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Myocardial Perfusion Imaging in the Pediatric Population

Myocardial Perfusion Imaging in the Pediatric Population. Peter Gardiner, MB ChB, MRCP Vice President, Medical Sciences Bristol-Myers Squibb Medical Imaging. Bristol-Myers Squibb Medical Imaging. A worldwide leader in cardiovascular imaging research Product line includes:

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Myocardial Perfusion Imaging in the Pediatric Population

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  1. Myocardial Perfusion Imaging in the Pediatric Population Peter Gardiner, MB ChB, MRCP Vice President, Medical Sciences Bristol-Myers Squibb Medical Imaging

  2. Bristol-Myers Squibb Medical Imaging • A worldwide leader in cardiovascular imaging research • Product line includes: • Cardiolite®(Kit for the Preparation of Technetium Tc99m Sestamibi for Injection) • Definity®(Vial for Perflutren Lipid Microsphere Injectable Suspension) • Committed to appropriate evaluation of imaging drugs and cardiac imaging procedures in children • Focus on nuclear myocardial perfusion imaging (MPI)

  3. Nuclear Myocardial Perfusion Imaging • Only modality approved by FDA for assessment of myocardial perfusion and function • >13 years experience with Tc99m agents • Indications: Perfusion; function; exercise and pharmacologic stress • Extensive literature documenting use in diagnosis, prognosis and risk stratification • Safe and well tolerated • Continued growth in usage

  4. Cardiolite®(Kit for the Preparation of Technetium Tc99m Sestamibi for Injection) • Launched in US in 1991 • Indications: myocardial perfusion and function; exercise and pharmacologic stress; developing information for use in patient management decisions • Leadership position: • Clinical use • Continued significant investment in Clinical Research and Education

  5. Nuclear Myocardial Perfusion Imaging in Children • Lack of substantial, well-controlled clinical studies to define dosing and efficacy • Usage - ~ 2-3,000 studies in 2002 • Patient populations: • Kawasaki’s Disease • Cardiac transplant vasculopathy • Cardiomyopathies (including hypertrophic and drug-induced) • Congenital heart disease, including anomalous LCA

  6. Nuclear Myocardial Perfusion Imaging in Children • Advantages • Extensive experience and FDA approved for use in adults • Operator independent • Reduced dose and duration of imaging with Tc99m based agents • Disadvantages • Radiation exposure • Limited information on dosing (only weight-based) • Lack of substantial efficacy data

  7. Nuclear Myocardial Perfusion Imaging in Children Summary • Nuclear imaging is the only modality approved by FDA for assessment of myocardial perfusion and function in adults • Extensive experience in adults • Limited and variable experience in children • Bristol-Myers Squibb Medical Imaging (BMS MI) supports FDA’s initiatives to evaluate nuclear cardiac imaging in children

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