Molecular imaging of plaques in coronary arteries with PET and SPECT

Coronary artery disease remains a major cause of mortality. Presence of atherosclerotic plaques in the coronary artery is responsible for lu-men stenosis which is often used as an indicator for determining the severity of coronary artery disease. However, the degree of coronary lumen stenosis is not often related to compromising myocardial blood flow, as most of the cardiac events that are caused by atherosclerotic plaques are the result of vulnerable plaques which are prone to rupture. Thus, identification of vulnerable plaques in coronary arteries has become increas-ingly important to assist identify patients with high cardiovascular risks. Molecular imaging with use of positron emission tomography （PET） and single photon emission computed tomography （SPECT） has fulfilled this goal by providing functional information about plaque activity which enables accurate assessment of plaque stability. This review article provides an overview of diagnostic applications of molecular imaging tech-niques in the detection of plaques in coronary arteries with PET and SPECT. New radiopharmaceuticals used in the molecular imaging of coro-nary plaques and diagnostic applications of integrated PET/CT and PET/MRI in coronary plaques are also discussed.

Coronary CT angiography:Diagnostic value and clinical challenges

Coronary computed tomography(CT)angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography.Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320-slice CT scanners.Despite the promising diagnostic value,coronary CT angiography is still limited in some areas,such as inferior temporal resolution,motion-related artifacts and high false positive results due to severe calcification.The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners.Prognostic value of coronary CT angiography in coronary artery disease is also discussed,while limitations and challenges of coronary CT angiography are highlighted.

Diagnostic value of18F-FDG PET in the assessment of myocardial viability in coronary artery disease：A comparative study with99mTc SPECT and echocar-diography

ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） when compared to99mTc single photon emission computed tomography （SPECT） and echocardiography, with invasive coronary angiography as the gold standard.MethodsThirty patients with diagnosed CAD met the selection criteria, with 10 of them （9 men, mean age 59.5 ± 10.5 years） undergoing all of these imaging proce-dures consisting of SPECT and PET, echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Inter- and intra-observer agreement was assessed for di-agnostic performance of SPECT and PET.ResultsOf all patients with proven CAD, 50% had triple vessel disease. Diagnostic sensitivity of SPECT, PET and echocardiography was 90%, 100% and 80% at patient-based assessment, respectively. Excellent agreement was achieved between inter-observer and intra-observer agreement of the diagnostic value of SPECT and PET in myocardial viability （k= 0.9）. Conclusion18F-FDG PET has high diagnostic value in the assessment of myocardial viability in patients with known CAD when com-pared to SPECT and echocardiography. Further studies based on a large cohort with incorporation of18F-FDG PET into patient management are warranted.

The Gravity Environment of Zhouqu Debris Flow of August 2010 and Its Implication for Future Recurrence

This study investigates the geological background of the August 7-8, 2010 Zhouqu debris flows in the northwestern Chinese province of Gansu, and possible future occurrence of such hazards in the peri-Tibetan Plateau (TP) regions. Debris flows are a more predictable type of landslide because of its strong correlation with extreme precipitation. However, two factors affecting the frequency and magnitude of debris flows: very fine scale precipitation and degree of fracture of bedrock, both defy direct observations. Annual mean Net Primary production (NPP) is used as a surrogate for regional precipitation with patchiness filtered out, and gravity satellite measured regional mass changes as an indication of bedrock cracking, through the groundwater as the nexus.?The GRACE measurements indicate a region (to the north east of TP) of persistent mass gain (started well before the 2008 Wenchuan earthquake), likely due to increased groundwater percolation. While in the neighboring agricultural region further to the north east, there are signal of decreased fossil water reservoir. The imposed stress fields by large scale increase/decrease groundwater may contribute to future geological instability of this region. Zhouqu locates right on the saddle of the gravity field anomaly. The region surrounding the Bay of Bangle (to the southeast of TP) has a similar situation. To investigate future changes in extreme precipitation, the other key player for debris flows, the “pseudo-climate change” experiments of a weather model forced by climate model provided perturbations on the thermal fields are performed and endangered locations are identified. In the future warmer climate, extreme precipitation will be more severe and debris will be more frequent and severe.

