Nuclear myocardial perfusion imaging with a novel cadmium-zinc-telluride detector SPECT/CT device: first validation versus invasive coronary angiography

Abstract

In this first report on CZT SPECT/CT MPI comparison versus angiography we confirm a high accuracy for detection of angiographically documented CAD. Methods The study population included 66 patients (79% men; mean age 63±11 years) who underwent one day 99m Tc-tetrofosmin pharmacologic stress/rest examination and angiography within 3 month. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) as well as accuracy of the CT x-ray based attenuation corrected CZT MPI for detection of CAD (≥ 50% luminal narrowing) was calculated on a per-patient base. ResultsThe prevalence of angiographic CAD in the study population was 82%. Sensitivity, specificity, PPV, NPV and accuracy were 87%, 67%, 92%, 53% and 83%, respectively. ConclusionsIn this first report on CZT SPECT/CT MPI comparison versus angiography we document a high accuracy for detection of angiographically documented CAD.3

Cadmium-Zinc-Telluride Myocardial Perfusion Imaging in Obese Patients

“…After 392 6 47 MBq of 99m Tc-tetrofosmin had been administered, stress MPI images were acquired approximately 60 min later (during 5 min) on the CZT camera. This acquisition was followed by rest MPI using the identical protocol several minutes after administration of a 3 times higher dose of 99m Tctetrofosmin (1,143 6 133 MBq), as previously validated (9,10). MPI scans were acquired using a multipinhole collimator and 19 stationary detectors simultaneously imaging 19 different views of the heart as previously reported (6).…”

Evaluation of the Correlation Between Myocardial Perfusion Scan Findings and Invasive Coronary Angiography Results

“…In this study it was concluded that abnormal perfusion revealed the hemodynamic significance of anatomic lesions on angiography and was able to show coronary atherosclerosis before clinical symptoms indication and played a major role in the decision to angiography; also a normal perfusion scan, which has rejected a normal ischemia, cannot rule out ischemic coronary artery disease (33). Fiechter et al (2011) obtained a sensitivity of 87% and specificity of 67% for myocardial perfusion imaging (34). In all these studies, the sensitivity and specificity of myocardial scintigraphy was estimated at a high level, representing the diagnostic value of this method.…”

Attenuation Correction Maps for SPECT Myocardial Perfusion Imaging from Contrast-Enhanced Coronary CT Angiography: Gemstone Spectral Imaging with Single-Source Dual Energy and Material Decomposition

“…The 1-d 99m Tc-tetrofosmin adenosine stress (0.14 mg/kg/min over 6 min)/rest electrocardiogram-gated imaging protocol was previously described in detail (9)(10)(11). In brief, 60 min after the injection of 300-350 MBq of 99m Tc-tetrofosmin, images were acquired (over 5 min) with a cadmium-zinc-telluride camera, a tracer dose 3 times higher than the stress dose was injected, and image acquisition was initiated within a few minutes.…”