Updated on Dec 14, 2022 | Uncategorized
Mount Sinai Morningside recently installed a new rubidium generator to facilitate a reliable source of isotopes for cardiac positron emission tomography (PET) studies.
With this update, Mount Sinai will become the leading health system in New York City offering high-quality, timely, and easy access to the entire range of advanced cardiac PET imaging. Cardiac PET testing includes three common type of studies: cardiac stress imaging with PET; cardiac PET viability imaging; and cardiac PET infection and inflammation imaging.
Cardiac stress PET myocardial perfusion imaging is the most accurate non-invasive test to diagnose obstructive coronary artery disease as well as coronary microvascular dysfunction, which is a common cause of symptoms and morbidity among patients who have ischemia with non-obstructive coronary arteries (INOCA) with continued symptoms.
Other key advantages of cardiac PET include:
- Significantly lower radiation dose to the patient—approximately 3 mSV, or millisieverts, a unit of radiation exposure, per study, equal to about the amount of radiation a person is exposed to from natural sources over the course of a year.
- Superior imaging technology leading to excellent image quality even among patients with unfavorable bodily characteristics such as obesity or women with large breasts or breast implants.
- Availability of coronary artery calcium score information to detect subclinical atherosclerosis.
- Availability of absolute myocardial blood flow quantitation, which helps to accurately diagnose flow-obstructing CAD including high-risk, multi-vessel CAD, diffuse atherosclerosis, post-heart transplant vasculopathy, and microvascular dysfunction in INOCA.
- Increased efficiency and significantly shorter study time—a rest and stress Rb-82 PET takes about 30 minutes.
Due to these advantages, recent American College of Cardiology and American Heart Association guidelines on chest pain evaluation endorse the preferred use of cardiac PET over other stress imaging modalities.
Common indications for cardiac PET stress testing are:
- Symptomatic patients with suspected ischemia unable to exercise or complete exercise during a treadmill test.
- Previous poor quality stress imaging: equivocal or inconclusive results, artifact on images, patients with discordant results on angiogram and stress study.
- Body characteristics affecting image quality: large breasts, obesity, pleural effusions, chest wall deformities.
- High-risk patients to avoid diagnostic errors: patients with history of chronic kidney disease, diabetes, suspected left main or multi-vessel disease, extensive known CAD, suspected transplant vasculopathy, known CAD prior to high-risk revascularization.
- Young patients with established CAD requiring testing to avoid repeat radiation exposure.
- Situations where myocardial flow quantitation is necessary for clinical decision-making, (e.g. microvascular dysfunction and/or suspected multi-vessel disease).
Cardiac PET viability testing is the gold standard for detecting hibernating myocardium among patients with suspected ischemic cardiomyopathy and heart failure with significant CAD. Cardiac PET guided management has been shown to reduce long-term adverse cardiac events among these patients.
Cardiac infection and inflammation PET imaging is critical for the diagnosis and management of patients with suspected or known cardiac sarcoidosis, suspected prosthetic valve endocarditis, left ventricular assist device (LVAD) infections, pocket, and other cardiac device infections.
To refer a patient for a cardiac PET scan, please contact the Cardiology Department at Mount Sinai Morningside 212-636-4809 or send an email to cardiacPet-scan@mountsinai.org.
Click here for more information on the PET CT program at Mount Sinai Morningside.
Oct 21, 2021 | Uncategorized
Katherine Meckel
Can the bacteria in your gut influence addictive behavior? That is the question that Katherine Meckel is studying and trying to answer. Currently a fifth-year PhD candidate in neuroscience at the Icahn School of Medicine at Mount Sinai, Ms. Meckel is one of 31 young scientists from across the country to be honored with the National Institutes of Health (NIH) Blueprint Diversity Specialized Predoctoral to Postdoctoral Advancement in Neuroscience (D-SPAN) Award.
The award will provide Ms. Meckel with a six-year, $447,000 fellowship to fund the remaining two years of her PhD studies, as well as four years of postdoctoral research. The D-SPAN Award recognizes outstanding trainees from historically underrepresented communities in the sciences.
