Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Camoni, Luca; Santos, Andrea; Attard, Marieclaire; Mada, Marius; Pietrzak, Agata; Rac, Sonja; Rep, Sebastijan; Terwinghe, Christelle; Costa, Pedro Fragoso

doi:10.1186/s41824-020-00080-0

Cited by 12 publications

(6 citation statements)

References 94 publications

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“…Non-ECG-gated, free-breathing low-dose CT was acquired on a conventional hybrid gamma-camera [Discovery NM670pro hybrid gamma-camera: 120 kV/20-120 mA, pitch 1.375:1, slice 1.25 mm (General Electric Healthcare, Haifa, Israel) or Symbia T2: 130 kV/30 mA, slice 2.5 mm (Siemens Healthineers, Erlangen, Germany)], placing the patient in the same position as on the CZT gamma-camera, with the arms above the head. Those parameters were in agreement with the recent best practices for CT-based attenuation correction (AC) and coronary calcium score (CCS) in nuclear cardiology (15). The procedure timeline is displayed in Figure 2.…”

Section: Spect Acquisitionsupporting

confidence: 82%

Myocardial Flow Reserve Measurement During CZT-SPECT Perfusion Imaging for Coronary Artery Disease Screening: Correlation With Clinical Findings and Invasive Coronary Angiography—The CFR-OR Study

et al. 2021

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Purpose: The aim of this study was to assess the results of cadmium zinc telluride (CZT)- single-photon emission computed tomography (SPECT) myocardial flow reserve (MFR) in coronary artery disease (CAD) screening regarding clinical risk and its correlation to invasive coronary angiography (ICA).Methods: A total of 137 patients (61 male and 76 female) referred for CAD screening myocardial perfusion imaging (MPI) between November 2018 and April 2020 were included in the CFR-OR prospective trial. The 10-year risk of cardiovascular death according to the European Society of Cardiology (SCORE) was calculated. SPECT 1-day 99mTc-tetrofosmin protocol was acquired on CZT cardiac-dedicated pinhole cameras. Low-dose thoracic CT was used for coronary calcium score (CCS) evaluation. ICA, when performed within 3 months, was also analyzed.Results: Mean SCORE and mean global MFR were, respectively, 4 ± 3.1% and 2.50 ± 0.74; 34 patients had impaired CFR (using a threshold of 2). There was a significant inverse correlation between MFR and SCORE (p = 0.006), gender (p = 0.019), and number of cardiovascular risk factors (p = 0.01). MFR was significantly reduced in patients with CCS above 1 (p = 0.01). No significant correlation was found between MFR and individual cardiovascular risk factors (dyslipidemia, hypertension, diabetes, or family history of CAD). A total of 23 patients underwent ICA. Global MFR SPECT sensitivity and specificity were 83.3 and 100 %, respectively, with an area under the curve of 0.94.Conclusion: Adding MFR to SPECT MPI for CAD screening on CZT camera may contribute to high-risk patient identification and enhance diagnostic performances. MFR could help physician decision to perform ICA.

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Section: Spect Acquisitionsupporting

confidence: 82%

Myocardial Flow Reserve Measurement During CZT-SPECT Perfusion Imaging for Coronary Artery Disease Screening: Correlation With Clinical Findings and Invasive Coronary Angiography—The CFR-OR Study

et al. 2021

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“…CAC scores were obtained primarily from CT images performed specifically for CAC scoring or from calculations from routine SPECT/CT protocol images, as previously described. 20 Several CAC scores were also calculated from a cCTA, as previously described. 21 , 22 …”

Section: Methodsmentioning

confidence: 99%

High Coronary Artery Calcium Score Is Associated With Increased Major Adverse Cardiac Events After Liver Transplantation

