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E1041. Follow Your Heart: Teaching Cardiac PET and Amyloid Imaging Using Clay Models - Concepts and Interpretation of Studies
Authors
  1. Ayman Farag; Westchester Medical Center
  2. Nathaniel Goldman; New York Medical College
  3. Prem Swaroop Patel; Westchester Medical Center
  4. Jared Meshekow; Westchester Medical Center
  5. Lillian Chiu; New York Medical College
  6. Diwakar Jain; Westchester Medical Center
  7. Perry Gerard; Westchester Medical Center
Background
Cardiac amyloidosis (CA) is one of the most rapidly progressive inflammatory cardiac diseases. There are several types of amyloidosis determined by the type of amyloid protein infiltrating the systemic organs. The most common form is light chain amyloidosis and transthyretin amyloidosis. If left untreated, median survival with light chain amyloidosis is less than 6 months compared to 3 to 5 years with the transthyretin type, which advocate how essential is the early detection and management. CA has significant adverse effects on the mechanical and electrical cardiac function leading to systolic and diastolic heart failure, congestive heart failure, restrictive cardiomyopathy, atrial fibrillation and heart block. Until recently, CA was only diagnosed by a positive endomyocardial biopsy or a positive extracardiac biopsy in combination with left ventricular wall thickness of more than 12 mm on echocardiography unexplained by other causes. Endomyocardial biopsy is an invasive procedure that cardiologists prefer avoiding in older patients with multiple co-morbidities or in patients with early nonspecific signs. Cardiac PET serves as an advanced imaging modality that is highly sensitive with a reasonable number of validated radiotracers in the diagnosis of CA. Clinicians are leaning towards acquiring cardiac PET if the patient’s clinical presentation triggers the clinical suspicion of CA as a possible diagnosis, entertaining the non-invasive advantage of PET imaging and the value of early detection by imaging. Besides, cardiac PET isn’t only beneficial in establishing a diagnosis, but also with the follow up of the disease progression, as well as monitoring response to therapy. Cardiac PET imaging is also useful in diagnosing other conditions such as cardiac sarcoidosis. In our project, learners use clay models to reconstruct the heart in three-dimension involving the detected lesions within the reconstructed image. We believe that this type of learning provides better visualization of the pathology and a straightforward presentation that enriches the learning process for residents and students, and easier approach for patient education.

Educational Goals / Teaching Points
-To discuss the use of clay models as a tool to teach residents, students and patients about cardiac PET and amyloid Imaging -To review the radiologic features of amyloidosis, sarcoidosis and the role of cardiac PET in diagnosis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
-Cardiac PET scan -Cardiac amyloidosis -Cardiac sarcoidosis -Clay models to reconstruct the heart in three-dimension involving the detected lesions within the reconstructed image

Conclusion
Cardiac PET plays an essential role in diagnosing cardiac amyloidosis. The use of clay models serves a more visual, simple approach outlining the imaging details for residents, students and patients. It offers a unique learning experience of the radiologic features of cardiac amyloidosis and a feasible way for disease detection with high sensitivity as well as management, yielding a better quality of medical care.