A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

Objectives The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease. Methods A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease. Results Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPISPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification. Conclusions There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patientswith suspected coronary artery disease.

Endovascular stent graft repair of abdominal aortic aneurysms:Current status and future directions

Endovascular stent graft repair of abdominal aortic aneurysm(AAA)has undergone rapid developments since it was introduced in the early 1990s.Two main types of aortic stent grafts have been developed and are currently being used in clinical practice to deal with patients with complicated or unsuitable aneurysm necks,namely,suprarenal and fenestrated stent grafts.Helical computed tomography angiography has been widely recognized as the method of choice for both pre-operative planning and post-operative followup of endovascular repair(EVAR).In addition to 2D axial images,a number of 2D and 3D reconstructions are generated to provide additional information about imaging of the stent grafts in relation to the aortic aneurysm diameter and extent,encroachment of stent wires to the renal artery ostium and position of the fenestrated vessel stents.The purpose of this article is to provide an overview of applications of EVAR of AAA and diagnostic applications of 2D and 3D image visualizations in the assessment of treatment outcomes of EVAR.Interference of stent wires with renal blood flow from the hemodynamic point of view will also be discussed,and future directions explored.

Hurricane Camille 1969 and Storm-Triggered Landslides in the Appalachians and a Perspective in a Warmer Climate

This study analyzes storm-triggered landslides in the US Appalachians, in the current geological setting. Concave valleys that favor the convergence of surface runoff are the primary locales for landslides. If the slopes are weathered to the same degree and have the same vegetation coverage, slope orientation (azimuthal) is not critical for slope stability. However, it is found that for the region south of the Black Mountains (North Carolina), north-facing slopes are more prone to slide, because, for the regions not limited by water availability (annual precipitation), the northern slopes usually are grass slopes. For the slopes of the Blue Ridge Mountains, south facing slopes are more prone to slide. Gravity measurements over the past decade reveal that geological conditions, the chute system and underground cracks over the region are stable. Future changes in storm-triggered landslide frequency are primarily controlled by changes in extreme precipitation. Thus, a series of ensemble climate model experiments is carried out to investigate possible changes in future extreme precipitation events, using a weather model forced by atmospheric perturbations from ensemble climate models. Over 50 locations are identified as prone to future landslides. Many of these locales are natural habitats to the Appalachian salamanders. In a future warmer climate, more severe extreme precipitation events are projected because of increased atmospheric water vapor and more frequent passages of tropical cyclone remnants. There is also a likely shift of tropical cyclone tracks and associated extreme precipitations, and the cluster center of Appalachians’s scarps is expected to move westward, with ecological consequences for the endemic salamanders.

Hurricane Camille 1969 and Storm-Triggered Landslides in the Appalachians and a Perspective in a Warmer Climate

This study analyzes storm-triggered landslides in the US Appalachians, in the current geological setting. Concave valleys that favor the convergence of surface runoff are the primary locales for landslides. If the slopes are weathered to the same degree and have the same vegetation coverage, slope orientation (azimuthal) is not critical for slope stability. However, it is found that for the region south of the Black Mountains (North Carolina), north-facing slopes are more prone to slide, because, for the regions not limited by water availability (annual precipitation), the northern slopes usually are grass slopes. For the slopes of the Blue Ridge Mountains, south facing slopes are more prone to slide. Gravity measurements over the past decade reveal that geological conditions, the chute system and underground cracks over the region are stable. Future changes in storm-triggered landslide frequency are primarily controlled by changes in extreme precipitation. Thus, a series of ensemble climate model experiments is carried out to investigate possible changes in future extreme precipitation events, using a weather model forced by atmospheric perturbations from ensemble climate models. Over 50 locations are identified as prone to future landslides. Many of these locales are natural habitats to the Appalachian salamanders. In a future warmer climate, more severe extreme precipitation events are projected because of increased atmospheric water vapor and more frequent passages of tropical cyclone remnants. There is also a likely shift of tropical cyclone tracks and associated extreme precipitations, and the cluster center of Appalachians’s scarps is expected to move westward, with ecological consequences for the endemic salamanders.