Working in the lab of Drew D. Kiraly, MD, PhD, Ms. Meckel is drawing upon her background in gastroenterology and neuropharmacology to study the effects of the gut microbiome on gene expression and behavior in a rodent model of cocaine use disorder.
“When we look at human patients and also animal models of substance use disorders, we see highly altered gene expression in response to cocaine and other drugs of abuse,” she explains. “This seems to emerge from long-term adaptations or ‘molecular scars’ which affect the ability of gene sequences in the DNA to be accessed and expressed. My work seeks to understand how gut bacteria and the metabolites they produce regulate the structure and accessibility of the DNA, influencing gene expression and ultimately drug-seeking behaviors.”
Dr. Kiraly, her dissertation advisor, praises her tenacity in establishing a new line of research within the field of neuroscience. “Katherine has generated a tremendous amount of exciting data, which provides insight into the mechanisms of gut-brain communication,” says Dr. Kiraly, Assistant Professor of Psychiatry, and Neuroscience, at Icahn Mount Sinai. “Her work holds potential to uncover novel pathways for drug development, which may one day lead to much-needed treatments for patients with substance use disorders.”
Trusting Her Gut Intuition
As an undergraduate, Ms. Meckel pursued a rigorous five-year dual degree program in Voice Performance and Biochemistry at Lawrence University in Appleton, Wisconsin. There, she conducted neuropharmacology research under Bruce Hetzler, PhD, studying the effects of methylphenidate (Ritalin) on rodent behavior and visual processing.
After graduating, she joined the Section of Gastroenterology at the University of Chicago, working under Joel Pekow, MD, and Marc Bissonnette, MD, to study the effects of diet and metabolism on inflammatory bowel disease and colorectal cancer.
Ms. Meckel credits her time in gastroenterology for encouraging a more integrative physiological approach, which now informs her studies. “Often times in neuroscience, we study the brain in isolation,” she says. “But it’s important to consider that the brain exists in communication with the other peripheral organs throughout the body, and they influence each other’s activity.”
Building Community for Students With Disabilities
Ms. Meckel has also emerged as a leader in disability rights since joining Icahn Mount Sinai. Together with classmates Jessica Pintado Silva and Marisa Goff, she co-founded Disability Rights, Education, and Awareness at Mount Sinai (DREAMS), which provides peer mentoring and support to graduate students with visible and invisible disabilities.
“As a queer, disabled individual, I often compare living with invisible chronic illness to ‘being in the closet.’ If you didn’t know me well, you probably wouldn’t realize I am disabled,” she says. “But much of my life outside of lab is characterized by managing chronic health flares.”
Ms. Meckel expressed gratitude to her advisors and the National Institute of Neurological Disorders and Stroke for supporting her training. “I hope that my experience inspires disabled and chronically ill trainees to continue in the sciences,” she says. “So we can share our unique perspectives and bring new innovation to STEM.”
Oct 8, 2021 | Stories of Excellence, Uncategorized
Lea Tsao, MS, CSRS
The Rehabilitation Department at Mount Sinai West would like to highlight Lea Tsao, MS, CSRS, an occupational therapist who works on our inpatient unit and on the acute medical floors.
When Lea started working with us, she was immediately dedicated to patients, willing to learn, and eager to help. She has a track record for going above and beyond for her patients, giving them not only excellent care but in difficult moments giving heartfelt words of encouragement that could inspire anyone else in the room listening.
Lea has been involved in several challenging cases, but we’d especially like to acknowledge her role in helping a patient who had a complex clinical presentation and a limited support system. Over several months, Lea remained an advocate for his functional progress and for the goal of getting him home. She advocated for interdisciplinary communication, family involvement, and comprehensive care. Her consistency allowed for the continuity of care we strive for as health care providers to best meet the individual needs of our patients.
Without a doubt, this patient also benefitted from the care of numerous physical therapists, including Caitlin Counihan, Victor Rhee, and Erika Chason. Many of them worked to bring the patient’s mobility closer and closer toward functional independence.
We are very lucky to have a team of dedicated therapists and good human beings.
