Stress thallium-201/rest technetium-99m sequential dual-isotope high-speed myocardial perfusion imaging validation versus invasive coronary angiography

Barone-Rochette, Gilles; Leclere, Mélanie; Calizzano, Alex; Vautrin, Estelle; Gallazzini-Crepin, C.; Broisat, Alexis; Ghezzi, Cathérine; Baguet, Jean Philippe; Machecourt, J; Vanzetto, Gérald; Fagret, Daniel

doi:10.1007/s12350-014-0016-0

Cited by 20 publications

(10 citation statements)

References 32 publications

(44 reference statements)

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“…Because of the geometry of detection and focused acquisition, the ratio between acquired 201 Tl myocardial counts and total acquired counts is better with CZT cameras, approximately 0.35 to 0.50 versus 0.15 to 0.20 with Anger cameras [31][32][33]. The published studies conclude that with CZT cameras and 201 Tl, acquisition times can be reduced down to 4-6 min or injected activities decreased down to 0.7 MBq/kg with high quality images [33].…”

Section: Dual Perfusion Imagingmentioning

confidence: 99%

Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM)

Denis

Marie

Ben‐Haim

et al. 2016

Eur J Nucl Med Mol Imaging

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The trade-off between resolution and count sensitivity dominates the performance of standard gamma cameras and dictates the need for relatively high doses of radioactivity of the used radiopharmaceuticals in order to limit image acquisition duration. The introduction of cadmium-zinc-telluride (CZT)-based cameras may overcome some of the limitations against conventional gamma cameras. CZT cameras used for the evaluation of myocardial perfusion have been shown to have a higher count sensitivity compared to conventional single photon emission computed tomography (SPECT) techniques. CZT image quality is further improved by the development of a dedicated three-dimensional iterative reconstruction algorithm, based on maximum likelihood expectation maximization (MLEM), which corrects for the loss in spatial resolution due to line response function of the collimator. All these innovations significantly reduce imaging time and result in a lower patient's radiation exposure compared with standard SPECT. To guide current and possible future users of the CZT technique for myocardial perfusion imaging, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, has decided to examine the current literature regarding procedures and clinical data on CZT cameras. The committee hereby aims 1) to identify the main acquisitions protocols; 2) to evaluate the diagnostic and prognostic value of CZT derived myocardial perfusion, and finally 3) to determine the impact of CZT on radiation exposure.

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Section: Dual Perfusion Imagingmentioning

confidence: 99%

Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM)

Denis

Marie

Ben‐Haim

et al. 2016

Eur J Nucl Med Mol Imaging

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“…2 Many of these studies have assessed the diagnostic performance of MPI with CZT cameras (Table 1). 1,[3][4][5][6][7][8] Further, in a meta-analysis by Nudi et al, the sensitivity of CZT SPECT was found to be range between 0.78 and 0.89 and the specificity ranged from 0.62 to 0.76. 9 While the sensitivity is comparable to prior studies, the specificity is lower.…”

Section: Czt Versus Conventional Spectmentioning

confidence: 95%

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

Peters

Kumar

Patil

2019

Journal of Nuclear Cardiology

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“…3 The authors propose a fast test, which was utilized in 1,336 patients, but analyzed in only 214 patients. Using the GE Discovery NM 530 high-efficiency SPECT camera (GE Healthcare), a mean dose of 82 MBq (2.2 mCi) of Tl-201 was injected at peak stress, 5 minutes stress imaging followed and a mean dose of 314 MBq (8.5 mCi) of Tc-99m was injected after stress imaging and 5 minutes rest imaging followed 2 minutes later.…”

Section: See Related Article Pp 513-522mentioning

confidence: 99%

Return of dual-isotope SPECT myocardial perfusion imaging? Not so fast…

Henzlova

Duvall

2015

Journal of Nuclear Cardiology

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Myocardial perfusion imaging remains the most frequently used non-invasive modality for the detection and risk stratification of patients with obstructive epicardial coronary artery disease (CAD). From its inception more than 40 years ago, the mode of stressing, choice of radioactive tracers, and detection technology, have evolved: From exercise stress alone to a choice of four pharmacological stressors, from thallium-201 (Tl-201) to technetium-99m (Tc-99m) tracers, from planar to SPECT imaging, from single head to dual-head cameras, from Na-I crystals to CZT solid state cameras. Despite the long track record of diagnostic accuracy, prognostic robustness and ubiquitous availability, continued success for the modality cannot be taken for granted. With competition from the emergence of other non-invasive modalities (stress echocardiography, cardiac CT angiography, cardiac MRI) and with documented changes in the clinical manifestations of CAD, 1,2 the demands on the safety, efficiency, and convenience of myocardial perfusion imaging continue to grow.In the long absence of new tracers (Tc-99m-based agents were introduced more than 25 years ago!), the recent advent of solid state high-efficiency SPECT cameras allows for a re-assessment of by now ancient imaging protocols. Obvious and justified criticism of the length of the traditional rest-stress sequence as well as growing awareness of radiation doses to the patients and to the medical personnel can now be addressed with imagination and inventiveness.One of the novel tested approaches is described in the current issue of the Journal by authors from Grenoble, France.3 The authors propose a fast test, which was utilized in 1,336 patients, but analyzed in only 214 patients. Using the GE Discovery NM 530 high-efficiency SPECT camera (GE Healthcare), a mean dose of 82 MBq (2.2 mCi) of Tl-201 was injected at peak stress, 5 minutes stress imaging followed and a mean dose of 314 MBq (8.5 mCi) of Tc-99m was injected after stress imaging and 5 minutes rest imaging followed 2 minutes later. Thus, the whole stress-rest sequence was completed in 22.4 ± 4 minutes. Correlation with coronary angiography in 104 patients with high CAD prevalence was good. Normalcy rate in 110 patients with low pretest probability was also high.A similar protocol and tracer dosage (2-2.5 mCi of Tl-201 and 8-10 mCi of Tc-99m) was reported in 2009 by Berman et al using a different high-efficiency CZT cardiac camera (D-SPECT, Spectrum Dynamics, Israel) in 374 patients. 4 Image quality, radiation dose, and study length were analyzed, but not correlation to angiography.There are pros and cons of both Tl-201 and Tc-99m as myocardial perfusion agents, even though Tc-99m agents are currently used in the vast majority of SPECT myocardial perfusion imaging studies. Tl-201 has a rapid blood clearance half-time (\30 seconds), a high first pass extraction ([88%) and better linearity between flow und uptake.5 Tc-99m sestamibi, on the other hand, has a longer blood clearance half-time ([1 minute), smaller first pas...

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Stress thallium-201/rest technetium-99m sequential dual-isotope high-speed myocardial perfusion imaging validation versus invasive coronary angiography

Abstract: Dual-isotope high-speed MPI is reliable at detecting or ruling out CAD. NCT01785589.

Cited by 20 publications

References 32 publications

Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM)

Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM)

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

Return of dual-isotope SPECT myocardial perfusion imaging? Not so fast…

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