The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
François Rouzet - One of the best experts on this subject based on the ideXlab platform.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis?
Current Cardiology Reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel S. Slama, François RouzetAbstract:Purpose of Review Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Recent Findings Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. Summary By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis
Current cardiology reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel Slama, François RouzetAbstract:Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
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Nuclear Imaging in Sarcoidosis.
Seminars in nuclear medicine, 2018Co-Authors: Eve Piekarski, Khadija Benali, François RouzetAbstract:Sarcoidosis is a multisystem granulomatosis which may result in a wide variety of clinical and biological presentations. Symptoms are often nonspecific, and incidental abnormal findings on chest radiography is rather common. Although sarcoidosis resolves favorably in most cases, some localizations can provoke functional impairment or even impact on patients' prognosis. The diagnosis is based on a pathological hallmark which is the non-necrotizing epithelioid-cell rich granuloma. Owing to the ability to detect inflammation throughout the body with a high sensibility, FDG-PET/CT gained a central role in sarcoidosis because it can suggest the diagnosis in certain clinical context, guide biopsy, evaluate the extent of the disease, help assess the prognosis, and monitor immunosuppressive therapy. This review will briefly describe clinical and typical findings of conventional Imaging according to organ involvement, in order to highlight the additional information provided by Nuclear Imaging. In the future, we can expect to further improve diagnostic performance of Imaging in some indications through the availability of more specific radiopharmaceuticals and the wider use of combined PET/MRI.
Jeroen J. Bax - One of the best experts on this subject based on the ideXlab platform.
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Clinical topic: Nuclear Imaging in hypertrophic cardiomyopathy
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2014Co-Authors: Victoria Delgado, Jeroen J. BaxAbstract:Non-invasive cardiac Imaging plays a central role in the diagnosis and management of patients with hypertrophic cardiomyopathy. Transthoracic echocardiography is the Imaging technique of first choice to evaluate wall thickness, left ventricular systolic and diastolic function, presence of left ventricular outflow tract obstruction, and abnormal mitral anatomy, whereas cardiac magnetic resonance provides additional information on tissue characterization (replacement fibrosis) using late gadolinium enhancement. Nuclear Imaging techniques permit also the assessment of left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy but are more frequently used to evaluate myocardial ischemia (particularly assessment of microvascular dysfunction using positron emission tomography) and abnormal sympathetic myocardial innervation. This review article provides an overview of the use of Nuclear Imaging techniques to refine the phenotyping and risk stratification of patients with hypertrophic cardiomyopathy with particular focus on prediction of progression to overt heart failure, detection of myocardial ischemia, and evaluation of the arrhythmogenic substrate and risk of sudden cardiac death.
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Nuclear Imaging to Assess Infarction, Reperfusion, No-Reflow, and Viability
Management of Myocardial Reperfusion Injury, 2012Co-Authors: Victoria Delgado, Arend F.l. Schinkel, Kai-hang Yiu, Jeroen J. BaxAbstract:Thrombolytic therapy and primary percutaneous coronary have improved the survival of patients with acute myocardial infarction. However, this superior survival leads to an increased prevalence of left ventricular systolic dysfunction and development of heart failure at follow-up. Nuclear Imaging permits comprehensive evaluation of patients with coronary artery disease. In the setting of acute myocardial infarction, 99mTc-sestamibi SPECT provides information on myocardium at risk, infarct size and myocardial salvage, well-known measures of the efficacy of reperfusion therapy, and important prognostic markers. In addition, Nuclear Imaging permits the assessment of no-reflow phenomenon that may take place during thrombolysis or percutaneous revascularization techniques. Timely detection of this phenomenon may help to select the most appropriate therapies to improve the microcirculation of the infarcted areas and, consequently, to improve the contractile function of the myocardium at follow-up. Furthermore, Nuclear Imaging plays a central role in the evaluation of ischemic heart failure patients with a substantial amount of dysfunctional but viable myocardium who may benefit from coronary revascularization with significant improvements in left ventricular function, heart failure symptoms, and prognosis. This chapter will review the role of Nuclear Imaging in acute myocardial infarction, with special focus on the relevance of this technique to assess the efficacy of reperfusion therapy. In addition, a detailed appraisal of multimodality Imaging for noninvasive assessment of hibernating myocardium will be provided.
