Imperial College London
Alternate

Emeritus ProfessorRichardUnderwood

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Cardiac Imaging
 
 
 
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Contact

 

+44 (0)20 7351 8811srunderwood

 
 
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Location

 

2.30Britten WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Schofield:2021:10.1136/heartjnl-2019-315628,
author = {Schofield, R and Menezes, L and Underwood, SR},
doi = {10.1136/heartjnl-2019-315628},
journal = {Heart},
pages = {954--961},
title = {Nuclear cardiology: state of the art.},
url = {http://dx.doi.org/10.1136/heartjnl-2019-315628},
volume = {107},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Radionuclide imaging remains an essential component of modern cardiology. There is overlap with the information from other imaging techniques, but no technique is static and new developments have expanded its role. This review focuses on ischaemic heart disease, heart failure, infection and inflammation. Radiopharmaceutical development includes the wider availability of positron emission tomography (PET) tracers such as rubidium-82, which allows myocardial perfusion to be quantified in absolute terms. Compared with alternative techniques, myocardial perfusion scintigraphy PET and single photon emission computed tomography (SPECT) have the advantages of being widely applicable using exercise or pharmacological stress, full coverage of the myocardium and a measure of ischaemic burden, which helps to triage patients between medical therapy and revascularisation. Disadvantages include the availability of expertise in some cardiac centres and the lack of simple SPECT quantification, meaning that global abnormalities can be underestimated. In patients with heart failure, despite the findings of the STICH (Surgical Treatment for Ischemic Heart Failure) trial, there are still data to support the assessment of myocardial hibernation in predicting when abolition of ischaemia might lead to improvement in ventricular function. Imaging of sympathetic innervation is well validated, but simpler markers of prognosis mean that it has not been widely adopted. There are insufficient data to support its use in predicting the need for implanted devices, but non-randomised studies are promising. Other areas where radionuclide imaging is uniquely valuable are detection and monitoring of endocarditis, device infection, myocardial inflammation in sarcoidosis, myocarditis and so on, and reliable detection of deposition in suspected transthyretin-related amyloidosis.
AU  - Schofield,R
AU  - Menezes,L
AU  - Underwood,SR
DO  - 10.1136/heartjnl-2019-315628
EP  - 961
PY  - 2021///
SN  - 1355-6037
SP  - 954
TI  - Nuclear cardiology: state of the art.
T2  - Heart
UR  - http://dx.doi.org/10.1136/heartjnl-2019-315628
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33483353
UR  - https://heart.bmj.com/content/early/2021/01/22/heartjnl-2019-315628
UR  - http://hdl.handle.net/10044/1/86465
VL  - 107
ER  -
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