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2013 | OriginalPaper | Hoofdstuk

12. Nuclear Imaging in Cardiovascular Medicine

Auteurs : Diwakar Jain, MD, FACC, FRCP, FASNC, Barry L. Zaret, MD, FACC

Uitgeverij: Springer New York

Abstract

Nuclear cardiovascular imaging uses various radioisotopes labeled to suitable molecules to noninvasively image various biological phenomena in the intact human body under various physiological conditions. In cardiovascular medicine, we can study myocardial perfusion, function, and metabolism at rest and with exercise or pharmacological stress. Myocardial perfusion imaging is perhaps the most powerful and widely used noninvasive test for diagnosing, risk stratification, and evaluating the progress of patients with coronary artery disease. A number of advances have been made recently in the techniques and instrumentation used for myocardial perfusion imaging, to improve its diagnostic accuracy and patient comfort and reduce radiation exposure to the patients. Single-photon emission tomography (SPECT) is the conventional technique for nuclear imaging. However, positron emission tomography (PET) is increasingly being used. PET imaging offers better resolution and better image quality and less susceptibility to technical artifacts compared to SPECT imaging. A number of new molecular imaging techniques are currently under development. These techniques use novel radiopharmaceuticals and offer the possibility of noninvasive imaging of several complex biological phenomena such as myocardial ischemia; atheroma, vascular inflammation, and vascular remodeling; angiogenesis, stem cell and gene therapy, and gene expression; and myocardial injury, repair, and remodeling.

vorige hoofdstuk Cardiac Catheterization

volgende hoofdstuk Cardiovascular Magnetic Resonance and Multidetector Computed Tomography

Jain D, Strauss HW. Introduction to nuclear cardiology. In: Dilsizian V, Narula J, editors. Atlas of nuclear cardiology. London: Current Science; 2003. p. 1–18.

Wackers FJT, Fetterman RC, Mattera JA, Clements JP. Quantitative planar thallium-201 stress scintigraphy: a critical evaluation of the method. Semin Nucl Med. 1985;15:46–66.PubMed

Jain D, Zaret BL. Nuclear imaging techniques for the assessment of myocardial viability. Cardiol Clin. 1995;13:43–57.PubMed

Wackers FJT. The maze of myocardial perfusion imaging protocols in 1994. J Nucl Cardiol. 1994;1:180–8.PubMed

Dilsizian V, Rocco T, Freedman N, et al. Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging. N Engl J Med. 1990;323:141–6.PubMed

The Cardiovascular Council Board of Directors. Cardiovascular nuclear imaging: balancing proven clinical value and potential radiation risk. J Nucl Med. 2011;52:1162–4.

Jain D. ^99mTechnetium labeled myocardial perfusion imaging agents. Semin Nucl Med. 1999;29:221–36.PubMed

Zaret BL, Rigo P, Wackers FJT, and the Tetrofosmin International Trial Group, et al. Myocardial perfusion imaging with technetium-99m tetrofosmin: comparison to thallium-201 imaging and coronary angiography in a phase III multicenter trial. Circulation. 1995;91:313–9.PubMed

Jain D, Wackers FJT, Mattera J, et al. Biokinetics of ^99mTc-tetrofosmin: myocardial perfusion imaging agent: implications for a one day imaging protocol. J Nucl Med. 1993;34:1254–9.PubMed

10.

Joseph B, Bhargava KK, Kandimala J, et al. The nuclear imaging agent sestamibi is a substrate for both MDR1 and MDR2 p-glycoprotein genes. Eur J Nucl Med. 2003;30:1024–31.

11.

Pazhenkottil AP, Ghadri JR, Nkoulou RN, Wolfrum M, Buechel RR, Küest SM, et al. Improved outcome prediction by SPECT myocardial perfusion imaging after CT attenuation correction. J Nucl Med. 2011;52:196–200.PubMed

12.

Travin MI. Cardiac cameras. Semin Nucl Med. 2011;41:182–201.PubMed

13.

Dorbala S, Murthy VL. Coronary artery calcification and vascular function. J Nucl Cardiol. 2012;19:227–9.PubMed

14.

