Frans J. Th. Wackers, M.D. Professor of Diagnostic Radiology and Medicine Senior Research Scientist Cardiovascular Nuclear Imaging and Exercise Laboratories.

M.D., Ph.D., University of Amsterdam, The Netherlands, 1970; Military Service, The Netherlands, 1970-1972; Internal Medicine Residency, University of Amsterdam, The Netherlands, 1972-1974; Cardiology Fellow, University of Amsterdam, The Netherlands, 1974-1977; Cardiology Faculty, Yale University School of Medicine, 1977-1981; Cardiology Faculty, University of Vermont College of Medicine, 1981-1984; Rejoined Cardiology Faculty, Yale University School of Medicine; Director, Cardiovascular Nuclear Imaging Laboratory, 1984-2005; Professor Emeritus Dec 31, 2007.

Clinical Applications of Radionuclide Cardiac Imaging; Computer Image Quantification

Radionuclide cardiac imaging allows for noninvasive assessment of cardiac function and regional blood flow. Dr. Wackers’ interest is specifically directed towards cardiac imaging of patients with acute ischemic syndromes: acute infarction and unstable angina. Radionuclide imaging is an intrinsically quantitative methodology since emanated photons generate digital image data. Quantification of images is of clinical importance since the degree of abnormalities is directly related to patients¹ prognosis and outcomes.



Work in our laboratory has shown that acute ischemia can reliably be detected by noninvasive imaging of intravenously administered radiotracers that accumulate in the heart proportional to blood flow. In acute heart attacks the area at risk for infarction can be visualized and quantified. The results and effectiveness of interventions that restore blood flow can thus be quantified noninvasively as well. We have pioneered the use of radionuclide imaging for evaluating and triaging patients with acute chest pain in the emergency department. A long time focus of research and development in our laboratory has been on the reliable and reproducible quantification of regional abnormalities in blood flow during physical and pharmacological stress. These methods have been applied to a number of clinical trials with new radiotracers.



The laboratory has also been the central radionuclide core laboratory for numerous multicenter clinical trials using radionuclide imaging as endpoints. The laboratory has the capability to convert image data acquired on a wide variety of computers to one uniform format, for uniform image data analysis.

The laboratory performed comparative studies on the clinical effectiveness using a number of new radiotracers for cardiac imaging under a variety of acute and chronic clinical conditions. Another recent area of interest is the development of pathways and algorithms for optimal and cost-effective utilization of various noninvasive imaging modalities.




Dr Wackers is the Principal Investigator and Chair of the multicenter Detection of Ischemia in Asymptomatic Diabetics (DIAD) study. The study started in September 2000. A total of 1,123 patients were recruited and 5-year follow-up was completed in September 2007. Dr. Wackers was Director of the Yale Cardiovascular Nuclear Imaging Laboratory from 1984 – 2005. Since 2008 he Professor Emeritus and continues his involvement in research and teaching as a Senior Research Scientist.


Wackers FJTh, Chyun DA, Young LH, Heller GV, Iskandrian AE, Davey JA, Barrett EJ, Taillefer R, Wittlin SD, Filipchuk N, Ratner RE, Inzucchi SE.  Resolution of Asymptomatic Myocardial Ischemia in Patients with Type 2 Diabetes in the Detection of Ischemia in Asymptomatic Diabetes DIAD Study.  Diabetes Care; 30:2892-2898, 2007.

Wackers FJTh, Bruni W, Zaret BL. Nuclear Cardiology, The Basics; How to Set Up and Maintain a Laboratory.  Second Edition, Humana Press, NJ,  2007

Russell RR, Abbott BG, Arrighi JA, Mengel FM, Cohen MC, Garcia EV, Hendel RC, Holly TA, Mieres JH, Shaw LJ, Thomas GS, Thompson RC, Wackers FJTh, Bax JJ.  Highlights of the 2007 Scientific Sessions of the American Society of Nuclear Cardiology.  J Am Coll Cardiol; 50:2336-2343, 2007

Abu-Khalaf M, Juneja V, Chung G, DiGiovanna M, Sipples R, McGurk M, Zelterman D, Haffty B, Reiss M, Wackers FJTh, Lee F, Burtness B.  Long term assessment of cardiac function after dose –dense and –intense sequential doxorubicin (A), paclitaxel (T) and cyclophosphamide (C) as adjuvant therapy for high risk breast cancer.  Breast Cancer Research and Treatment; 104:341-349, 2007.

