Compartmental Modeling of Technetium-99m–Labeled Teboroxime with Dynamic Single-Photon Emission Computed Tomography

Bella, E.V.R. Di; Ross, Steven G.; Kadrmas, Dan; Khare, H.S.; Christian, Paul E.; McJames, Scott; Gullberg, Grant T.

doi:10.1097/00004424-200103000-00007

Cited by 31 publications

(26 citation statements)

References 14 publications

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“…99m Tc-tetrofosmin was used in this study because it constitutes the most commonly used radiotracer for SPECT MPI in daily clinical routine. However, 99m Tc tracers with more favorable tracer kinetics such as found for teboroxime (32) may help in improving the role of MFR by CZT.…”

Section: Discussionmentioning

confidence: 99%

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET

et al. 2016

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Recent advances in SPECT technology including cadmium-zinctelluride (CZT) semiconductor detector material may pave the way for absolute myocardial blood flow (MBF) measurements by SPECT. The aim of the present study was to compare K 1 uptake rate constants as surrogates of absolute MBF and myocardial flow reserve index (MFRi) in humans as assessed with a CZT SPECT camera versus PET. Methods: Absolute MBF was assessed in 28 consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by 99m Tc-tetrofosmin CZT SPECT and 13 N-ammonia PET, and MFR was calculated as a ratio of hyperemic over resting MBF. Results from both MPI methods were compared, and correlation coefficients were calculated. The diagnostic accuracy of CZT MFRi to predict an abnormal MFR defined as PET MFR less than 2 was assessed using a receiver-operator-characteristic curve. The definition of coronary artery disease (CAD) was originally based on the presence of anatomic luminal narrowing greater than 50%. Over the past decades, however, many advances in imaging techniques have enhanced our pathophysiologic understanding of CAD. It has been recognized that many factors beyond luminal narrowing may determine whether or not an anatomic coronary lesion induces ischemia. Because this cannot be comprehensively addressed by coronary angiography alone, nuclear myocardial perfusion imaging (MPI) has been well established as a tool for providing proof of ischemia. This is mandatory for prognostically relevant target lesion revascularization in chronic stable CAD. Because revascularization of a non-flow-limiting coronary stenosis is not beneficial to the patient, neither from a prognostic nor from a symptomatic point of view, nuclear MPI has been suggested as a gatekeeper for invasive coronary angiography (1-3). MPI studies with PET have demonstrated that absolute myocardial blood flow (MBF) and flow reserve (MFR) provide incremental diagnostic (4) and prognostic (5) information over relative perfusion alone. Quantitative assessment of MBF is difficult with standard SPECT for which detectors need to rotate around the patient and for which unfavorable properties of the currently available flow tracers hamper accurate MBF quantification because of nonlinear extraction fraction with roll-off at higher flow values. The recent advances in SPECT technology including semiconductor detector material (cadmium zinc telluride [CZT]) allow acquisition in a nonrotating mode and therefore acquisition of time-activity curves. This may enable absolute MBF and MFR estimation by SPECT as recently shown in experimental animal models (6), which may pave the way for its implementation in clinical routine (7). More knowledge on the impact of the tracer properties on the values obtained from quantification is crucial.The aim of the present study was a head-to-head comparison in humans of indices of absolute MBF and MFR as assessed with 99m Tc-tetrofosmin on a CZT SPECT camera versus MBF and MFR measured with 13 N-ammonia on a PET scanner. MATERIALS AND...