Gould KL. Coronary flow reserve and pharmacologic stress perfusion imaging: beginnings and evolution. JACC Cardiovasc Imaging. 2009;2:664–9.PubMed

15.

Samady H, Wackers FJ, Zaret BL, et al. Pharmacological stress perfusion imaging with adenosine: role of simultaneous low level treadmill exercise. J Nucl Cardiol. 2002;9:188–96.PubMed

16.

Taillefer R, Amyot R, Turpin S, et al. Comparison between dipyridamole and adenosine as pharmacologic coronary vasodilators in detection of coronary artery disease with thallium 201 imaging. J Nucl Cardiol. 1996;3:204–11.PubMed

17.

Iskandrian AE, Bateman TM, Belardinelli L, Blackburn B, Cerqueira MD, Hendel RC, et al. Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: results of the ADVANCE phase 3 multicenter international trial. J Nucl Cardiol. 2007;14:645–58.PubMed

18.

Holly TA, Satran A, Bromet DS, et al. The impact of adjunctive adenosine infusion during exercise myocardial perfusion imaging: results of the Both Exercise and Adenosine Stress Test (BEAST) trial. J Nucl Cardiol. 2003;10:291–6.PubMed

19.

Gemignani AS, Abbott BG. The emerging role of the selective A2A agonist in pharmacologic stress testing. J Nucl Cardiol. 2010;17:494–7.PubMed

20.

Udelson JE, Heller GV, Wackers FJ, et al. Randomized, controlled dose-ranging study of the selective adenosine A2A receptor agonist binodenoson for pharmacological stress as an adjunct to myocardial perfusion imaging. Circulation. 2004;109:457–64.PubMed

21.

Prenner BM, Bukofzer S, Behm S, Feaheny K, McNutt BE. A randomized double-blind, placebo controlled study assessing the safety and tolerability of regadenoson in subjects with asthma or chronic obstructive pulmonary disease. J Nucl Cardiol. 2012;19:681–92.PubMed

22.

Palani G, Husain Z, Salinas RC, Karthikeyan V, Karthikeyan AS, Ananthsubramanyam K. Safety of regadenoson as pharmacological stress agent for myocardial perfusion imaging in chronic kidney disease patients not on hemodialysis. J Nucl Cardiol. 2011;18:605–11.PubMed

23.

Hage FG, Iskandrian AE. The effect of caffeine on adenosine myocardial perfusion imaging: time to reassess? J Nucl Cardiol. 2012;19:415–9.PubMed

24.

Tejani FH, Thompson RC, Kristy P, McNutt BE, Iskandrian AE. The effect of caffeine on the accuracy of regadenoson stress myocardial perfusion imaging for detecting reversible perfusion defects. J Nucl Cardiol. 2011;18:759–60 (abstract).

25.

Henzlova MJ, Cerqueira MD, Mahmarian JJ, Yao SS, Quality Assurance Committee of the American Society of Nuclear Cardiology. Stress protocols and tracers. J Nucl Cardiol. 2006;13:e 80–90.

26.

Geleinjnse ML, Kranning BJ, Nemes A, et al. Incidence, pathophysiology and treatment of complications during dobutamine, atropine echocardiography. Circulation. 2010;121:1756–67.

27.

Wackers FJ. Science, art, and artifacts: how important is quantification for the practicing physician interpreting myocardial perfusion studies? J Nucl Cardiol. 1994;1:S109–17.PubMed

28.

Wackers FJ. The art of communicating the nuclear cardiology report. J Nucl Cardiol. 2011;18:833–5.PubMed

29.

Hendel RC, Wackers FJ, Berman DS, Facaro E, DePuey EG, Klein L, et al. American Society of Nuclear Cardiology consensus statement: reporting of radionuclide myocardial perfusion imaging. J Nucl Cardiol. 2006;13:e152–6.PubMed

30.

Gowda A, Peddington L, Shandilya V, Gavriluke A, Jain D. Abnormal intense skeletal radiotracer uptake on myocardial perfusion imaging with Tc-99m sestamibi. J Nucl Cardiol. 2006;13:427–31.PubMed

31.

Ghanbarinia A, Chandra S, Jain D. Renal abnormalities on myocardial SPECT perfusion imaging. Nucl Med Commun. 2008;29:588–92.PubMed

32.

