Marcelo Di Carli explains new uses of cardiac nuclear imaging beyond perfusion

Nuclear cardiology is entering a new era—one that goes well beyond the traditional focus on myocardial perfusion imaging. According to Marcelo Di Carli, MD, chief of the division of nuclear medicine and molecular imaging and executive director of cardiovascular imaging at Brigham and Women’s Hospital, the field is rapidly expanding into diagnosing and monitoring complex cardiac diseases such as amyloidosis, sarcoidosis, myocarditis and even cardiovascular infections.

"It's a very exciting that nuclear cardiology is not just perfusion imaging, there are other areas where nuclear cardiology is fairly unique in its role," Di Carli, editor-in-chief of the Journal of Nuclear Cardiology, told Cardiovascular Business.

Amyloidosis imaging becomes routine

Perhaps the most transformative development, Di Carli said, has been the adoption of nuclear imaging as the primary non-biopsy method for diagnosing cardiac amyloidosis. Using bone-avid radiotracers such as pyrophosphate scans, clinicians can now make a definitive diagnosis without the need for invasive tissue biopsy.

“We have one of the most available, least expensive and powerful tools to make a non-biopsy diagnosis of cardiac amyloidosis,” he explained. “I would say 80-90% of patients now being diagnosed are using this pathway.”