenuation and scatter from subdiaphragmatic structures. Although supplemental prone imaging is therefore routinely advised, many patients cannot tolerate it. Moreover, very large patients cannot be accommodated in the solid-state camera gantries. Since data are acquired simultaneously with an arc of solid-state detectors around the chest, no temporally dependent "rotating" projection images are obtained. Therefore, patient motion can be neither detected nor corrected. In contrast, traditional sodium iodide SPECT cameras provide rotating projection images to allow technologists and physicians to detect and correct patient motion and to accurately detect the position of soft tissue attenuators and to anticipate associated artifacts. Very large patients are easily accommodated. Low-dose x-ray attenuation correction is widely available. Also, relatively inexpensive low-count density software is provided by many vendors, allowing shorter SPECT acquisition times and reduced injected activity approaching that achievable with solid-state cameras.