Almazan

Sakulsaengprapha

et al. 2023

Transplantation Direct

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The sponsor(s) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. P.-H.C. reports serving as a Medical Safety Officer for the Nonalcoholic Steatohepatitis Clinical Research Network, a Steering Committee member for Liver TransplantationBackground. Liver transplantation (LT) candidates frequently have multiple cardiovascular risk factors, and cardiovascular disease is a major cause of morbidity and mortality after LT. Coronary artery calcium (CAC) scores are a noninvasive assessment of coronary artery disease using computed tomography. This study examines CAC scores and cardiac risk factors and their association with outcomes after LT. Methods. Patients who underwent LT between January 2010 and June 2019 with a pretransplant CAC score were included in this study. Patients were divided by CAC score into 4 groups (CAC score 0, CAC score 1-100, CAC score 101-400, CAC score >400). Major adverse cardiovascular events (MACEs) were defined as myocardial infarction, stroke, revascularization, heart failure, atrial fibrillation, and cardiovascular death. Associations between CAC score and MACE or all-cause mortality within the 5-y post-LT follow-up period were analyzed using Cox regression. Statistical significance was defined as P < 0.05. Results. During the study period, 773 adult patients underwent their first LT, and 227 patients met our study criteria. The median follow-up time was 3.4 (interquartile range 1.9, 5.3) y. After 5 y, death occurred in 47 patients (20.7%) and MACE in 47 patients (20.7%). In multivariable analysis, there was no difference in death between CAC score groups. There was significantly higher risk of MACE in the CAC score >400 group, with a hazard ratio 2.58 (95% confidence interval 1.05, 6.29). Conclusions. CAC score was not associated with all-cause mortality. Patients with CAC score >400 had an increase in MACEs within the 5-y follow-up period compared with patients with a CAC score = 0. Further research with larger cohorts is needed to examine cardiac risk stratification in this vulnerable patient population.

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“…Strategies used in PET/CT to correct the respiratory motion introduced myocardial mismatches can also be used in PET/MR. It starts from aligning single-phase CT to respiratory-gated PET [8], phase-matched PET and CT in 4D-PET/CT imaging [9], and shallow tidal free-breathing or endexpiratory breath-hold CT aligned to free-breathing PET in clinical practice [10].…”

Section: Introductionmentioning

confidence: 99%

A two-stage cardiac PET and late gadolinium enhancement MRI co-registration method for improved assessment of non-ischemic cardiomyopathies using integrated PET/MR

Zhang

Chen

Wan

et al. 2022

Eur J Nucl Med Mol Imaging

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PurposeRespiratory motion causes mismatches between PET images of the myocardium and the corresponding cardiac MR images in cardiac integrated PET/MR. The mismatch may affect the attenuation correction and the diagnosis of non-ischemic cardiomyopathies. In this study, we present a two-stage cardiac PET and MR Late Gadolinium Enhancement (LGE) co-registration method, which seeks to improve diagnostic accuracy of non-ischemic cardiomyopathies via better image co-registration using an integrated wholebody PET/MR system. MethodsThe proposed PET and LGE two-stage co-registration method was evaluated through comparison with one-stage direct co-registration and no-registration. One hundred and ninety-one slices of LGE and forty lesions were studied. Two trained nuclear medicine physicians independently assessed the displacement between LGE and PET to qualitatively evaluate the co-registration quality. The changes of the mean SUV in the normal myocardium and the LGE-enhanced lesions before and after image co-registration were measured to quantitatively evaluate the accuracy and value of image co-registration. ResultsThe two-stage method had an improved image registration score (4.93±0.89) compared with the noregistration method (3.49±0.84, p value <0.001) and the single-stage method (4.23±0.81, p value <0.001).Furthermore, the two-stage method led to increased SUV value in the myocardium (3.87±2.56) compared with the no-registration method (3.14±1.92, p value <0.001) and the single-stage method (3.32±2.16, p value <0.001). The mean SUV in the LGE lesion signi cantly increased from 2.51±2.09 to 2.85±2.35 (p value<0.001) after the two-stage co-registration. ConclusionThe proposed two-stage registration method signi cantly improved the co-registration between PET andLGE in integrated PET/MR imaging. The technique may improve diagnostic accuracy of non-ischemic cardiomyopathies via better image co-registration.Registered No.

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Best practice for the nuclear medicine technologist in CT-based attenuation correction and calcium score for nuclear cardiology

Cited by 12 publications

References 94 publications

Myocardial Flow Reserve Measurement During CZT-SPECT Perfusion Imaging for Coronary Artery Disease Screening: Correlation With Clinical Findings and Invasive Coronary Angiography—The CFR-OR Study

Myocardial Flow Reserve Measurement During CZT-SPECT Perfusion Imaging for Coronary Artery Disease Screening: Correlation With Clinical Findings and Invasive Coronary Angiography—The CFR-OR Study

High Coronary Artery Calcium Score Is Associated With Increased Major Adverse Cardiac Events After Liver Transplantation

A two-stage cardiac PET and late gadolinium enhancement MRI co-registration method for improved assessment of non-ischemic cardiomyopathies using integrated PET/MR

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