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The role of Nuclear Imaging in the failing heart: myocardial blood flow, sympathetic innervation, and future applications
Heart failure reviews, 2010Co-Authors: Mark J. Boogers, Kenji Fukushima, Frank M. Bengel, Jeroen J. BaxAbstract:Heart failure represents a common disease affecting approximately 5 million patients in the United States. Several conditions play an important role in the development and progression of heart failure, including abnormalities in myocardial blood flow and sympathetic innervation. Nuclear Imaging represents the only Imaging modality with sufficient sensitivity to assess myocardial blood flow and sympathetic innervation of the failing heart. Although Nuclear Imaging with single-photon emission computed tomography (SPECT) is most commonly used for the evaluation of myocardial perfusion, positron emission tomography (PET) allows absolute quantification of myocardial blood flow beyond the assessment of relative myocardial perfusion. Both techniques can be used for evaluation of diagnosis, treatment options, and prognosis in heart failure patients. Besides myocardial blood flow, cardiac sympathetic innervation represents another important parameter in patients with heart failure. Currently, sympathetic nerve Imaging with 123-iodine metaiodobenzylguanidine (123-I MIBG) is often used for the assessment of cardiac innervation. A large number of studies have shown that an abnormal myocardial sympathetic innervation, as assessed with 123-I MIBG Imaging, is associated with increased mortality and morbidity rates in patients with heart failure. Also, cardiac 123-I MIBG Imaging can be used to risk stratify patients for ventricular arrhythmias or sudden cardiac death. Furthermore, novel Nuclear Imaging techniques are being developed that may provide more detailed information for the detection of heart failure in an early phase as well as for monitoring the effects of new therapeutic interventions in patients with heart failure.
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Erratum to: The Use of Nuclear Imaging for Cardiac Resynchronization Therapy
Current Cardiology Reports, 2010Co-Authors: Ji Chen, Jeroen J. Bax, Mark J. Boogers, Prem Soman, Ernest V. GarciaAbstract:Erratum to: Curr Cardiol Rep DOI 10.1007/s11886-010-0086-9 Chen J, Boogers MJ, Bax JJ, et al.: The Use of Nuclear Imaging for Cardiac Resynchronization Therapy.Curr Cardiol Rep 2010, 12:185–191. The abovementioned article was published in the March 2010 issue of Current Cardiology Reports (volume 12, issue 2). The article inadvertently listed the middle initial of the second author incorrectly. The name should have been listed as Mark J. Boogers.
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Nuclear Imaging in heart failure.
Cardiology clinics, 2009Co-Authors: Jeroen J. Bax, Mark M Boogers, Joanne D. SchuijfAbstract:Heart failure is becoming the main clinical challenge in cardiology in the twenty-first century and is associated with high morbidity and mortality. Currently, several therapeutic options are available for heart failure patients, including medical therapy, revascularization, advanced cardiac surgery, device therapy, and cardiac transplantation. Future therapies are directed at cell and gene therapy. In this article the role of Nuclear Imaging in the management of heart failure patients is discussed.
Eve Piekarski - One of the best experts on this subject based on the ideXlab platform.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis?
Current Cardiology Reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel S. Slama, François RouzetAbstract:Purpose of Review Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Recent Findings Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. Summary By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis
Current cardiology reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel Slama, François RouzetAbstract:Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
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Nuclear Imaging in Sarcoidosis.
Seminars in nuclear medicine, 2018Co-Authors: Eve Piekarski, Khadija Benali, François RouzetAbstract:Sarcoidosis is a multisystem granulomatosis which may result in a wide variety of clinical and biological presentations. Symptoms are often nonspecific, and incidental abnormal findings on chest radiography is rather common. Although sarcoidosis resolves favorably in most cases, some localizations can provoke functional impairment or even impact on patients' prognosis. The diagnosis is based on a pathological hallmark which is the non-necrotizing epithelioid-cell rich granuloma. Owing to the ability to detect inflammation throughout the body with a high sensibility, FDG-PET/CT gained a central role in sarcoidosis because it can suggest the diagnosis in certain clinical context, guide biopsy, evaluate the extent of the disease, help assess the prognosis, and monitor immunosuppressive therapy. This review will briefly describe clinical and typical findings of conventional Imaging according to organ involvement, in order to highlight the additional information provided by Nuclear Imaging. In the future, we can expect to further improve diagnostic performance of Imaging in some indications through the availability of more specific radiopharmaceuticals and the wider use of combined PET/MRI.
