Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT

Dijk, J. D. van; Jager, Pieter L.; Mouden, Mohamed; Slump, Cornelis H.; Ottervanger, J. P.; Boer, Jaep de; Oostdijk, Ad H. J.; Dalen, J. A. van

doi:10.1007/s12350-014-9942-0

Cited by 25 publications

(42 citation statements)

References 24 publications

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“…We also recognize that the shorter follow-up period in the CZT group may have resulted in under-reporting of adverse cardiac events. Finally, although we used a low-dose stress-only protocol, recent studies have shown the feasibility of CZT SPECT imaging with even lower amounts of radiotracer activity [21,22].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Yokota

Mouden

Ottervanger

et al. 2015

Eur J Nucl Med Mol Imaging

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Section: Discussionmentioning

confidence: 99%

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Yokota

Mouden

Ottervanger

et al. 2015

Eur J Nucl Med Mol Imaging

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“…186 The tradeoff between patient dose and acquisition time must be considered on an individual basis taking into account the scanners used. Newer generation imaging equipment, including high-efficiency CZT cameras, 187 Anger cameras 186 with improved sensitivity and advanced post-processing solutions-such as iterative reconstruction, resolution recovery, and noise reduction-provide flexible options for reducing radiotracer dose, yet preserving image quality.…”

Section: Minimizing Radiation Exposurementioning

confidence: 99%

Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging Guidelines: Instrumentation, Acquisition, Processing, and Interpretation

Dorbala

Ananthasubramaniam

Armstrong

et al. 2018

Journal of Nuclear Cardiology

283

186

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“…Patients included in the first period received a fixed activity. Based on the outcomes of our previous studies, 11,13 we changed our clinical protocol, as shown in Figure 1. Patients included in the second group received a patient-specific activity.…”

Section: Patient Populationmentioning

confidence: 99%

“…In our previous studies, we demonstrated that a body-weight dependent activity protocol not only resulted in an improved image quality but also in the possibility to further lower the tracer activity. 11,12 Prognostic evidence that such a low bodyweight dependent activity protocol with limited scan time does not affect diagnostic outcome is lacking. Hence, our aim was to compare the standard fixedactivity protocol (FAP) and patient-specific low-activity protocol (PLAP) with regard to percentage of scans interpreted as normal, radiation dose, and prognostic value for CZT-SPECT MPI.…”

Section: Introductionmentioning

confidence: 99%

Effect of a patient-specific minimum activity in stress myocardial perfusion imaging using CZT-SPECT: Prognostic value, radiation dose, and scan outcome

Dijk

Borren

Mouden

et al. 2018

Journal of Nuclear Cardiology

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Background. SPECT Myocardial perfusion imaging (MPI) is associated with a relatively high radiation burden and decreasing image quality in heavy patients. Patient-specific low-activity protocols (PLAPs) are suggested but follow-up data is lacking. Our aim was to compare the use of a standard fixed-activity protocol (FAP) with a PLAP in cadmium zinc telluride (CZT)-SPECT MPI.Methods. We retrospectively included 1255 consecutive patients who underwent CZT-SPECT stress-optional rest MPI. 668 Patients were scanned using FAP (370 MBq) and 587 patients using PLAP (2.25 MBq·kg −1 ). Percentage of scans interpreted as normal, radiation dose, and 1-year follow-up including hard event rates (all-cause death or non-fatal myocardial infarction) were collected and compared.Results. The percentage of scans interpreted as normal was 67% in FAP and 70% in PLAP groups (P = .29). The annualized hard event rates in these patients were 1.0% in the FAP and 0.9% in the PLAP group (P = .86). However, the mean radiation dose decreased by 23% for stress-only and by 15% to 2.6 mSv for stress-optional rest MPI after introduction of the PLAP (p<0.001).Conclusions. Introduction of a patient-specific low-activity protocol does not affect the percentage of scans interpreted as normal or prognosis but significantly lowers the radiation dose for CZT-SPECT MPI. (J Nucl Cardiol 2018;25:26-35.) Spanish AbstractAntecedentes. El estudio de imagen de perfusión miocárdica con SPECT (MPI, por sus siglas en ingles) se asocia con una carga de radiación relativamente alta y una menor calidad de imagen en pacientes obesos. Se sugieren protocolos de baja actividad específica para cada pacientes (PBAP), sin embargo faltan datos de seguimiento. Nuestro objetivo fue comparar el uso de un protocolo con actividad fija estándar (PAF) con un PBAP en un estudio de perfusión miocárdica con SPECT CZT cadmio-zinc-telurio. Métodos. Incluimos de manera retrospectiva 1255 pacientes consecutivos que se sometieron a un SPECT CZT de estrés con fase de reposo de manera opcional. 668 pacientes fueron escaneados usando un PAF (370 MBq) y 587 pacientes utilizando un PBAP (2.25 MBq/kg). Los porcentajes de exploraciones interpretadas como normales, dosis de radiación y seguimiento de un año incluyendo tasas de eventos duros (muerte por todas las causas o infarto de miocardio no fatal) fueron recolectados y comparados.Resultados. El porcentaje de exploraciones interpretadas como normales fue de 67% en el PAF y de 70% en el PBAP (p = 0.29). Las tasas de eventos duros anuales en estos pacientes fueron del 1.0% en el PAF y del 0.9% en el PBAP (p = 0.86). Sin embargo, la dosis de radiación media disminuyó en un 23% para los estudios de solo estrés y en un 15% para 2.6 mSv en el estudio de estrés con reposo opcional después de la introducción del PBAP (p <0,001).Conclusiones. La introducción de un protocolo de baja actividad específica para el paciente no afecta el porcentaje de estudios interpretados como normal o el pronóstico, sin embargo reduce significativamente la dosis de ra...

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Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT

Abstract: Also in CZT SPECT image quality decreases with weight. The use of a tracer dose and scan time that depends linearly on patient's body weight corrected for the varying image quality in CZT-SPECT MPI. This leads to better radiation exposure justification.

Cited by 25 publications

References 24 publications

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging Guidelines: Instrumentation, Acquisition, Processing, and Interpretation

Effect of a patient-specific minimum activity in stress myocardial perfusion imaging using CZT-SPECT: Prognostic value, radiation dose, and scan outcome

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