Diagnostic accuracy of cadmium-zinc-telluride-based myocardial perfusion SPECT: impact of attenuation correction using a co-registered external computed tomography

Abstract

Attenuation correction with a co-registered external CT is feasible using CZT cameras and improves diagnostic accuracy mostly by improving specificity over uncorrected images.

Diagnostic implications of CZT SPECT and impact of CT attenuation correction

“…The authors reported that with visual analysis the sensitivity/specificity of CZT SPECT was 87%/67% and that with semi-automated analysis the sensitivity/ specificity was 74%/67%. 25 Overall, these studies reported high sensitivities and reasonable specificities ( Figure 1); [23][24][25] however, the number of patients in each study was limited.…”

“…Interestingly, the authors found significantly improved diagnostic accuracy in the RCA territory (P = 0.002) but not in the LAD (P = 0.35) or LCx (P = 0.08) territories. 23 Esteves et al investigated a subset of 55 patients that underwent coronary angiography within 2 months of CZT SPECT. In their primary analysis, there was a non-significant difference in specificity for obstructive CAD between CTAC and NAC (75% versus 44%; P = 0.15).…”

Which SPECT for today, which SPECT for tomorrow?

“…CT attenuation would add additional cost to an already high purchase price. It could be done on a close-by free standing CT, 20 but this is not widely practiced and logistically difficult.…”

Cardiac SPECT/CT Imaging: CT Attenuation Correction and SPECT/CT Hybrid Imaging

“…The degree of attenuation artifacts in CZT images is markedly higher than in conventional NaI images (Figure 1). AC using supine-prone acquisition or CTAC is a possible solution [43,44]. Although the majority of dedicated CZT gamma cameras do not include an integrated CT scanner, CTAC can be conducted using an external-CT-derived attenuation map and CTAC software.…”