Battling Cardiovascular Disease with Nuclear Medicine
Improving Cardiovascular Disease Management Using Diagnostic Imaging
350 participants from 91 Member States gathered to exchange experience, ideas and new research in diagnostic imaging for cardiovascular disease; a disease responsible for 30% of all deaths globally. (Photo: Y. Pynda/IAEA)
Cardiovascular diseases (CVDs) kill more people globally than any other disease. Nuclear imaging technology plays an ever more central role in detecting these diseases early. It is used to improve "outcomes" for patients, meaning that early and precise disease diagnosis informs effective treatment and leads to a faster, more complete return to health.
At the IAEA's first International Conference on Integrated Medical Imaging in Cardiovascular Diseases (IMIC 2013), over 350 participants from 91 Member States gathered for an intensive five-day exchange of knowledge, experience and research findings on the topic.
In his opening address to IMIC 2013, IAEA Deputy Director General Daud Mohamad and Head of the Department of Nuclear Sciences and Applications said "there is a need for a worldwide initiative to combat the challenge of cardiovascular diseases. This would require coordination and partnership of non-governmental international organizations with national governments to increase awareness, to actively promote prevention of CVDs, and to provide efficient and cost-effective assistance in disease management."
The IAEA is working with partner organizations around the world to train practitioners and enhance diagnostic capabilities with a focus on quality and safety. Deputy Director General Daud noted that "the Agency through its Division of Human Health with its expertise in nuclear medicine and diagnostic imaging promotes safety and quality in applying these techniques in disease management in our Member States. This is done through the provision of information and educational material, on-line and on-site training courses, via technical cooperation projects and coordinated research activities. A most recent addition to this effort is the provision of webinar series, co-organized with professional societies." The IAEA currently offers two webinars: one focuses on myocardial perfusion imaging in collaboration with the American Society of Nuclear Cardiology, and the second handles computed tomography with the Society of Nuclear Medicine and Molecular Imaging.
Medical imaging and nuclear medicine technologies offer precise, sometimes three-dimensional views of anatomical and physiological function. As specialised training is required to safely and effectively employ medical imaging and nuclear medicine technologies, continuing education is of vital importance to ensure that the best possible patient care is provided.
The content of the Conference was accredited by European Union of Medical Specialists ( UEMS) through the European Accreditation Council for Continuing Medical Education (EACCME) with Continuing Medical Education (CME) credits. Maurizio Dondi, Head of Nuclear Medicine and Diagnostic Imaging at the IAEA, emphasized that "these credits are important for continuous professional development of medical professionals. For the first time at an IAEA Conference, participants were awarded with the CME credits."
The IMIC Conference was attended by a multidisciplinary team of professionals including physicians specialized in nuclear medicine, cardiology, radiology; medical physicists; radiographers; radiochemists and radiopharmacists.
The strength and limitation of each diagnostic imaging modality in cardiovascular diseases management was discussed using case studies and available evidence in an interactive manner thus improving the learning experience.
The constantly evolving state of technology and clinical applications in the medical imaging field was analysed. They focussed on the challenges faced by medical practitioners in developing countries, who are particularly affected by the rapid changes. Methods to appropriately use available resources were discussed.
Experts also discussed future challenges and trends of imaging modalities as applied to cardiology and the role of the professional international organizations and the IAEA in addressing these.
The IMIC 2013 presentations included the entire spectrum of issues related to diagnostic imaging in cardiology with a special focus on tailoring imaging based on the needs of the patient for better clinical output. The presentations will be available on the Agency's Human Health Campus
The programme included 25 plenary sessions and four interactive read with expert sessions as well as the presentation of 163 posters submitted by participants, of which 14 received an outstanding papers award.
Organized by the IAEA from 30 September to 4 October 2013, IMIC 2013 was made possible with the cooperation of several professional organizations including: the American Heart Association, American Society of Nuclear Cardiology, Asian Regional Cooperative Council for Nuclear Medicine, Australian and New Zealand Society of Nuclear Medicine, European Association of Nuclear Medicine, European Society of Radiology, International Society of Radiology, Society of Nuclear Medicine and Molecular Imaging, Society of Radiopharmaceutical Sciences, and the World Federation of Nuclear Medicine and Biology.
Organizing conferences to improve clinical practice and share knowledge, experience and research findings is just one of the many mechanisms that the IAEA uses to support health and prosperity in its Member States. The IAEA's programmes in this area have a global reach from Cuba to Vietnam and Macedonia to Burkina Faso. These programmes help Member States build capacity and the necessary competencies to use advanced nuclear medicine and diagnostic imaging technologies, like SPECT and MRI (see below), which can potentially save millions of lives.
Cardiovascular diseases are among the leading causes of death worldwide. The World Health Organization estimates that as many as 30% of all global deaths can be attributed to cardiovascular disease; in 2008 that was estimated to be roughly 17.3 million people, almost 10 million more than the 7.6 million cancer deaths. Over 80% of cardiovascular disease deaths occur in low and middle income countries, with Africa and Asia having the highest rates of ischemic heart disease, which is the building up of plaque on the inner walls of arteries leading to high blood pressure and heart attacks. The highest mortality rates are registered in growing economies such as Brazil, India, China, Russia and South Africa, where smoking and obesity increase risks, yet these behaviours can be changed through lifestyle choices.
SPECT - Single-Photon Emission Computed Tomography is an imaging technique which uses a rotating camera to detect gamma rays released by gamma-emitting radioactive substances that were injected into the patient beforehand. Different radioactive substances localise in specific organs or areas in the body. When injected they reveal the shape or functioning of the target area to the camera, which is then reconstructed into an image by a computer.
PET - Positron Emission Tomography works in the same way as SPECT, but uses a radioactive substance that decays faster and produces two gamma rays moving in opposite directions. This allows views from multiple angles and so making it possible to produce a 3D visualisation of the target area or organ.
MRI - Magnetic Resonance Imaging produces an image by using a powerful magnet. The magnet creates a magnetic pulse that aligns water molecules in the patient's body. When the pulse stops the molecules relax and reverse back to their previous state, which in turn produces a tiny amount of radiation. Highly sensitive instruments detect the radiation and the resulting information can be translated into an image. Changing the strength and angle of the magnetic fields creates differences between tissue types, allowing doctors to visualize tissues normally too soft to detect through other means.
CT - X-ray Computed Tomography creates an image by rotating an X-ray emitting source and an opposing sensor around a patient. As the X-rays pass through the patient they are deflected and changed. These minute changes are detected by the sensor whose output is translated into an image. The resulting images are cross-sectional "slices" of a patient.
ECHO - An Echocardiogram is a sonogram or ultrasound image of a heart. An ultrasound signal (a sound wave with a frequency above the upper limits of human hearing) is directed to the heart and as it bounces back after encountering tissues or bone, it is picked up by a sensor. Depending on the frequency of the sound and the time it takes it to return, it is possible to create an image of the patient's heart.
-- By Michael Madsen, IAEA Division of Public Information
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