Coronary artery calcium score:Re-evaluation of its predictive value for coronary artery disease

Coronary artery disease is the leading cause of death in advanced countries and its prevalence is increasing among the developing countries.Cardiac computed tomography(CT) has been increasingly used in the diagnosis of coronary artery disease due to its rapid improvements in multislice CT scanners over the last decade,and this less-invasive technique has become a potentially effective alternative to invasive coronary angiography.Quantifying the amount of coronary artery calcium with cardiac CT has been widely accepted as a reliable non-invasive technique for predicting risk of future cardiovascular events.However,the main question that remains uncertain is whether routine,widespread coronary artery calcium scoring in an individual patient will result in an overall improvement in quality of care and clinical outcomes.In this commentary,we discuss a current issue of the clinical value of coronary artery calcium scoring with regard to its value of predicting adverse cardiac events.We also discuss the applications of coronary artery calcium scores in patients with different risk groups.

The transport of chemical components in homogeneous snowpacks on Urumqi Glacier No.1, eastern Tianshan Mountains, Central Asia

Chemical records from alpine ice cores provide an invaluable source of paleoclimatic and environ- mental information. Not only the atmospheric chemical composition but also depositional and post-depositional processes are recorded within snow/tim strata. To interpret the environmental and climatic significance of ice core records, we studied the variability of glacier snowpack chemistry by investigating homogeneous snowpacks from October 2003 to September 2006 on Urumqi Glacier No. 1 in eastern Tianshan Mountains, Central Asia. Principle Component Analysis of ionic species in dry and wet seasons revealed the impact of meltwater in redistributing ions in the snowpacks. The 1st, 2nd and 3rd principle components for dry seasons differ significantly, reflecting complex associations between depositional or/and post-depositional processes. The variability trend of ionic concentrations during the wet seasons was found to fit a Gauss Function with significant parameters. The elution factor revealed that more than half of ions are leached out during the wet seasons. Differences with respect to ion snowpack mo- bility were found. Of the ions studied SO42- was the most mobile and Mg2＋ the least mobile. A threshold relationship between air temperatures and the elution process was investigated over the study period. The results indicate that the strong melt/ablation processes and iconic redistribution occur at a threshold air temperature of 0℃. The study found that surface melt on the snowpacks is the main factor causing the alteration of the snowpack chemistry. Rainfall also has an impact on the chemistry but plays a less significant role than the surface melt.

Radiation dose measurements in coronary CT angiography

Coronary computed tomography(CT)angiography has been recognized as the most rapidly developed imaging technique in the diagnosis of coronary artery disease due to the emergence and technological advances in multislice CT scanners.Coronary CT angiography has been confirmed to demonstrate high diagnostic and predictive value in coronary artery disease when compared to invasive coronary angiography.However,it suffers from high radiation dose which raises concerns in the medical field.Various dose-reduction strategies have been proposed with effective outcomes having been achieved to reduce radiation exposure to patients.This article provides an introduction and overview of the series of articles that will focus on each particular topic related to coronary CT angiography.

Coronary CT angiography:Beyond morphological stenosis analysis

With the introduction of 64- and post-64 slice computed tomography(CT)technology,coronary CT angiography has been increasingly used as a less invasive modality for the diagnosis of coronary artery disease.Despite its high diagnostic value and promising results compared to invasive coronary angiography,coronary CT angiography is associated with high radiation dose,leading to potential risk of radiation-induced cancer.A variety of dose-reduction strategies have been reported recently to reduce radiation dose with effective outcomes having been achieved.This article presents an overview of the various methods currently used for radiation dose reduction.

