The European procedural guidelines for radionuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radiopharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation-scatter compensation, data analysis, reports and image display, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocardial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocardial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness.

Differences in the performance of cadmium-zinc-telluride (CZT) cameras or collimation systems that have recently been commercialized for myocardial SPECT remain unclear. In the present study, the performance of 3 of these systems was compared by a comprehensive analysis of phantom and human SPECT images. Methods: We evaluated the Discovery NM 530c and DSPECT CZT cameras, as well as the Symbia Anger camera equipped with an astigmatic (IQÁSPECT) or parallel-hole (conventional SPECT) collimator. Physical performance was compared on reconstructed SPECT images from a phantom and from comparable groups of healthy subjects. Results: Classifications were as follows, in order of performance. For count sensitivity on cardiac phantom images (countsÁs 21 ÁMBq 21 ), DSPECT had a sensitivity of 850; Discovery NM 530c, 460; IQÁSPECT, 390; and conventional SPECT, 130. This classification was similar to that of myocardial counts normalized to injected activities from human images (respective mean values, in countsÁs 21 ÁMBq 21 : 11.4 6 2.6, 5.6 6 1.4, 2.7 6 0.7, and 0.6 6 0.1). For central spatial resolution: Discovery NM 530c was 6.7 mm; DSPECT, 8.6 mm; IQÁSPECT, 15.0 mm; and conventional SPECT, 15.3 mm, also in accordance with the analysis of the sharpness of myocardial contours on human images (in cm 21 : 1.02 6 0.17, 0.92 6 0.11, 0.64 6 0.12, and 0.65 6 0.06, respectively). For contrast-to-noise ratio on the phantom: Discovery NM 530c had a ratio of 4.6; DSPECT, 4.1; IQÁSPECT, 3.9; and conventional SPECT, 3.5, similar to ratios documented on human images (5.2 6 1.0, 4.5 6 0.5, 3.9 6 0.6, and 3.4 6 0.3, respectively). Conclusion: The performance of CZT cameras is dramatically higher than that of Anger cameras, even for human SPECT images. However, CZT cameras differ in that spatial resolution and contrast-to-noise ratio are better with the Discovery NM 530c, whereas count sensitivity is markedly higher with the DSPECT.Key Words: CZT-cameras; high-speed SPECT; myocardial perfusion imaging; count sensitivity St ress myocardial SPECT has been markedly enhanced by the recent commercialization of cameras with semiconductor (cadmium-zinc-telluride [CZT]) detectors or new collimation systems. These improved systems enhance the sensitivity of count detection and thereby enable recording times or tracer doses to be reduced, a property that has highly favorable consequences on patient comfort and radiation exposure (1-4). This enhancement is based mainly on acquisitions that are heart-centric but obtained with very different technologies: first, for the IQÁSPECT system (Siemens Medical Solutions (5-8)), an Anger camera equipped with collimators convergent on the image center (astigmatic collimators); second, for the DSPECT system (Spectrum Dynamics (9-13)), mobile columns of CZT detectors with wide parallel-hole collimators; and third, for the Discovery NM 530c system (GE Healthcare (14-21)), fixed CZT detectors with multipinhole collimators.The respective performance of these new cameras and collimation systems has been analyzed, but ...

No abstract