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

Dorbala, Sharmila; Ananthasubramaniam, Karthik; Armstrong, Ian; Chareonthaitawee, Panithaya; DePuey, E. Gordon; Einstein, Andrew J.; Gropler, Robert J.; Holly, Thomas A.; Mahmarian, John J.; Park, Mi Ae; Polk, Donna M.; Russell, Raymond R.; Slomka, Piotr J.; Thompson, Randall C.; Wells, R. Glenn

doi:10.1007/s12350-018-1283-y

Cited by 265 publications

(182 citation statements)

References 180 publications

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“…Dose optimization in myocardial perfusion imaging (MPI) is a complex topic with several aspects that need to be considered. The general strategy for dose reduction proposed in this paper can be applied, integrating the specificities of MPI (26)(27)(28)(29).…”

Section: Cardiac Imagingmentioning

confidence: 99%

Technologist Approach to Global Dose Optimization

Costa

Testanera

Camoni

et al. 2018

J. Nucl. Med. Technol.

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Section: Cardiac Imagingmentioning

confidence: 99%

Technologist Approach to Global Dose Optimization

Costa

Testanera

Camoni

et al. 2018

J. Nucl. Med. Technol.

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“…4 For Tc-99m sestamibi, minimum delays of 15 to 20 minutes for exercise, 45 to 60 minutes for rest, and 60 minutes for pharmacologic stress are recommended. 5 For Tc-99m tetrofosmin, minimum delays of 10 to 15 minutes for exercise, 30 to 45 minutes for rest, and 45 minutes for pharmacologic stress are optimal. 5 Published peer-reviewed studies examining optimal times between injection and imaging generally focus on a single property of the tracers.…”

Section: Introductionmentioning

confidence: 99%

“…5 For Tc-99m tetrofosmin, minimum delays of 10 to 15 minutes for exercise, 30 to 45 minutes for rest, and 45 minutes for pharmacologic stress are optimal. 5 Published peer-reviewed studies examining optimal times between injection and imaging generally focus on a single property of the tracers. Because of this, it can be difficult to identify evidence-based opportunities to optimize imaging protocols.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of tetrofosmin versus sestamibi achieved through shorter injection-to-imaging times: A systematic review of the literature

Duvall

Case

Lundbye

et al. 2021

Journal of Nuclear Cardiology

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Based on superior image quality, more accurate gated images, and lower radiation exposure to patients, Technetium-99m (Tc-99m) based tracers are preferred over Thallium-201 for SPECT myocardial perfusion imaging. The two Tc-99m tracers, sestamibi and tetrofosmin, have many similar characteristics but there are differences in blood and liver clearance rates, as well as the recommended time after injection for imaging to achieve optimal image quality. Because published peer-reviewed studies examining optimal times between injection and imaging are limited, it can be difficult to identify evidence-based opportunities to optimize imaging protocols. Using systematic literature review methods, this study was designed to identify and consolidate the available evidence on the use of sestamibi compared to tetrofosmin for variable injection to imaging times in regard to test efficiency, including test length and re-scan rates, and image quality, including overall quality and cardiac to extra-cardiac ratios. The composite of this data shows that earlier imaging with tetrofosmin is equivalent to later imaging with sestamibi when assessing subjective image quality or when quantifying heart-to-extra-cardiac ratios. Image quality and heart-to-extra-cardiac ratios comparing early versus later imaging with tetrofosmin were comparable if not equivalent to each other. The equivalency of the imaging quality occurs with 15 minutes (on average) earlier imaging compared to sestamibi and 30 minutes compared to standard time tetrofosmin. The subjective findings of equivalent image quality are also shown with objective measurements of heart-to-extra-cardiac ratios. In this review, the significantly shorter injection-to-acquisition times with tetrofosmin compared to sestamibi resulted in better efficiency and less waiting times for patients; in addition, significantly higher re-scan rates with sestamibi compared to tetrofosmin due to hepatic activity contributed to better throughput with tetrofosmin. (J Nucl Cardiol 2020)

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“…1 The use of electrocardiographic gating also enabled accurate measurements of left ventricle (LV) wall motion, ejection fractions, and volumes, which allows the possibility to integrate several important functional information to perfusion evaluation. 2 In the last years, the introduction of dedicated cardiac cameras equipped with Cadmium-Zinctelluride (CZT) technology has further improved the spatial and temporal resolution, with a significant reduction in the acquisition time and injected dose. [3][4][5] Nevertheless, attention should also be paid to unexpected artifacts using CZT detectors too.…”

mentioning

confidence: 99%