Ritesh Dhar

Real world MRI experience with nonconditional and conditional cardiac rhythm devices after MagnaSafe

The recent MagnaSafe Registry demonstrated safety of nonthoracic magnetic resonance imaging (MRI) with nonconditional cardiac implantable electronic devices (CIEDs). However, independent validation and extension to thoracic MRIs are needed.

IMPACT OF TRANSITIONING FROM SPECT TO PET ON MYOCARDIAL ISCHEMIA DETECTION: EXPERIENCE FROM A HIGH VOLUME “REAL WORLD” PRACTICE

Myocardial Perfusion Imaging (MPI) with PET technology has been shown to improve ischemia detection compared to SPECT, however limited data are available comparing the modalities in clinical practice. We report the impact of transitioning from SPECT testing to PET on the ability to assess myocardial

Implementation of a cardiac PET stress program: comparison of outcomes to the preceding SPECT era

BACKGROUND Cardiac positron emission testing (PET) is more accurate than single photon emission computed tomography (SPECT) at identifying coronary artery disease (CAD); however, the 2 modalities have not been thoroughly compared in a real-world setting. We conducted a retrospective analysis of 60-day catheterization outcomes and 1-year major adverse cardiovascular events (MACE) after the transition from a SPECT- to a PET-based myocardial perfusion imaging (MPI) program. METHODS MPI patients at Intermountain Medical Center from January 2011-December 2012 (the SPECT era, n = 6,777) and January 2014-December 2015 (the PET era, n = 7,817) were studied. Outcomes studied were 60-day coronary angiography, high-grade obstructive CAD, left main/severe 3-vessel disease, revascularization, and 1-year MACE-revascularization (MACE-revasc; death, myocardial infarction [MI], or revascularization >60 days). RESULTS Patients were 64 ± 13 years old; 54% were male and 90% were of European descent; and 57% represented a screening population (no prior MI, revascularization, or CAD). During the PET era, compared with the SPECT era, a higher percentage of patients underwent coronary angiography (13.2% vs. 9.7%, P < 0.0001), had high-grade obstructive CAD (10.5% vs. 6.9%, P < 0.0001), had left main or severe 3-vessel disease (3.0% vs. 2.3%, P = 0.012), and had coronary revascularization (56.7% vs. 47.1%, P = 0.0001). Similar catheterization outcomes were seen when restricted to the screening population. There was no difference in 1-year MACE-revasc (PET [5.8%] vs. SPECT [5.3%], P = 0.31). CONCLUSIONS The PET-based MPI program resulted in improved identification of patients with high-grade obstructive CAD, as well as a larger percentage of revascularization, thus resulting in fewer patients undergoing coronary angiography without revascularization. FUNDING This observational study was funded using internal departmental funds.

DIFFERENCES IN CORONARY FLOW RESERVES BY GENDER AND DIABETIC STATUS AS IDENTIFIED USING CARDIAC PET/CT

Existing literature is scarce regarding normal and abnormal measurements for coronary flow reserve (CFR) non-ischemic rubidium PET/CT cardiac stress perfusion scans using regadenoson as the stress agent. Here we analyze and compare global and vessel-specific CFR between diabetics (DM) and non-