Papaioannou GI, Kasapis C, Seip RL, Grey NJ, Katten D, Wackers FJTh, Inzucchi SE, Engel S, Taylor A, Young LH, Chyun DA, Davey JA, Iskandrian AE, Ratner RE, Robinson EC, Carolan S, Heller GV.  Value of peripheral vascular endothelial function in the detection of relative myocardial ischemia in asymptomatic type 2 diabetic patients who underwent myocardial perfusion imaging. J Nucl Cardiol 12: 362-368, 2006.

Chyun DA, Melkus GD, Katten DM, Price WJ, Davey JA, Grey N, Heller G, Wackers FJTh. The Association of Psychological Factors, Physical Activity, Neuropathy, and Quality of Life in Type 2 Diabetes. Biological Research for Nursing;7(4):279-288, 2006.

Wackers FJTh.  Asymptomatic patients with diabetes mellitus should be screened for coronary artery disease.  J Nucl Cardiol;13:609-615, 2006

Miller TD, Redberg RF, Wackers FJTh.  Screening asymptomatic diabetic patients for coronary artery disease.  Why not?  J Am Coll Cardiol;48:761-764, 2006

Chyun DA, Katten DM, Melkus GD, Talley S, Davey JA, Wackers FJTh.  The impact of screening for asymptomatic myocardial ischemia in individuals with type 2 diabetes. J Cardiov Nursing. 21:E1-E7, 2006

Cerqueira MD, Berman DS, DiCarli MF, Schelbert HR, Wackers FJTh, Williams KA.  Task Force 5:  Training in Nuclear Cardiology.  J Am Coll Cardiol. 47:898-904, 2006

Scholte JHA, Bax JJ, Wackers FJTh.  Screening of asymptomatic patients with type 2 diabetes mellitus for silent coronary artery disease.  Combined use of stress myocardial perfusion imaging and coronary calcium scoring.  J Nuc Cardiol; 13:11-18, 2006

Jang IK, Weissman NJ, Picard MH, Zile MR, Pettigrew V, Shen S. Tatsuno J, Hibberd MG, Wackers FJTh and the EVOLVE Investigators.  A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction.  Am Heart Journal;155-1;113.e1-113.e8, 2008.

Jang IK, Pettigrew V, Picard MH, Kowey PR, Demmel V, Zile MR, Tatsuno J, Wackers FJTh, Hibberd M.  A randomized, double-blind, placebo-controlled study of the safety and efficacy of intravenous MCC-135 as an adjunct to primary percutaneous coronary intervention in patients with acute myocardial infarction:  rationale and design of the evaluation of MCC-135 for left ventricular salvage in acute MI (EVOLVE) study.  J Thromb Thrombolysis.  20:147-53, 2005.

Masood Y, Liu Y, DePuey EG, Taillefer R, Araujo LI, Allen S, Delbeke D, Anstett F, Peretz A, Zito MJ, Tsatkin V, Wackers FJTh. Clinical validation of attenuation correction using x-ray CT-derived attenuation maps. Multi-center clinical trial with angiographic correlation.  J Nuc Cardiol 12: 676-686, 2005.

Wackers FJTh. Third Annual Mario S. Verani M.D. Memorial Lecture: The future of clinical nuclear cardiology.  J Nucl Cardiol;12:381-91, 2005

Wackers FJTh. On the bright right side.  J Nucl Cardiol 12:378-80, 2005

Wackers FJ Th.  Diabetes and coronary artery disease: the role of stress myocardial perfusion imaging.  Cleveland Clinic J Med 72:21-33, 2005

Liu, Y-H, Sinusas, A.J., Khaimov, Gebuza, BI, Wackers FJTh. New hybrid count- and geometry-based method for quantification of left ventricular volumes and ejection fraction from ECG-gated SPECT: Methodology and validation. J of Nucl Cardiol; 12:55-65, 2005

Inzucchi SE, Young LH, Chyun DA, Wackers FJTh. Screening for coronary artery disease in diabetic patients: The DIAD Study.  Brit J Diab Vasc Dis 4:317-319, 2004

Kontos MC, Wackers FJTh. Acute rest myocardial perfusion imaging for chest pain.J Nucl Cardiol 11; 470-481, 2004

Wackers FJ Th, Young LH, Inzucchi SE, Chyun DA, Davey JA, Barrett EJ, Taillerfer R, Wittlin SD, Heller GV, Filipchuk N, Engel S, Ratner RE, Iskandrian AE, for the Detection of Ischemia in Asymptomatic Diabetics (DIAD) Investigators.  Detection of Silent Myocardial Ischemia in Asymptomatic Patients with Type 2 Diabetes (The DIAD Study).  Diabetes Care 27; 1954-1961, 2004

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Last modified:Wednesday, 09-Apr-2008 13:14:19 EDT (PL).