The effect of CT-based attenuation correction on the automatic perfusion score of myocardial perfusion imaging using a dedicated cardiac solid-state CZT SPECT/CT

Abstract

Specifically designed databases for solid-state CZT cardiac SPECT provide accurate quantitation of perfusion scores concordant with those previously validated for conventional SPECT. AC and NAC CZT scores differed significantly, especially in men.

Quantitative analysis: Specific normal database for the best practice

“…These studies demonstrated improved diagnostic confidence and accuracy with CT AC. [5][6][7] Recently, Kennedy et al demonstrated that specifically designed databases for solid-state CZT cardiac SPECT provide accurate quantitation of perfusion scores concordant with those previously validated for conventional SPECT 8 (Figures 1 and 2). It is important to point out that the same concordance was not achieved using solely the normal default database available for the conventional system.…”

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

“…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.…”

“…Kennedy et al 1 demonstrate a reasonable correlation between CZT and conventional NaI scanners. Their data are in agreement with prior studies that indicate CZT could be associated with lower specificity and a higher number of false positives.…”

“…Kennedy et al 1 add to the limited body of literature on the use of CTAC in CZT SPECT. They found that AC significantly decreased the SSS and SRS in men when compared with NAC, but not in women.…”

“…In the current issue, Kennedy et al 1 further validate cadmium-zinc-telluride (CZT) SPECT, including the use of customized databases for automated perfusion scoring. They also demonstrate the utility of CT attenuation correction to reduce false positives and improve diagnostic accuracy.…”