Impact of a new ultrafast CZT SPECT camera for myocardial perfusion imaging: fewer equivocal results and lower radiation dose

Mouden, Mohamed; Timmer, Jorik R.; Ottervanger, Jan Paul; Reiffers, S.; Oostdijk, Ad H. J.; Knollema, Siert; Jager, Pieter L.

doi:10.1007/s00259-012-2086-z

Cited by 88 publications

(57 citation statements)

References 26 publications

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“…Although quantitative perfusion protocols using classic Anger cameras have recently been described and validated (26,27), state-of-theart dedicated cardiac cameras, for which clinical performance has clearly been demonstrated (28)(29)(30), appear as the natural tool for the development of steady myocardial perfusion quantitation in SPECT.…”

Section: Discussionmentioning

confidence: 99%

SPECT Myocardial Perfusion Reserve in Patients with Multivessel Coronary Disease: Correlation with Angiographic Findings and Invasive Fractional Flow Reserve Measurements

et al. 2015

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Quantification of myocardial perfusion reserve (MPR) is an emerging topic in nuclear cardiology with an expected diagnostic and prognostic incremental value, especially for patients with severe coronary artery disease. The advent of new dedicated solid-state cameras has opened new perspectives for perfusion quantitation in SPECT. We appraised the feasibility of perfusion reserve estimation using a cadmium zinc telluride camera in a cohort of multivessel patients and its pertinence with respect to angiographic data. Methods: Twenty-three patients with known multivessel coronary artery disease were prospectively enrolled. Dynamic SPECT acquisitions using 99m Tc-tetrofosmin at rest and after vasodilator stress were performed using a dedicated cadmium zinc telluride camera. Reconstructed frames were automatically segmented to extract the vascular input function and the myocardial uptake curve. Onecompartment kinetic modeling was used to estimate global and regional uptake values, and then myocardial blood flow was derived using the Renkin-Crone equation. Global and regional MPR was assessed using flow difference (stress − rest) and flow ratio (stress/rest). All patients underwent control coronary angiography within 4 wk, which served as the reference for MPR index assessment. Relevant angiographic findings included maximal stenosis and (for a subgroup of 26 vessels) invasive measurement of fractional flow reserve (FFR). A stenosis was considered obstructive if greater than 50% and an FFR abnormal if lower than 0.8. Results: Global MPR correlated well with number of obstructed vessels (P , 0.001). After multivariate analysis, both regional flow ratio and flow difference were significantly associated with maximal stenosis (P , 0.001) and FFR (P , 0.001). Regional MPR indices were significantly different in obstructed and nonobstructed vessels (P , 0.001) and in vessels with normal and abnormal FFR (P , 0.001). With a cutoff of 2, the sensitivity, specificity, and accuracy of regional flow ratio were, respectively, 80%, 85%, and 81% for the detection of obstructed vessels and 89%, 82%, and 85% for the detection of abnormal FFR. Conclusion: Scintigraphic estimations of global and regional MPR in multivessel patients using a cadmium zinc telluride camera appear to correlate well with invasive angiographic findings, including maximal stenosis and FFR measurements.

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Section: Discussionmentioning

confidence: 99%

SPECT Myocardial Perfusion Reserve in Patients with Multivessel Coronary Disease: Correlation with Angiographic Findings and Invasive Fractional Flow Reserve Measurements

et al. 2015

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“…Acquisition time was 12 minutes for the stress images and 15 minutes for the rest images as previously described. 7 From May 2010 until June 2013, patients (n=4049) were scanned with a cadmium zinc telluride-based SPECT/CT camera (Discovery NM/CT 570c, GE Healthcare) with 19 stationary cadmium zinc telluride detectors simultaneously imaging 19 cardiac views. Each detector comprised 32×32 pixelated (2.46×2.46 mm) cadmium zinc telluride elements.…”

Section: Myocardial Perfusion Imagingmentioning

confidence: 99%

Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients

Engbers

Timmer

Ottervanger

et al. 2016

Circ: Cardiovascular Imaging

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Background— The prognostic value of coronary artery calcium (CAC) scoring on top of myocardial perfusion imaging with single-photon emission computed tomography (SPECT) in patients suspected for coronary artery disease is not well established. Methods and Results— Four thousand eight hundred ninety-seven symptomatic patients without a history of coronary artery disease referred for SPECT and CAC scoring were included. Major adverse cardiac events (MACEs) were defined as late revascularization (>90 days after scanning), nonfatal myocardial infarction, and all-cause mortality. The frequency of abnormal SPECT increased with higher CAC scores, from 12% in patients with CAC scores of 0 to 19%, 32%, 37%, and 50% among those with CAC scores 1 to 99, 100 to 399, 400 to 999, and ≥1000, respectively ( P <0.001). During a median follow-up of 940 days (25th to 75th percentile, 581–1377), a total of 278 MACEs were observed. Overall incidence of MACE was 2.3% per year. A stepwise increase of MACE was present with increasing CAC scores, both in patients with normal SPECT (annual event rate CAC score 0: 0.6%; CAC score ≥1000: 5.5%) and abnormal SPECT (annual event rate CAC score 0: 0.4%; CAC score ≥1000: 7.6%). After multivariate analysis, both SPECT and CAC score were independent predictors of MACE (CAC score ≥1000: hazard ratio, 7.7; P <0.001 and large perfusion defect on SPECT: hazard ratio, 3.7; P <0.001). Conclusions— CAC score and SPECT are independent predictors of MACE in patients suspected for coronary artery disease. Our findings strongly support performing a CAC score in addition to SPECT in symptomatic patients to better define the risk of events during follow-up.

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“…19 Despite these apparent benefits, CZT is still susceptible to attenuation artifact. Liu et al used an anthropomorphic torso phantom and found that CZT had higher myocardial count sensitivity, better signal-tonoise ratio, and superior uniformity of overall myocardial tracer uptake compared to NaI; however, CZT was more susceptible to inferior and inferolateral attenuation with lower normalized uptake compared to the NaI camera in the anthropomorphic torso model to simulate a male patient.…”

Section: Role For Ct Attenuation Correctionmentioning

confidence: 99%

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

Peters

Kumar

Patil

2019

Journal of Nuclear Cardiology

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Impact of a new ultrafast CZT SPECT camera for myocardial perfusion imaging: fewer equivocal results and lower radiation dose

Cited by 88 publications

References 26 publications

SPECT Myocardial Perfusion Reserve in Patients with Multivessel Coronary Disease: Correlation with Angiographic Findings and Invasive Fractional Flow Reserve Measurements

SPECT Myocardial Perfusion Reserve in Patients with Multivessel Coronary Disease: Correlation with Angiographic Findings and Invasive Fractional Flow Reserve Measurements

Prognostic Value of Coronary Artery Calcium Scoring in Addition to Single-Photon Emission Computed Tomographic Myocardial Perfusion Imaging in Symptomatic Patients

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

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