Bateman TM, O’Keefe JH, Dong VM, et al. Coronary angiographic rates after stress single photon emission computed tomographic scintigraphy. J Nucl Cardiol. 1995;2:217–23.PubMed

33.

Berman DS, Hachamovitch R, Shaw LJ, Friedman JD, Hayes SH, Thomson LEJ, et al. Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. J Nucl Med. 2006;47:1107–18.PubMed

34.

Taylor AJ, Sackett MC, Beller GA. The degree of ST-segment depression on symptom-limited exercise testing: relation to the myocardial ischemic burden as determined by thallium-201 scintigraphy. Am J Cardiol. 1995;75:228–31.PubMed

35.

Iskander S, Iskandrian AE. Risk assessment using single-photon emission computed tomographic technetium-99m sestamibi imaging. J Am Coll Cardiol. 1998;32:57–62.PubMed

36.

Thomas GS, Miyamoto MI, Morello P, et al. Technetium-99m sestamibi myocardial perfusion imaging predicts clinical outcome in the community outpatient setting: the Nuclear Utility in the Community (NUC) Study. J Am Coll Cardiol. 2004;43:213–23.PubMed

37.

Gibson RS, Watson DD, Craddock GB, et al. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. Circulation. 1983;68:321–36.PubMed

38.

Jain D, Wackers FJT, Zaret BL. Radionuclide imaging techniques in the thrombolytic era. In: Becker R, editor. Modern era of coronary thrombolysis. 1st ed. Norwell: Kluwer Academic Publishers; 1994. p. 195–218.

39.

Gani F, Jain D, Lahiri A. The role of cardiovascular imaging techniques in the assessment of patients with acute chest pain. Nucl Med Commun. 2007;28:441–9.PubMed

40.

Udelson JE, Beshansky JR, Ballin DS, et al. Myocardial perfusion imaging for evaluation and triage of patients with suspected acute cardiac ischemia: a randomized controlled trial. JAMA. 2002;288:2693–700.PubMed

41.

Nabi F, Chang SM, Xu J, Gigliotti E, Mahmarian JJ. Assessing risk in acute chest pain: value of stress myocardial perfusion imaging in patients admitted through emergency department. J Nucl Cardiol. 2012;19:233–43.PubMed

42.

Wackers FJT. Acute chest pain of uncertain etiology, the long and short view. J Nucl Cardiol. 2012;19:220–3.PubMed

43.

Abbott BG, Jain D. Impact of myocardial perfusion imaging on clinical management and the utilization of hospital resources in suspected acute coronary syndromes. Nucl Med Commun. 2003;24:1061–9.PubMed

44.

Hoffmann U, Truong QA, Fleg JL, Goehler A, Gazelle S, Wiviott S, et al. Design of the Rule Out Myocardial Ischemia/Infarction Using Computer Assisted Tomography: a multicenter randomized comparative effectiveness trial of cardiac computed tomography versus alternative triage strategies in patients with acute chest pain in the emergency department. Am Heart J. 2012;163:330–8.PubMed

45.

Gibbons RJ. Chest pain triage in the emergency department. Is CT coronary angiography the answer. J Nucl Cardiol. 2012;19:404–6.PubMed

46.

Leppo JA. Preoperative cardiac risk assessment for noncardiac surgery. Am J Cardiol. 1995;75:42D–51.PubMed

47.

Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for non-cardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2007;50:e242–64.

48.

Ragosta M, Beller GA, Watson DD, et al. Quantitative planar rest-redistribution ²⁰¹Tl imaging in detection of myocardial viability and prediction of improvement in left ventricular function after coronary bypass surgery in patients with severely depressed left ventricular function. Circulation. 1993;87:1630–41.PubMed

49.

Caner B, Beller GA. Are technetium-99m-labeled myocardial perfusion agents adequate for detection of myocardial viability? Clin Cardiol. 1998;4:235–42.

50.

He ZX, Verani MS, Liu XJ. Nitrate-augmented myocardial imaging for assessment of myocardial viability [editorial]. J Nucl Cardiol. 1995;2:352–7.PubMed

51.

