Clinical Feasibility of Simultaneous Acquisition Rest ^99mTc/Stress ²⁰¹Tl Dual-Isotope Myocardial Perfusion Single-Photon Emission Computed Tomography With Semiconductor Camera

Abstract

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp camera has cadmium-zinc-telluride (CZT) detectors and direct conversion of scintillation without NaI crystal. The CZT gamma camera is also expected to improve image contrast, provide multi-isotope imaging, faster scan and short acquisition time. 9 A novel dedicated cardiac scanner, the D-SPECT (Spectrum Dynamics, Caesarea, Israel), has 9 CZT detectors (40×160 mm) with square-hole tungsten collimators. In our previous experiment, D-SPECT had 1.6-and 1.4-fold better full width at half maximum (FWHM) in both 99 m Tc and 201 Tl line-sources than the conventional anger gamma camera, respectively. Regarding photon count sensitivity, D-SPECT also had 5.03-and 6.31-fold higher photon count · s -1 · MBq -1 tress myocardial perfusion single-photon emission computed tomography (MPS) is the standard diagnostic modality in patients with known or suspected coronary artery disease (CAD). 1-4 Stress-induced myocardial ischemia and left ventricular (LV) functional parameters are markers of future cardiac events. 5-7 Moreover, recent clinical guidelines recommend ≥10% myocardial ischemia in the LV as an indication for coronary revascularization. 8 Precise diagnosis and quantification using MPS would facilitate this.Technical features of the recently developed semiconductor gamma camera include high spatial resolution, high sensitivity and high energy-spectrum resolution. This type of gamma

Dual-isotope myocardial perfusion SPECT imaging: Past, present, and future

“…8 Figure 1 demonstrates effective radiation doses associated with the single-and dual-isotope procedures, based on injected activity doses in the current study by Imbert et al A complete stress and rest dual-isotope testing still involved higher per-patient radiation dose compared to the single-isotope procedure (8.3 vs 4.3 mSv, respectively) ( Figure 1A), but accounted for much lower radiation dose compared to the traditional rest Tl-201/ stress Tc-99m sestamibi protocol using a conventional Anger camera (over 20 mSv), or previously reported dual-isotope protocols using a CZT camera. [9][10][11] A stressonly rate of 40% would result in a substantial reduction of average effective radiation to 3 mSv for the singleisotope and 5.4 mSv for the dual-isotope procedure ( Figure 1B).…”

“…Another interesting dual-isotope MPI protocol has been recently suggested by Makita and colleagues from Japan. 11 These investigators evaluated a CZT-MPI protocol, starting with rest Tc-99m-tetrofosmin injection, followed by adenosine stress Tl-201 and simultaneous acquisition of both isotopes. Patients also underwent a second dual-isotope imaging 30 minutes later for the comparison of ECG-gated wall motion with the immediately post-stress acquisition.…”

Diagnostic Performance of the Simultaneous Acquisition Rest ^{99 m}Tc-Tetrofosmin/Stress ²⁰¹Tl Dual-Isotope Protocol With a Semiconductor Camera ― Comparison With the Rest-Stress ^{99 m}Tc-Tetrofosmin Protocol ―

“…Makita et al conducted simultaneous acquisition rest 99 m Tc-tetrofosmin/ stress 201 Tl MPI using the D-SPECT system in 2016, and found a high diagnostic accuracy for CAD with a short examination time. 15 However, the superiority of the diagnostic value of the simultaneous acquisition rest 99 m Tc-tetrofosmin/stress 201 Tl dual-isotope (SDI) protocol has not yet been compared with that of the rest-stress 99 m Tc-tetrofosmin protocol (Tc/Tc protocol). Therefore, in the present study we retrospectively evaluated and compared the diagnostic values of these 2 protocols.…”

Noninvasive Vascular Function Tests – Long Journey for Predicting Cardiovascular Events –

“…Multiple imaging methods, including single photon emission computed tomography, for assessing left ventricular function are also available to assess prognosis. 6 In addition, a noninvasive exercise stress test is widely performed after ACS to detect residual ischemia. Regarding patients with ACS, the contributions of this study to our knowledge are important.…”