Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study
Abstract:Background
Obesity is a common source of artifact on conventional SPECT myocardial perfusion imaging (MPI). We evaluated image quality and diagnostic performance of high-efficiency (HE) cadmium-zinc-telluride (CZT) parallel-hole SPECT-MPI for coronary artery disease (CAD) in obese patients.
Methods and Results
118 consecutive obese patients at 3 centers (BMI 43.6±8.9 kg/m2, range 35–79.7 kg/m2) had upright/supine HE-SPECT and ICA >6 months (n=67) or low-likelihood of CAD (n=51). Stress quantitative total per… Show more
“…BMI was higher in the DM groups, and neither attenuation correction nor parallel hole CZT SPECT MPI was used, which enhances diagnostic accuracy for detection of angiographic stenosis in obese patients. 26 The findings of this landmark Morales study support the concept of CAD risk equivalence of diabetes and CAD in a population more than seven times larger than that studied in the original Haffner East West study. 5 They also support AHA guidelines which recommend treating CAD risk factors in DM patients without CAD as aggressively as in non-diabetic patients with CAD.…”
“…BMI was higher in the DM groups, and neither attenuation correction nor parallel hole CZT SPECT MPI was used, which enhances diagnostic accuracy for detection of angiographic stenosis in obese patients. 26 The findings of this landmark Morales study support the concept of CAD risk equivalence of diabetes and CAD in a population more than seven times larger than that studied in the original Haffner East West study. 5 They also support AHA guidelines which recommend treating CAD risk factors in DM patients without CAD as aggressively as in non-diabetic patients with CAD.…”
“…The literature suggests that perhaps D-SPECT camera (Spectrum Dynamics) is more suitable for imaging obese patients compared to the Discovery 530 (GE Healthcare). 22 What do we need to know in the future? Only preliminary data are available for some of the following: should include solid-state cameras for time to diagnosis, radiation dose, and cost effectiveness.…”
“…6 Supine and upright imaging with CZT in obese patients has also demonstrated diagnostic accuracy for CAD. 13,14 Although these techniques have been used, more recently hybrid SPECT/CT systems allow for high-quality attenuation maps due to improved signal-to-noise ratio and better resolution. 15 CTAC for conventional SPECT imaging has been validated to improve diagnostic accuracy and risk stratification compared with non-attenuation (NAC) corrected imaging.…”
Section: Role For Ct Attenuation Correctionmentioning
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