Bonow RO, Holly TA. Myocardial viability testing: still viable after stich? J Nucl Cardiol. 2011;18:991–4.PubMed

52.

Iskandrian AE, Hage FG. Towards personalized myocardial viability testing: personal reflections. J Nucl Cardiol. 2012;19:216–9.PubMed

53.

Borges-Neto S, Shaw LJ, Kesler KL, et al. Prediction of severe coronary artery disease by combined rest and exercise radionuclide angiocardiography and tomographic perfusion imaging with technetium 99m-labeled sestamibi: a comparison with clinical and electrocardiographic data. J Nucl Cardiol. 1997;4:189–94.PubMed

54.

Lee KL, Proyer DB, Pieper KS, et al. Prognostic value of radionuclide angiography in medically treated patients with coronary artery disease: a comparison with clinical and catheterization variables. Circulation. 1990;82:1705–17.PubMed

55.

The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992;327:685–91.

56.

Schwartz RG, McKenzie B, Alexander J, et al. Congestive heart failure and left ventricular dysfunction complicating doxorubicin therapy: seven-year experience using serial radionuclide angiocardiography. Am J Med. 1987;82:1109–18.PubMed

57.

Jain D, Zaret BL. Antimyosin cardiac imaging: will it play a role in the detection of doxorubicin cardiotoxicity? J Nucl Med. 1990;31:1970–5 (editorial).PubMed

58.

Panjrath GS, Jain D. Monitoring of chemotherapy induced cardiotoxicity: role of cardiac nuclear imaging. J Nucl Cardiol. 2006;13:415–26.PubMed

59.

Mitani I, Jain D, Joska TM, et al. Doxorubicin cardiotoxicity: prevention of congestive heart failure with serial cardiac function monitoring with equilibrium radionuclide angiocardiography in the current era. J Nucl Cardiol. 2003;10:132–9.PubMed

60.

Bonow RP, Kent KM, Rosing DR, et al. Exercise-induced ischemia in mildly symptomatic patients with coronary artery disease and preserved left ventricular function: identification of subgroups at risk of death during medical therapy. N Engl J Med. 1984;311:1339–45.PubMed

61.

Zaret BL, Jain D. Monitoring of left ventricular function with miniaturized non-imaging detectors. In: Zaret BL, Beller GA, editors. Nuclear cardiology: state of the art and future directions. 2nd ed. St. Louis: Mosby Year Book; 1999. p. 191–200.

62.

Burg MM, Jain D, Soufer R, et al. Role of behavioral and psychological factors in mental stress induced silent left ventricular dysfunction in coronary artery disease. J Am Coll Cardiol. 1993;22:440–8.PubMed

63.

Jain D, Burg MM, Soufer RS, Zaret BL. Prognostic significance of mental stress induced left ventricular dysfunction in patients with coronary artery disease. Am J Cardiol. 1995;76:31–5.PubMed

64.

Jiang W, Babyak M, Krantz DS, et al. Mental stress-induced myocardial ischemia and cardiac events. JAMA. 1996;275:1651–6.PubMed

65.

Krantz DS, Santiago HT, Kop WJ, et al. Prognostic value of mental stress testing in coronary artery disease. Am J Cardiol. 1999;84:1292–7.PubMed

66.

Jain D, Lahiri A, Raftery EB. Immunoscintigraphy for detecting acute myocardial infarction without electrocardiographic changes. Br Med J. 1990;300:151–3.

67.

Dec GW, Palacios I, Yasuda T, et al. Antimyosin antibody cardiac imaging: its role in the diagnosis of myocarditis. J Am Coll Cardiol. 1990;16:97–104.PubMed

68.

Carrio I, Estorch M, Berna L, et al. Indium-111-antimyosin and iodine-123-MIBG studies in early assessment of doxorubicin cardiotoxicity. J Nucl Med. 1995;36:2044–9.PubMed

69.

Mariani G, Villa G, Rossettin PF, et al. Detection of acute myocardial infarction by 99mTc-labeled D-glucaric acid imaging in patients with chest pain. J Nucl Med. 1999;40:1832–9.PubMed

70.

Hofstra L, Liem IH, Dumont EA, et al. Visualisation of cell death in vivo in patients with acute myocardial infarction. Lancet. 2000;356:209–12.PubMed

71.