Bruce E. Lehnert - One of the best experts on this subject based on the ideXlab platform.
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Detection of ventricular shunt malfunction in the ED: relative utility of radiography, CT, and Nuclear Imaging
Emergency Radiology, 2011Co-Authors: Bruce E. Lehnert, Habib Rahbar, Annemarie Relyea-chew, David H. Lewis, Michael L. Richardson, James R. FinkAbstract:The study objective was to determine the relative diagnostic utility of the radiographic shunt series (SS), head computed tomography (CT), and Nuclear Imaging performed in our Emergency Department (ED) for evaluating ventricular shunt malfunction. We retrospectively reviewed medical records, head CT (if performed), and Nuclear Imaging (if performed) for all ED patients with suspected shunt malfunction from 2002 to 2007 who underwent plain film shunt evaluation (296 cases/186 individuals) to determine if surgical shunt revision was performed. Logistic regression analysis was applied. Four percent (12/296) of radiographic SS were abnormal. Only 0.3% (1/296) underwent surgical revision in the absence of an abnormal head CT or Nuclear Imaging. Eighteen percent (51/282) of head CT exams were positive and 19% (24/128) of Nuclear Imaging exams were positive for shunt malfunction. Twenty-three percent (67/296) underwent surgical shunt revisions. Statistical analysis demonstrated that SS evaluation was not significantly associated with surgical shunt revision (OR 0.92; 95% CI, 0.7–1.2; p = 0.47). Head CT demonstrated a significant association with surgical revision (OR 1.4; 95% CI, 1.2–1.5; p
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Detection of ventricular shunt malfunction in the ED: relative utility of radiography, CT, and Nuclear Imaging
Emergency radiology, 2011Co-Authors: Bruce E. Lehnert, Habib Rahbar, Annemarie Relyea-chew, David H. Lewis, Michael L. Richardson, James FinkAbstract:The study objective was to determine the relative diagnostic utility of the radiographic shunt series (SS), head computed tomography (CT), and Nuclear Imaging performed in our Emergency Department (ED) for evaluating ventricular shunt malfunction. We retrospectively reviewed medical records, head CT (if performed), and Nuclear Imaging (if performed) for all ED patients with suspected shunt malfunction from 2002 to 2007 who underwent plain film shunt evaluation (296 cases/186 individuals) to determine if surgical shunt revision was performed. Logistic regression analysis was applied. Four percent (12/296) of radiographic SS were abnormal. Only 0.3% (1/296) underwent surgical revision in the absence of an abnormal head CT or Nuclear Imaging. Eighteen percent (51/282) of head CT exams were positive and 19% (24/128) of Nuclear Imaging exams were positive for shunt malfunction. Twenty-three percent (67/296) underwent surgical shunt revisions. Statistical analysis demonstrated that SS evaluation was not significantly associated with surgical shunt revision (OR 0.92; 95% CI, 0.7–1.2; p = 0.47). Head CT demonstrated a significant association with surgical revision (OR 1.4; 95% CI, 1.2–1.5; p < 0.001), as did Nuclear Imaging (OR 1.4; 95% CI, 1.2–1.6; p < 0.001). Patients with suspected ventricular shunt malfunction frequently require surgical revision. Abnormal radiographic SS was not associated with progression to surgical shunt revision, whereas abnormal head CT and abnormal Nuclear Imaging were significantly associated with surgical revision. We conclude that radiographic SS in the ED is of low diagnostic utility and that patients with suspected shunt malfunction should instead initially undergo CT and/or Nuclear Imaging.
Vincent Algalarrondo - One of the best experts on this subject based on the ideXlab platform.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis
Current cardiology reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel Slama, François RouzetAbstract:Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis?
Current Cardiology Reports, 2018Co-Authors: Vincent Algalarrondo, Eve Piekarski, Ludivine Eliahou, Dominique Le Guludec, Michel S. Slama, François RouzetAbstract:Purpose of Review Nuclear Imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of Nuclear Imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA). Recent Findings Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA. Summary By its unique ability to assess both amyloid burden and cardiac denervation, Nuclear Imaging may prove useful as part of multimodality Imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.
