<p>Myocardial perfusion imaging is considered one of the leading non-invasive diagnostic tools for the assessment of patients with known or suspected coronary artery disease and other cardiac pathologies. The technical improvement of the currently used gamma-tomographic devices has increased the diagnostic capability of this technique. In recent years, the use of dedicated cardiac SPECT cameras with solid-state cadmium–zinc–telluride (CZT) technology has increased in nuclear imaging. These new CZT technologies have several advantages over existing scanner models. The development of new CZT detectors and their collimator configuration has increased scanning sensitivity and spatial resolution values. Also, due to the significantly higher sensitivity of new CZT detectors and new methods of data processing, radiologists have already introduced new scanning protocols and methods for radionuclide assessment of myocardial blood flow, reserve and non-invasive visualisation of the functioning of the sympathetic nervous system into clinical practice. The purpose of this review is to provide data on the main technical characteristics of gamma cameras equipped CZT detectors as well as the current possibilities of using CZT cameras for examining patients with various cardiovascular diseases.</p><p>Received 1 April 2020. Revised 22 April 2020. Accepted 30 April 2019.</p><p><strong>Funding:</strong> The work is supported by a grant of the Russian Science Foundation No. 17-75-20118.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: S.M. Minin, K.V. Zavadovky, A.B. Romanov<br />Drafting the article: S.M. Minin, K.V. Zavadovky, N.A. Nikitin, A.V. Mochula, A.B. Romanov<br />Critical revision of the article: S.M. Minin, K.V. Zavadovky<br />Final approval of the version to be published: S.M. Minin, K.V. Zavadovky, N.A. Nikitin, A.V. Mochula, A.B. Romanov</p>
Background
Epicardial adipose tissue (EAT) has been considered as one of the probable triggers of atrial fibrillation (AF). CT‐rediomics is a perspective noninvasive method of assessment of EAT. We evaluate the radiomic phenotype of EAT in patients with lone AF in the prognosis of AF recurrence after catheter ablation.
Methods
A total of 43 patients with lone AF referred for CA and 20 out‐hospital patients without arrhythmia underwent multidetector computed tomography coronary angiography. Segmentation of EAT and extraction radiomic features were performed on calcium scoring series using by 3D‐Slicer. Clinical follow‐up was performed for 12 months period after the CA.
Results
EAT in patients with lone AF had a distinct radiomic phenotype. Thus, 45 of 93 calculated radiomic features, volume and attenuation of EAT were significantly different between patients with lone AF and persons without any arrhythmia. In addition, 17 radiomic features were significantly different in subgroups with and without AF recurrence. Multivariate regression analysis demonstrated that only gray level nonuniformity normalized (GLSZM) was an independent predictor of AF recurrence (OR 1.0027, 95%CI 1.0009–1.0044, p = 0.002). ROC analysis data showed that GLSZM >1227.4 indicates high probability of AF recurrence during 12 months (sensitivity 89.4%, specificity 70.8%, AUC: 0.809; p = 0.001).
Conclusion
The radiomic parameter GLSZM is associated with late AF recurrence after CA in patients with lone AF. In current study GLSZM was a stronger predictor of lone AF recurrence in multivariate analysis comparing with other established risk factors and EAT volume and attenuation.
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