Blankenberg F, Mari C, Strauss HW. Imaging cell death in vivo. Q J Nucl Med. 2003;47:337–48.PubMed

72.

Narula J, Acio ER, Narula N, Samuels LE, Fyfe B, Wood D, et al. Annexin imaging for non-invasive clinical detection of apoptosis. Nat Med. 2001;7:1347–52.PubMed

73.

Panjrath GS, Patel V, Valdiviezo C, Narula N, Narula J, Jain D. Potentiation of doxorubicin cardiotoxicity by iron loading in a rodent model. J Am Coll Cardiol. 2007;49:2459–66.

74.

Dorbala S, Hachamovitch R, Curillova Z, Thomas D, Vangala D, Kwong RY, et al. Incremental prognostic value of gated Rb-82 positron emission tomography myocardial perfusion imaging over clinical variables and rest LVEF. JACC Cardiovasc Imaging. 2009;2:846–54.PubMed

75.

Bax JJ, Patton JA, Poldermans D, et al. 18-Fluorodeoxyglucose imaging with positron emission tomography and single photon emission computed tomography: cardiac applications. Semin Nucl Med. 2000;30:281–98.PubMed

76.

Heller G, Calnon D, Dorbala S. Recent advances in cardiac PET and PET/CT myocardial perfusion imaging. J Nucl Cardiol. 2009;16:962–9.PubMed

77.

Bengel FM, Higuchi T, Javadi MS, Lautamaki R. Cardiac positron emission tomography. J Am Coll Cardiol. 2009;54:1–15.PubMed

78.

Nekolla SG, Reder S, Saraste A, Higuchi T, Dzewas G, Preissel A, et al. Evaluation of the novel myocardial perfusion positron-emission tomography tracer ¹⁸F-BMS-747158-02. Circulation. 2009;119:2333–42.PubMed

79.

Beller GA, Watson DD. A welcomed new myocardial perfusion imaging agent for positron emission tomography. Circulation. 2009;119:2299–301.PubMed

80.

Jain D, Ghanbarinia A, He ZX. Developing a new PET myocardial perfusion tracer. J Nucl Cardiol. 2009;16:689–90 (editorial).PubMed

81.

Murthy V, Naya M, Foster CR, Hainer J, Gaber M, Di Carli G, et al. Improved cardiac risk assessment with non-invasive measures of coronary flow reserve. Circulation. 2011;124:2215–24.PubMed

82.

Gewirtz H. PET measurement of adenosine stimulated absolute myocardial blood flow for physiological assessment of the coronary circulation. J Nucl Cardiol. 2012;19:347–57.PubMed

83.

Maddahi J. Properties of an ideal PET perfusion tracer: new PET tracer cases and data. J Nucl Cardiol. 2012;19:S30–7.PubMed

84.

Dunphy MP, Freiman A, Larson SM, Strauss HW. Association of vascular ¹⁸F-FDG uptake with vascular calcification. J Nucl Med. 2005;46:1278–84.PubMed

85.

Abdelbaky A, Tawakol A. Noninvasive positron emission tomography imaging for coronary arterial inflammation. Curr Cardiovasc Imaging Rep. 2011;4:41–9.PubMed

86.

Dweck MR, Chow MWL, Joshi N, et al. Coronary arterial ¹⁸F-sodium fluoride uptake: a novel marker of plaque biology. J Am Coll Cardiol. 2012;59:1539–48.PubMed

87.

Douglas PS, Carr JJ, Cerqueira MD, Cummings JE, Gerber TC, Mukherjee D, et al. Developing an action plan for patient radiation safety in adult cardiovascular medicine: proceedings from the Duke University Clinical Research Institute/American College of Cardiology Foundation/American Heart Association Think Tank held on Feb 28, 2011. J Am Coll Cardiol. 2012;59:1833–47.PubMed

88.

Beller GA. Tests that may be overused or misused in cardiology: the choosing wisely campaign. J Nucl Cardiol. 2012;19:401–3.PubMed

89.

Einstein AJ. Effects of radiation exposure from cardiac imaging: how good are the data? J Am Coll Cardiol. 2012;59:553–65.PubMed

90.

