PurposeWe assessed the feasibility of myocardial blood flow (MBF) and flow reserve (MFR) estimation using dynamic SPECT with a novel CZT camera in patients with stable CAD, in comparison with 15O–water PET and fractional flow reserve (FFR).MethodsThirty patients were prospectively included and underwent FFR measurements in the main coronary arteries (LAD, LCx, RCA). A stenosis ≥50% was considered obstructive and a FFR abnormal if ≤0.8. All patients underwent a dynamic rest/stress 99mTc-sestamibi CZT-SPECT and 15O–water PET for MBF and MFR calculation. Net retention kinetic modeling was applied to SPECT data to estimate global uptake values, and MBF was derived using Leppo correction. Ischemia by PET and CZT-SPECT was considered present if MFR was lower than 2 and 2.1, respectively.ResultsCZT-SPECT yielded higher stress and rest MBF compared to PET for global and LAD and LCx territories, but not in RCA territory. MFR was similar in global and each vessel territory for both modalities. The sensitivity, specificity, accuracy, positive and negative predictive value of CZT-SPECT were, respectively, 83.3, 95.8, 93.3, 100 and 85.7% for the detection of ischemia and 58.3, 84.6, 81.1, 36.8 and 93% for the detection of hemodynamically significant stenosis (FFR ≤ 0.8).ConclusionsDynamic 99mTc-sestamibi CZT-SPECT was technically feasible and provided similar MFR compared to 15O–water PET and high diagnostic value for detecting impaired MFR and abnormal FFR in patients with stable CAD.

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Background: Evaluate the physical performance of the VERITON CzT camera (Spectrum Dynamics, Caesarea, Israel) that benefits from new detection architecture enabling whole-body imaging compared to that of a conventional dual-head Anger camera. Methods: Different line sources and phantom measurements were performed on each system to evaluate spatial resolution, sensitivity, energy resolution and image quality with acquisition and reconstruction parameters similar to those used in clinical routine. Extrinsic resolution was assessed using 99m Tc capillary sources placed successively in air, in a head and in a body phantom filled with background activity. Spectral acquisitions for various radioelements used in nuclear medicine (99m Tc, 123 I, 201 Tl, 111 In) were performed to evaluate energy resolution by computing the FWHM of the measured photoelectric peak. Tomographic sensitivity was calculated by recording the total number of counts detected during tomographic acquisition for a set of source geometries representative of different clinical situations. Sensitivity was also evaluated in focus mode for the CzT camera, which consisted of forcing detectors to collect data in a reduced field-of-view. Image quality was assessed with a Jaszczak phantom filled with 350 MBq of 99m Tc and scanned on each system with 30-,20-,10-and 5-min acquisition times.

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