Quantitative myocardial perfusion SPECT/CT for the assessment of myocardial tracer uptake in patients with three-vessel coronary artery disease: Initial experiences and results

Abstract

Background To evaluate quantitative myocardial perfusion SPECT/CT datasets for routine clinical reporting and the assessment of myocardial tracer uptake in patients with severe TVCAD. Methods MPS scans were reconstructed as quantitative SPECT datasets using CTs from internal (SPECT/CT, Q_INT) and external (PET/CT, Q_EXT) sources for attenuation correction. TPD was calculated and compared to the TPD from non-quantitative SPECT datasets of the same patients. SUVmax, SUVpeak, and SUVmean were compared between Q_INT and Q_EXT SPECT datasets. Global SUVmax and SUVpeak were compared between patients with and without TVCAD. Results Quantitative reconstruction was feasible. TPD showed an excellent correlation between quantitative and non-quantitative SPECT datasets. SUVmax, SUVpeak, and SUVmean showed an excellent correlation between Q_INT and Q_EXT SPECT datasets, though mean SUVmean differed significantly between the two groups. Global SUVmax and SUVpeak were significantly reduced in patients with TVCAD. Conclusions Absolute quantification of myocardial tracer uptake is feasible. The method seems to be robust and principally suitable for routine clinical reporting. Quantitative SPECT might become a valuable tool for the assessment of severe coronary artery disease in a setting of balanced ischemia, where potentially life-threatening conditions might otherwise go undetected.

Absolute quantitation of sympathetic nerve activity using 123I-metaiodobenzylguanidine SPECT-CT in neurology

“…The need for radionuclide therapy has primarily led to SPECT quantitation becoming more commonplace. The potential applications of absolute SPECT-CT image quantitation to diagnoses have been discussed, particularly in myocardial perfusion, 99m Tc-Pyrophosphate scintigraphy, and cardiac sympathetic nerve imaging (15,(21)(22)(23)(24). These applications should become more established in the eld of nuclear medicine diagnostics.…”

Absolute quantitation of sympathetic nerve activity using [123I] metaiodobenzylguanidine SPECT-CT in neurology

“…In addition, anatomically overlapping organs on two-dimensional (2D) images are avoided on 3D images. Calculating the absolute amount of myocardial uptake using quantitative SPECT might further improve Tc-Pyrophosphate scintigraphy, and cardiac sympathetic nerve imaging to diagnoses have been discussed (Ramsay and Cuscaden 2020;Dorbala et al 2021;Lehner et al 2022;Nakajima et al 2023;Saito et al 2023). These applications should become more established in the field of nuclear medicine diagnostics.…”