Latest Research News on Nuclear Cardiology : Nov 2020
Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology
As a consequence of improved technology, there is growing clinical interest in the use of multi-detector row computed tomography (MDCT) for non-invasive coronary angiography. Indeed, the accuracy of MDCT to detect or exclude coronary artery stenoses has been high in many published studies. This report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT (WG 5) of the European Society of Cardiology and the European Council of Nuclear Cardiology summarizes the present state of cardiac CT technology, as well as the currently available data concerning its accuracy and applicability in certain clinical situations. Besides coronary CT angiography, the use of CT for the assessment of cardiac morphology and function, evaluation of perfusion and viability, and analysis of heart valves is discussed. In addition, recommendations for clinical applications of cardiac CT imaging are given and limitations of the technique are described. 
Corridor4DM: The Michigan method for quantitative nuclear cardiology
Quantitative software for the analysis and review of myocardial perfusion emission computed tomography images is an indispensable tool in the nuclear physician’s evaluation of patients with known or suspected heart disease. The Corridor4DM (4DM) application (formerly known as 4DM-SPECT), developed at the University of Michigan Medical Center, is a quantitative software application providing automated processing, analysis, and reporting of myocardial perfusion and function from cardiac emission computed tomography studies in a tightly integrated, user-centered environment. With health care placing increased emphasis on higher quality and efficiency in diagnostic imaging, quantitative analysis and review software applications need to provide a comprehensive environment supporting correlative review of multimodality images, integrated report generation, and remote review capabilities. The current and future design capabilities of the 4DM software application are discussed with respect to the changing landscape of imaging, where cardiac computed tomography, positron emission tomography, structured reporting, and remote review are expanding the base requirement specifications for quantitative software. 
Proposal for standardization of 123I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology
This proposal for standardization of 123I-metaiodobenzylguanidine (iobenguane, MIBG) cardiac sympathetic imaging includes recommendations for patient information and preparation, radiopharmaceutical, injected activities and dosimetry, image acquisition, quality control, reconstruction methods, attenuation, scatter and collimator response compensation, data analysis and interpretation, reports, and image display. The recommendations are based on evidence coming from original or scientific studies whenever possible and as far as possible reflect the current state-of-the-art in cardiac MIBG imaging. The recommendations are designed to assist in the practice of performing, interpreting and reporting cardiac sympathetic imaging. The proposed standardization does not include clinical indications, benefits or drawbacks of cardiac sympathetic imaging, and does not address cost benefits or cost effectiveness; however, clinical settings of potential utility are mentioned. Standardization of MIBG cardiac sympathetic imaging should contribute to increasing its clinical applicability and integration into current nuclear cardiology practice. 
Pseudo Meig’s Syndrome: An Unusual Presentation
Aim: To describe the radiological findings in a case of pseudo Meig’s syndrome with rare association of pericardial effusion.
Presentation of Case: We report a case of pseudo Meig’s syndrome who also had pericardial effusion. The patient had sonography and MR imaging of the abdomen which showed uterine fibroid associated with bilateral pleural effusion, ascites and pericardial effusion. Subsequently, the patient underwent hysterectomy with bilateral salpingectomy following which ascites, pleural effusion and pericardial effusion resolved. Histopathological examination confirmed uterine leiomyoma with degenerative changes.
Discussion: Pseudo-Meig’s syndrome is a condition which describes the association of any ovarian tumor (benign or malignant) other than ovarian fibroma or any pelvic tumor with pleural effusion and ascites. Association of pericardial effusion along with this condition has been rarely reported. Most common tumors associated with this entity described in previous literature include leiomyoma of uterus and broad ligament, germ cell tumors etc. It becomes highly important to identify this condition as it is a curable condition mimicking malignancy and can avoid unnecessary interventions.
Conclusion: Pseudo-Meig’s syndrome associated with pericardial effusion is a rarely reported entity which can mimic malignant condition and hence it is important to consider it as a possibility in patients who present with pericardial effusion of unknown cause. 
The Association of Vitamin D Levels with the Extent and Severity of Coronary Artery Disease
Aims: Vitamin D is known for its primary role in calcium and bone homeostasis and regulation of parathyroid hormone (PTH) secretion. There is increasing evidence for health benefits accomplished by activated vitamin D, that go beyond these classical functions. Previous studies have suggested that lower Vitamin D levels are associated with increased cardiovascular disease (CVD) risk. Therefore, we aimed to evaluate relationship between vit D levels and extent and severity of coronary artery disease. Study Design: Cross-sectional.
Place and Duration of Study: Sample: Department of Cardiology, Bagcilar Training and Research Hospital between November 2009 and march 2010.
Methodology: We evaluated 135 patients who underwent elective coronary angiography between November 2009 and march 2010. Patients with renal failure(GFR less than 60ml/min per 1.73m2), history of malignancy within the past 5 years, any predominant non-cardiac disease, patients using any vitamin D supplement or with hyperparathyroidism or hypercalcemia were excluded.
The severity and extent of CAD were determined using the Gensini score. And, patients were classified as having advanced (≥40) or mild (<40) CAD according to the Gensini scores.
Results: The mean 25-OH D concentration was 18.7ng/mL. The overall prevalence of 25-OH D less then 15ng/mL was 34,8%(n=47), with 11% having 25-OH D less then 10ng/mL. Multivariate analysis revaeled that smoking, presence of hyperlipidemia, higher CRP levels, higher ALP levels and low levels of 25-OH D concentrations were significantly associated with higher Gensini Scores.
Conclusion: In our study, we found significant correlation between low vitamin D levels and higher Gensini scores. 
 Schroeder, S., Achenbach, S., Bengel, F., Burgstahler, C., Cademartiri, F., De Feyter, P., George, R., Kaufmann, P., Kopp, A.F., Knuuti, J. and Ropers, D., 2008. Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. European heart journal, 29(4), pp.531-556.
 Ficaro, E.P., Lee, B.C., Kritzman, J.N. and Corbett, J.R., 2007. Corridor4DM: the Michigan method for quantitative nuclear cardiology. Journal of nuclear cardiology, 14(4), pp.455-465.
 Flotats, A., Carrió, I., Agostini, D., Le Guludec, D., Marcassa, C., Schaffers, M., Somsen, G.A., Unlu, M. and Verberne, H.J., 2010. Proposal for standardization of 123 I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology. European journal of nuclear medicine and molecular imaging, 37(9), pp.1802-1812.
 Jayasree, Y., Rangasami, R., Radhan, P. and Rani, U. (2015) “Pseudo Meig’s Syndrome: An Unusual Presentation”, Journal of Advances in Medicine and Medical Research, 11(12), pp. 1-4. doi: 10.9734/BJMMR/2016/21978.
 Irfan, S., Ertugrul, O., Halil Ibrahim, B., Fahrettin, T., Suleyman Sezai, Y., Burak, A., Kamil, G. and H. Dinckal, M. (2014) “The Association of Vitamin D Levels with the Extent and Severity of Coronary Artery Disease”, Cardiology and Angiology: An International Journal, 2(4), pp. 304-316. doi: 10.9734/CA/2014/8705.