Coronary CT angiography:Dose reduction strategies

Coronary computed tomography(CT)angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography.Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320-slice CT scanners.Despite the promising diagnostic value,coronary CT angiography is still limited in some areas,such as inferior temporal resolution,motion-related artifacts and high false positive results due to severe calcification.The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners.Prognostic value of coronary CT angiography in coronary artery disease is also discussed,while limitations and challenges of coronary CT angiography are highlighted.

Coronary CT angiography:Beyond morphological stenosis analysis

Rapid technological developments in computed tomography(CT)imaging technique have made coronary CT angiography an attractive imaging tool in the detection of coronary artery disease.Despite visualization of excellent anatomical details of the coronary lumen changes,coronary CT angiography does not provide hemodynamic changes caused by presence of plaques.Computational fluid dynamics(CFD)is a widely used method in the mechanical engineering field to solve complex problems through analysing fluid flow,heat transfer and associated phenomena by using computer simulations.In recent years,CFD is increasingly used in biomedical research due to high performance hardware and software.CFD techniques have been used to study cardiovascular hemodynamics through simulation tools to assist in predicting the behaviour of circulatory blood flow inside the human body.Blood flow plays a key role in the localization and progression of coronary artery disease.CFD simulation based on 3D lumina reconstructions can be used to analyse the local flow fields and flow profiling due to changes of vascular geometry,thus,identifying risk factors for development of coronary artery disease.The purpose of this article is to provide an overview of the coronary CT-derived CFD applications in coronary artery disease.

Coronary CT angiography:State of the art

The aim o this article is to discuss the protocol o betablockers that is commonly used or prospectively ECGtriggered coronary computed tomography angiography(CCTA).It is essential to ensure a low and regular heart rate in patients undergoing prospectively ECG-triggered CCTA or optimal visualization o coronary arteries.Although early generations o computed tomographyscanners are not applicable to be tailored according to patients’heart rate,a low and regular heart rate is possible to be achieved by the administration o medications according to the beta-blocker protocol.Betablocker can be sa ely administered to reduce patients’heart rate or CCTA examination i patients are screened or certain contraindications.

An Overlooked Term in Assessment of the Potential Sea-Level Rise from a Collapse of the West Antarctic Ice Sheet

As to sea level rise (SLR) contribution, melting and setting afloat make no difference for land based ice. Melting of West Antarctic Ice Sheet (WAIS) into water is impossible in the upcoming several centuries, whereas breaking and partially afloat is likely as long as sea waters find a pathway to the bottom of those ice sectors with basal elevation below sea level. In this sense WAIS may be disintegrated in a future warming climate. We reassess the potential contribution to eustatic sea level from a collapse of WAIS and find that previous assessments have overlooked a contributor: slope instability after the cementing ice is removed. Over loading ice has a buttressing effect on slope movements the same way ice shelves hinder the flow of non-floating coastal ice. A sophisticated landslide model estimates a 9-mm eustatic SLR contribution from subsequent landslides.

Investigation on the Synthesis Mechanism of β-FeSi_2 Prepared by Pulsed Laser Deposition

The FeSi2 target alloy was fabricated by conventional powder metallurgy technology, and then, β-FeSi2 thin films was successfully prepared by pulsed laser deposition （PLD）. X-ray diffraction （XRD） and field emission scanning electron microscopy （FESEM） were used to characterize the structure, composition, and their changes in the process of β-FeSi2 preparation. In addition, a laser sintering process was also employed to prepare FeSi2 alloy. The analysis of radiation heat transfers in different-sized FeSi2 melt indicates that the cooling rate of the melt depends on the size, i.e., the cooling rate of the micron sized melt is 103 times greater than that of the millimeter-sized melt. The product a-FeSi2 by laser sintering and β-FeSi2 by PLD reveals the different phase transition process in crystallization of millimeter-sized and micron-sized （or submicron-sized） FeSi2 melt. The results of PLD preparation process shows that β-FeSi2 could be prepared through a liquid-phase sintering, followed by a rapid cooling.