The best of nuclear cardiology and MRI in 2002

In Nuclear Cardiology, the year 2002 was marked by a great number of studies on the gated-SPECT, which allows joint analysis of left ventricle perfusion and contraction. Even if conventional perfusion tomoscintigraphy confirms its foreground role, notably for prognostic evaluation, the value of the gated-SPECT is particularly significant in all areas of its use: coronary heart disease screening, prognosis evaluation, and myocardial viability assessment. Cavitary tomoscintigraphy allows direct evaluation of the ejection fraction and volumes in both ventricles. This innovative technique has been the subject of a great deal of methodological validation work, and will very likely replace traditional isotopic angiography in the future. At last, the value of MIBG scintigraphy for prognostic evaluation, of cardiac insufficiency has been defined, as has its significance for providing evidence of the effect of betablockers on pre-synaptic sympathetic innervation. The year 2002 has also been very fertile for technological innovations, methodological work, and in clinical studies concerning cardiac MRI. In particular, the significance of MRI for evaluating myocardial viability and the transmural extension of necrosis is now well established. Similarly, MRI is becoming an inescapable element in the assessment of congenital cardiopathy. However, its diffusion on a wider scale will only be possible if there is direct collaboration between cardiologists and radiologists.