Hendel RC, Cerqueira M, Douglas PS, et al. A multicenter assessment of the use of single-photon emission computed tomography myocardial perfusion imaging with appropriateness criteria. J Am Coll Cardiol. 2010;55:156–62.PubMed

91.

Jain D, McNulty PH. Exercise-induced myocardial ischemia: can this be imaged with F-18-fluorodeoxyglucose? J Nucl Cardiol. 2000;7:286–8 (editorial).PubMed

92.

He ZX, Shi RF, Wu YJ, et al. Direct imaging of exercise induced myocardial ischemia in coronary artery disease. Circulation. 2003;108:1208–13.PubMed

93.

Gould KL, Taegtmeyer H. Myocardial ischemia, fluorodeoxyglucose, and severity of coronary artery stenosis: the complexities of metabolic remodeling in hibernating myocardium (letter to the editor and response). Circulation. 2004;109:e167–70.PubMed

94.

Dou KF, Yang MF, Yang YJ, Jain D, He ZX. Myocardial ¹⁸FDG uptake after exercise-induced myocardial ischemia in patients with coronary artery disease. J Nucl Med. 2008;49:1986–91.PubMed

95.

Jain D, He ZX. Direct imaging of myocardial ischemia: a potential new paradigm in nuclear cardiovascular imaging. J Nucl Cardiol. 2008;15:617–30.PubMed

96.

Jain D, He ZX, Ghanbarinia A. Exercise ¹⁸FDG imaging for the detection of coronary artery disease: what are the clinical hurdles? Curr Cardiol Rep. 2010;12:170–8.PubMed

97.

Jain D, He ZX, Ghanbarinia A, Baron J, Gavriluke A. Direct imaging of myocardial ischemia with ¹⁸FDG: a new potentially paradigm shifting molecular cardiovascular imaging technique. Curr Cardiovasc Imaging Rep. 2010;3:134–50.

98.

Jacobson AF, Senior R, Cerqueira M, Wong N, Thomas GS, Lopez VA, et al. Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure: results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. J Am Coll Cardiol. 2010;55:2212–21.PubMed

99.

Abdullah M, Gerson MC. A step forward in the use of SPECT imaging with I-123-MIBG. J Nucl Cardiol. 2012;19:16–8.

100.

Berry CR, Garg PK, DeGrado TR, et al. Para-[18F] fluorobenzylguanidine kinetics in a canine coronary artery occlusion model. J Nucl Cardiol. 1996;3:119–29.PubMed

101.

Kontos MC, Dilsizian V, Weiland F, DePuey G, Mahmarian JJ, Iskandrian AE, et al. Iodofiltic acid (123I-BMIPP) fatty acid imaging improves initial diagnosis in emergency department patients with suspected acute coronary syndromes: a multicenter trial. J Am Coll Cardiol. 2010;56:290–9.PubMed

102.

Roderiguez-Porcel M, Cai W, Gheyseus O, et al. Imaging of VEGF receptor in a rat myocardial infarction model using PET. J Nucl Med. 2008;49:667–73.

103.

Sadeghi M, Krassilnikova S, Zhang J, et al. Imaging α_vß₃ integrin in vascular injury: does this reflect increased integrin expression or activation. Circulation. 2008;118:404–10.

104.

Wu JC, Inbushi M, Sunderasen G, et al. Positron emission tomography imaging of cardiac reporter gene expression in living rats. Circulation. 2002;106:180–3.PubMed

Heller GV, Hendel RC. Nuclear cardiology: practical applications. 1st ed. New York: McGraw-Hill; 2004.

Zaret BL, Beller GA, editors. Nuclear cardiology: state of the art and future directions. 4th ed. New York: Mosby-Elsevier; 2011.

Titel: Nuclear Imaging in Cardiovascular Medicine
Auteurs: Diwakar Jain, MD, FACC, FRCP, FASNC
Barry L. Zaret, MD, FACC
Uitgeverij: Springer New York
Boek: Essential Cardiology
Print ISBN: 978-1-4614-6704-5

Elektronisch ISBN: 978-1-4614-6705-2

Copyright: 2013
DOI: https://doi.org/10.1007/978-1-4614-6705-2_12

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