Criteria for the addition of prone imaging to myocardial perfusion single-photon emission computed tomography for inferior wall

Nakaya, Koji; Onoguchi, Masahisa; Nishimura, Yoshihiro; Kiso, Keisuke; Otsuka, Hideki; Nouno, Yoshifumi; Shibutani, Takayuki; Yasuda, Eisuke

doi:10.1097/mnm.0000000000000713

Cited by 5 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Van Dijk et al studied 107 patients and found that CTAC lowers the need for additional rest imaging: attenuation correction rectified equivocal scans in more than 50% [6]. With respect to prone imaging, Nakaya et al showed that in conventional SPECT imaging the radiopharmaceutical uptake in inferior wall segments increased [16]. These findings were confirmed by Arsanjani et al and Nishina et al [17,18].…”

Section: Discussionmentioning

confidence: 94%

Attenuation correction in CZT myocardial perfusion imaging comparison of supine-prone and low-dose CT-corrected supine acquisitions

Hahn

Kammeier²,

Burchert³

et al. 2021

Nuclear Medicine Communications

View full text Add to dashboard Cite

Aims The study aimed to investigate whether additional prone imaging delivers comparable results to supine imaging with low-dose computed tomography (CT) attenuation correction (CTAC) in cadmium, zinc and telluride (CZT) myocardial perfusion imaging. Methods and results Thirty-four patients with an indication for myocardial perfusion imaging were studied with a CZT camera in the supine and then prone position. Furthermore, a low-dose CT was acquired. Three data sets were reconstructed and considered for analysis: (1) supine CZT, (2) supine CZT with CTAC and (3) supine CZT with additional prone CZT. Based on 17-segment polartomograms, we compared radiopharmaceutical uptake percentage, summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), total ischemic and scarred segments, and finally scan classification and clinical decision-making. SSS of supine/supine-CTAC/supine-prone was 341/229/253 (P < 0.05), SRS was 246/156/164 (P < 0.05) and SDS was 104/88/96 (ns), respectively. Total ischemic segments were 65/67/65 (ns) and total scarred segments 96/62/69 (P < 0.05), respectively. The frequency of normal scans was highest for supine-prone, followed by supine-CTAC and supine (41/35/24%, respectively). Supine imaging indicated 23% of patients for invasive coronary angiography, both supine-CTAC and supine-prone 18%. These two showed a significant intercorrelation. Conclusion Additional prone imaging and CTAC are mainly correct for the amount and extent of myocardial scars. Both methods increase the frequency of normal scans and show a significant agreement in clinical decision-making. Additional prone imaging appears as a useful alternative when a low-dose CT for attenuation correction is not available.

show abstract

Section: Discussionmentioning

confidence: 94%

Attenuation correction in CZT myocardial perfusion imaging comparison of supine-prone and low-dose CT-corrected supine acquisitions

Hahn

Kammeier²,

Burchert³

et al. 2021

Nuclear Medicine Communications

View full text Add to dashboard Cite

show abstract

“…A meta-analysis investigating the diagnostic performance of SPECT to detect ischemia-causing stenosis by FFR showed that in spite of the high specificity of 84%, the sensitivity was as low as 61% [10]. The low sensitivity of SPECT to detect FFR-positive stenosis was shown in other studies which ranged from 35% [15] or CT attenuation correction [13] [16] could be used to improve the diagnostic accuracy of the inferior wall. Also, Cadmium-Zinc-Telluride detector SPECT would be superior to the conventional anger SPECT because of its higher count sensitivity [17].…”

Section: Discussionmentioning

confidence: 99%

Simplified Bernoulli Formula to Diagnose Ischemia-Causing Stenosis at Coronary CT Angiography: Comparison with SPECT

