Thursday, April 4, 2013

Comparison of fully automated computer analysis in nuclear SPECT

This study found that the Cedars-Sinai Total Perfusion Defect score performed well in comparison to two human readers. COMMENT:  this study compared two groups: computer vs human. The problem is that the "human" group consisted of only two readers. It would be a major misconception to assume that two expert readers adequately represent the entire population of expert readers in nuclear medicine. This is a common statistical error that was sadly repeated in this study.

Monday, March 18, 2013

Myocardial sympathetic innervation, function, and oxidative metabolism in non-infarcted myocardium in patients with prior myocardial infarction

BACKGROUND: Sympathetic innervation of the heart is a prognostic indicator for cardiac risk.

OBJECTIVE: This study looked at the relationship between sympathetic innervation and metabolism of the non-infarcted myocardium in patients with prior myocardial infarction.

PARTICIPANTS: 19 patients with previous myocardial infarction

METHODS: cardiac sympathetic innervation was assessed by 11C-hydroxyephedrine (HED) retention by positron emission tomography (PET).

  • 11C-HED retention was positively correlated with left ventricular ejection fraction
  • In patients with a left ventricular end systolic volume of over 41 mL, there was a reduced 11C-HED retention.
  • After myocardial infarction, there is impaired sympathetic innervation of the infarcted and non-infarcted myocardium.
COMMENT: measurement of sympathetic innervation is also possible using MIBG SPECT.