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Section: Discussionmentioning

confidence: 99%

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET

et al. 2016

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“…liver) allowing delayed imaging when some of the background activity has diminished. Tracers, such as 99m Tc-teboroxime, with properties well suited to measuring perfusion (11)(12)(13), but requiring rapid SPECT due to fast Illustration of attenuation and scatter in SPECT. Attenuation causes a reduction in measured counts, particularly in deep structures, while scatter causes mis-positioning of detected counts.…”

Section: Requirements For the Radio-tracermentioning

confidence: 99%

Quantitative Assessment of Regional Myocardial Blood Flow with Clinical SPECT

Iida

Maruno

Koshino

et al. 2016

Annals of Nuclear Cardiology

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“…3, wherein different TACs were introduced within the different organs based on compartmental modeling of experimental measurements. 31,32 A simulated perfusion defect was introduced in the anterior wall of the LV, as illustrated in Fig. 2 in a short-axis slice of the LV for two different gating intervals ͑ED and ES͒.…”

Section: Ivc Data Setsmentioning

confidence: 99%

Detectability of perfusion defect in five‐dimensional gated‐dynamic cardiac SPECT images

et al. 2010

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Purpose: In previous work, the authors developed and demonstrated the concept of an image reconstruction procedure aimed to unify gated and dynamic nuclear cardiac imaging, which the authors have termed five-dimensional (5D) SPECT. Gated imaging permits the clinician to evaluate wall motion and, through the use of stress and rest scans, allows perfusion defects to be observed. Dynamic imaging depicts kinetics in the myocardium, which can be used to evaluate perfusion, but traditional dynamic images are motionless and do not depict wall motion. In this article, the authors investigate the degree to which perfusion defects can be detected from the dynamic information conveyed by 5D images, a problem that is particularly challenging in the absence of multiple fast camera rotations. Methods: The authors first demonstrate the usefulness of dynamic reconstructed images for perfusion detection by using linear discriminant analyses ͑Fisher linear discriminant analysis and principal component analysis͒ and a numerical channelized Hotelling observer. The authors then derive three types of discriminant metrics for characterizing the temporal kinetic information in reconstructed dynamic images for differentiating perfusion defects from normal cardiac perfusion, which are the Fisher linear discriminant map, temporal derivative map, and kinetic parametric images. Results: Results are based on the NURBS-based cardiac-torso phantom with simulation of Tc99m-teboroxime as the imaging agent. The derived metric maps and quantitative contrast-to-noise ratio results demonstrate that the reconstructed dynamic images could yield higher detectability of the perfusion defect than conventional gated reconstruction while providing wall motion information simultaneously. Conclusions:The proposed metrics can be used to produce new types of visualizations, showing wall motion and perfusion information, that may potentially be useful for clinical evaluation. Since 5D imaging permits wall motion and kinetics to be observed simultaneously, it may ultimately obviate the need for separate stress and rest scans.

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Compartmental Modeling of Technetium-99m–Labeled Teboroxime with Dynamic Single-Photon Emission Computed Tomography

Abstract: Both 201Tl uptake and 99mTc-teboroxime kinetic parameters were well correlated with flow. The 99mTc-teboroxime washin parameters offer semiquantitative flow values and provide greater defect contrast than can be obtained with 201Tl uptake values.

Cited by 31 publications

References 14 publications

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET

Quantitative Assessment of Regional Myocardial Blood Flow with Clinical SPECT

Detectability of perfusion defect in five‐dimensional gated‐dynamic cardiac SPECT images

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Compartmental Modeling of Technetium-99m–Labeled Teboroxime with Dynamic Single-Photon Emission Computed Tomography

Abstract: Both 201Tl uptake and 99mTc-teboroxime kinetic parameters were well correlated with flow. The 99mTc-teboroxime washin parameters offer semiquantitative flow values and provide greater defect contrast than can be obtained with 201Tl uptake values.

Cited by 31 publications

References 14 publications

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using 99mTc-Tetrofosmin: Head-to-Head Comparison with 13N-Ammonia PET

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using 99mTc-Tetrofosmin: Head-to-Head Comparison with 13N-Ammonia PET

Quantitative Assessment of Regional Myocardial Blood Flow with Clinical SPECT

Detectability of perfusion defect in five‐dimensional gated‐dynamic cardiac SPECT images

Contact Info

Product

Resources

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Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET

Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium–Zinc–Telluride Detectors Using ^99mTc-Tetrofosmin: Head-to-Head Comparison with ¹³N-Ammonia PET