Hybrid Imaging of the Autonomic Cardiac Nervous System

Cardiac autonomic innervation is an integrative part of the physiology of the heart. This chapter reveals an overview of SPECT and PET application in cardiac sympathetic nervous system imaging in various cardiovascular diseases, including acquisition techniques and data analysis.</p

Large Vessel Vasculitis

2-[18F] fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has become part of the worldwide standard of care in oncology. For a decade, this functional imaging tool has also demonstrated important diagnostic results in inflammatory diseases, especially in large vessel vasculitis (LVV). Since clinical PET imaging is increasingly used in these two conditions, this chapter aims to assist imaging specialists and clinicians by getting acquainted with the PET imaging procedures and the current status in clinical practice for LVV. General background information, PET technical considerations (including patient preparation, imaging protocols, scoring methodology), diagnostic and prognostic performance, and response monitoring will be addressed, in line with recent international expert-based recommendations.Also, in the era of personalized medicine, new hybrid technologies such as PET/MR and PET radiotracers will be discussed.</sub

Cardiac PET Imaging of ATP Binding Cassette (ABC) Transporters:Opportunities and Challenges

Adenosine triphosphate binding cassette (ABC) transporters are a broad family of membrane protein complexes that use energy to transport molecules across cells and/or intracellular organelle lipid membranes. Many drugs used to treat cardiac diseases have an affinity for these transporters. Among others, P-glycoprotein (P-gp) plays an essential role in regulating drug concentrations that reach cardiac tissue and therefore contribute to cardiotoxicity. As a molecular imaging modality, positron emission tomography (PET) has emerged as a viable technique to investigate the function of P-gp in organs and tissues. Using PET imaging to evaluate cardiac P-gp function provides new insights for drug development and improves the precise use of medications. Nevertheless, information in this field is limited. In this review, we aim to examine the current applications of ABC transporter PET imaging and its tracers in the heart, with a specific emphasis on P-gp. Furthermore, the opportunities and challenges in this novel field will be discussed.</p

Long Axial Field-of-View PET for Ultra-Low-Dose Imaging of Non-Hodgkin Lymphoma during Pregnancy

Generally, positron emission tomography imaging is not often performed in the case of pregnant patients. The careful weighing of the risks of radiation exposure to the fetus and benefits for cancer staging and the swift onset of treatment for the mother complicates decision making in clinical practice. In oncology, the most commonly used PET radiotracer is 2-deoxy-2-[fluorine-18] fluoro-D-glucose (18F-FDG), a glucose analog which has established roles in the daily routines for, among other applications, initial diagnosis, staging, (radiation) therapy planning, and response monitoring. The introduction of long axial Field-of-View (LAFOV) PET systems allows for PET imaging with a reduced level of injected 18F-FDG activity while maintaining the image quality. Here, we discuss the first reported case of a pregnant patient diagnosed with follicular lymphoma using LAFOV PET imaging for the staging and therapy selection. The acquired PET images show diagnostic quality images with clearly distinguishable areas of lymphadenopathy, even with only 34 MBq of injected 18F-FDG activity, leading to a considerable decrease in the level of radiation exposure to the fetus