Tomizawa¹,

Arakawa²,

Yamamoto³

et al. 2019

ACT

View full text Add to dashboard Cite

Purpose: To compare the diagnostic performance of estimated energy loss (EEL) calculated using a simplified Bernoulli formula at coronary computed tomography (CT) and single photon emission computed tomography (SPECT) to diagnose ischemia-causing stenosis by invasive fractional flow reserve (FFR). Methods: We retrospectively included 43 patients who underwent coronary CT, SPECT, and FFR measurement by catheter within 3 months. When an intermediate stenosis (40% -70%) was present at CT, EEL was calculated using the following parameters: lesion length, diameter stenosis, minimal lumen area, and the myocardial volume. An EEL > 1.17 or diameter stenosis > 70% was determined ischemic. Stress-induced ischemia by SPECT was determined when a perfusion defect at stress was accompanied with a fill-in at rest. An FFR ≤ 0.80 or diameter stenosis >70 % was determined as ischemic by catheter. Results: A total of 26 vessels were determined as ischemic by catheter exam. The per-vessel sensitivity and specificity of EEL and SPECT were 81% vs 42% and 92% vs 91%, respectively. The accuracy of EEL to diagnose stenosis causing ischemia was significantly higher than SPECT (90% vs 81%, p = 0.04). The area under the curve of the receiver operating characteristics curve was also significantly higher for EEL than SPECT (0.86 vs 0.67, p < 0.005). Conclusions: EEL showed higher accuracy than SPECT to diagnose ischemia-causing stenosis by improving the sensitivity.

show abstract

“…Despite their improved performance characteristics, cardiac CZT cameras are still considered to provide suboptimal specificity for identifying significant coronary artery disease (23), and attenuation artifacts potentially play a substantial role in this setting. Indeed, attenuation artifacts are at least as severe with Anger cameras as with CZT cameras (1) and, to date, are far from being fully prevented or detected by the various methodologies and strategies elaborated for this purpose (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…Attempts to eliminate artifacts by imaging in the prone position have also been extensively reported (2,5,(9)(10)(11)(12)(13), with an efficiency not far from that obtained with the CT-based method for preventing inferior attenuation artifacts (5) and with the additional advantage of limiting certain breathing-related artifacts (cranial cardiac drift (12)). However, this method has the disadvantage of being somewhat uncomfortable and has been reported to produce anterior attenuation artifacts (11,13).…”

mentioning

confidence: 99%

“…However, this method has the disadvantage of being somewhat uncomfortable and has been reported to produce anterior attenuation artifacts (11,13). As a result, imaging protocols mixing SPECT recordings in different positions have been developed and proven relatively efficient (9,11,14), although the latter may be difficult to associate with the somewhat long recording times of low-dose protocols.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Assessment of Myocardial CZT SPECT Recording in a Forward-Leaning Bikerlike Position

Perrin¹,

Roch²,

Claudin³

et al. 2018

J Nucl Med

View full text Add to dashboard Cite

This prospective randomized study assessed myocardial perfusion imaging with the high-sensitivity D.SPECT cadmium-zinc-telluride camera in a forward-leaning bikerlike position, which may potentially lower diaphragmatic attenuation and reduce breathing-related cardiac motion, in a manner comparable to the prone position proposed with other SPECT cameras. Methods: Patients referred for a stress-rest 99m Tc-sestamibi protocol and positioned in the biker position, with the chest leaning forward on the D.SPECT camera-head at 35°from vertical, had an additional resting D.SPECT recording in the supine position (n 5 40) or in the sitting position with the back rearward at 30°from vertical (n 5 40). Segments with attenuation artifacts were defined as those with less than 65% uptake but with strictly normal contractility at gated SPECT and no defect reversibility from stress images. Results: The biker position was associated with lower heart-to-detector distances than the supine or sitting positions (both P , 0.001); lower cardiac motion amplitudes, assessed on panograms, than the supine position (P , 0.001); and fewer segments with attenuation artifacts than the supine position (on average, 1.10 ± 1.01 vs. 1.90 ± 1.74, P 5 0.010) or the sitting position (0.75 ± 0.93 vs. 1.38 ± 1.60, P 5 0.011). Conclusion: Myocardial perfusion images from D.SPECT are enhanced for patients positioned in a forward-leaning bikerlike position comparatively to sitting or supine positions, with a notably lower rate of attenuation artifacts.

show abstract

Criteria for the addition of prone imaging to myocardial perfusion single-photon emission computed tomography for inferior wall

Cited by 5 publications

References 7 publications

Attenuation correction in CZT myocardial perfusion imaging comparison of supine-prone and low-dose CT-corrected supine acquisitions

Attenuation correction in CZT myocardial perfusion imaging comparison of supine-prone and low-dose CT-corrected supine acquisitions

Simplified Bernoulli Formula to Diagnose Ischemia-Causing Stenosis at Coronary CT Angiography: Comparison with SPECT

Assessment of Myocardial CZT SPECT Recording in a Forward-Leaning Bikerlike Position

Contact Info

Product

Resources

About