Radionuclide Angiography

This chapter discusses the technique and use of radionuclide angiography with planar and tomographic imaging. Planar techniques have given way to tomographic imaging in recent years. An overview of RNA is given, including technical issues such as radiopharmaceutical administration, and performance aspects including image acquisition and data interpretation. First-pass RNA (FPRNA), gated planar equilibrium RNA (ERNA) and gated tomographic equilibrium blood pool imaging (GBP-SPECT) are discussed in detail. The use of RNA in select patient populations, including coronary artery disease, valvular disease and for monitoring chemotherapy is discussed. In addition, the use of RNA for the assessment of dyssynchrony is discussed.

Planar equilibrium shapes of a liquid drop on a membrane

The equilibrium shape of a small liquid drop on a smooth rigid surface is governed by the minimization of energy with respect to the change in configuration, represented by the well-known Young's equation.

Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension

Right ventricle ejection fraction (RVEF) evaluated with magnetic resonance imaging is a strong determinant of patient outcomes in pulmonary arterial hypertension. We evaluated the prognostic value of RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change 3–6 months after initiating pulmonary arterial hypertension-specific therapy.In a prospective cohort of newly diagnosed patients with idiopathic, heritable or anorexigen-associated pulmonary arterial hypertension, RVEF was measured at baseline (n=100) and 3–6 months after initiation of therapy (n=78). After a median follow-up of 4.1 years, 41 deaths occurred, including 35 from cardiovascular causes. Patients with a (median) baseline RVEF >25% had better survival than those with a RVEF <25% using Kaplan–Meier analysis (p=0.010). RVEF at baseline was an independent predictor of all-cause and cardiovascular mortality in adjusted Cox regression model (p=0.002 and p=0.007, respectively; HR 0.93 for both). Patients with stable or increased RVEF at 3–6 months had a trend for improved all-cause survival (HR 2.43, p=0.086) and had less cardiovascular mortality (HR 3.25, p=0.034) than those in whom RVEF decreased despite therapy.RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change in RVEF 3–6 months after therapy initiation independently predict outcomes in patients with pulmonary arterial hypertension.