Assessment of Myocardial CZT SPECT Recording in a Forward-Leaning Bikerlike Position

Abstract

This prospective randomized study assessed myocardial perfusion imaging with the high-sensitivity D.SPECT cadmium-zinc-telluride camera in a forward-leaning bikerlike position, which may potentially lower diaphragmatic attenuation and reduce breathing-related cardiac motion, in a manner comparable to the prone position proposed with other SPECT cameras. Methods: Patients referred for a stress-rest 99m Tc-sestamibi protocol and positioned in the biker position, with the chest leaning forward on the D.SPECT camera-head at 35°from vertical, had an additional resting D.SPECT recording in the supine position (n 5 40) or in the sitting position with the back rearward at 30°from vertical (n 5 40). Segments with attenuation artifacts were defined as those with less than 65% uptake but with strictly normal contractility at gated SPECT and no defect reversibility from stress images. Results: The biker position was associated with lower heart-to-detector distances than the supine or sitting positions (both P , 0.001); lower cardiac motion amplitudes, assessed on panograms, than the supine position (P , 0.001); and fewer segments with attenuation artifacts than the supine position (on average, 1.10 ± 1.01 vs. 1.90 ± 1.74, P 5 0.010) or the sitting position (0.75 ± 0.93 vs. 1.38 ± 1.60, P 5 0.011). Conclusion: Myocardial perfusion images from D.SPECT are enhanced for patients positioned in a forward-leaning bikerlike position comparatively to sitting or supine positions, with a notably lower rate of attenuation artifacts.

Ischemia Is an Efficient Predictor of Significant Coronary Artery Disease in Routine Reports of a Large-scale Clinical Cohort Using Very Low-dose Exercise-first Myocardial Perfusion SPECT

“…As already detailed elsewhere (4,5), we used a exercise-first single day protocol where the injected activities of 99m Tc-sestamibi were adapted to the high tomographic sensitivity of the DSPECT® camera and to bodyweight. No injection at rest was routinely scheduled when the exercise MPI was considered to be definitively normal, and the activities injected at rest were three times higher than those injected at stress (4,5,10).…”

“…SPECT acquisitions were initiated approximately 30 min after injection of tracer. Patients were set in a semi-reclining prone position (4,5,10). Acquisition time was set to target the recording of 500 myocardial kcounts and it was limited to a maximum of 10 min.…”

Performance Evaluation of a Novel Multi-PinHole Collimator on Triple-detector SPECT/CT for dedicated myocardial imaging

“…The patient scan was performed only in supine position, not considering the well reported bene ts of combined prone plus supine imaging (4,(53)(54)(55). Furthermore, patient image comparison with other dedicated systems could be biased due to the effects of patient positioning on the evaluation of myocardial perfusion SPECT (29,41,56). We included a single representative CAD patient MPH-Cardiac image set together with the conventional dual-head LEHR SPECT images; however, a comprehensive clinical validation should include a large population of patient images to analyze further the clinical relevance of the AnyScan TRIO MPH-Cardiac system.…”

Capabilities of Modern Semiconductor Gamma Cameras in Radionuclide Diagnosis of Coronary Artery Disease

“…Combined assessment of images acquired in the sitting and supine position (upright + supine), in comparison with the results of coronary angiography, provided a sensitivity and specificity of 94% and 86%, respectively, compared to studies acquired only in the upright (91% and 59%) or only supine (88% and 73%) positions; areas under the ROC curves differed statistically significantly (0.94 vs. 0.88 and 0.89, p < 0.05) [22]. The forward leaning bikerlike position decreased a distance between the heart and the detector and eliminated attenuation artifacts in relation to the sitting and supine position [32].…”