title: Clinical applications of radionuclide imaging in the evaluation and management of patients with congenital heart disease.
abstract: Non-invasive testing of children with congenital heart disease (CHD) began in the 1950s with the introduction of radionuclide studies to assess shunt fractions, pulmonary blood flow, and ventricular contractile function. Echocardiography and cardiac magnetic resonance imaging have since replaced radionuclide imaging in many of these roles. Concurrently, percutaneous and surgical repairs of complex CHD evolved, creating new roles for radionuclide imaging. In this paper on applications of radionuclide imaging in CHD, we review the multiple mechanisms for myocardial ischemia in CHD. We critically compare optimal radionuclide imaging techniques to other imaging modalities for assessing ischemia in CHD. We present the current role of nuclear imaging for assessing viability and pulmonary blood flow. We highlight the value added by advances in dedicated cardiac SPECT scanners, novel reconstruction software, and cardiac PET in performing low-dose radionuclide imaging in CHD. Finally, we discuss the emerging clinical indications for radionuclide imaging in CHD including coronary flow reserve assessment and evaluation of cardiovascular prosthesis and device infections.
authors.affiliation: The Philadelphia Adult Congenital Heart Disease Program. A Joint Program of Penn Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. sara.partington@uphs.upenn.edu.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Partington
authors.affiliation: Boston Adult Congenital Heart Disease and Pulmonary Hypertension program, A Joint Program of Brigham and Women's Hospital and the Boston Children's Hospital, Boston, MA, USA.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Valente
authors.affiliation: Boston Adult Congenital Heart Disease and Pulmonary Hypertension program, A Joint Program of Brigham and Women's Hospital and the Boston Children's Hospital, Boston, MA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Landzberg
authors.affiliation: Division of Nuclear Medicine, Department of Radiology, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Grant
authors.affiliation: Noninvasive Cardiovascular Imaging Program, Departments of Radiology and Medicine (Cardiology), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, 70 Francis Street, Shapiro 5th Floor, Room 128, Boston, MA, 02115, USA.
authors.forename: Marcelo F
authors.initials: MF
authors.lastname: Di Carli
authors.affiliation: Noninvasive Cardiovascular Imaging Program, Departments of Radiology and Medicine (Cardiology), Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, 70 Francis Street, Shapiro 5th Floor, Room 128, Boston, MA, 02115, USA. sdorbala@partners.org.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Dorbala
mesh_terms: D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
keywords: Myocardial perfusion imaging: SPECT; PET/CT imaging; congenital heart disease; coronary flow reserve; ischemia; magnetic resonance imaging; myocardial