Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

Buechel, Ronny R.; Pazhenkottil, Aju P.; Herzog, Bernhard A.; Husmann, Lars; Nkoulou, René; Burger, Irene A.; Valenta, Ines; Wyss, Christophe; Ghadri, Jelena R.; Kaufmann, Philipp A.

doi:10.1007/s00259-010-1480-7

Cited by 38 publications

(29 citation statements)

References 16 publications

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“…Several other applications allow to take even more complete advantage of the refinements offered by the new cameras which may further enhance the clinical importance of MPI. Although not applied in the present study, the geometry of the detector array allowing acquisition of all angles simultaneously facilitates breath-hold triggering, which can assist in discrimination of artefacts from true hypoperfusion similar to attenuation correction [21]. Furthermore, left ventricular dyssynchrony can be assessed with a scan time of 5 minutes, which may be repeatedly acquired [5] to enable optimization of pacing parameters in chronic resynchronization treatment for heart failure.…”

Section: Discussionmentioning

confidence: 99%

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

Fiechter

Ghadri

Küest

et al. 2011

Eur J Nucl Med Mol Imaging

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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

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Section: Discussionmentioning

confidence: 99%

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

Fiechter

Ghadri

Küest

et al. 2011

Eur J Nucl Med Mol Imaging

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“…The introduction of semiconductor detector technology using synthetic crystals composed of CZT undeniably constituted a revolutionary milestone in technical innovation for nuclear MPI, offering a variety of interesting new possibilities ranging from dynamic SPECT imaging for non-invasive quantitation of myocardial blood flow, 8 over respiratory triggering, 9 to low isotope dose SPECT with significantly reduced ionizing radiation exposure. 10 However, particularly the strive for a further reduction in radiation dose exposure will in turn inevitably again lead to a future increase in acquisition times because with the current CZT system sensitivity very short acquisition times of only 2 or 3 min may not yield sufficient count statistics if the isotope dose is substantially reduced.…”

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confidence: 99%

Moving ahead with CZT technology

Benz

Buechel

2016

Journal of Nuclear Cardiology

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“…Furthermore, novel image acquisition protocols with ultrafast CZT SPECT cameras including interval inspiratory breath-hold imaging reduce attenuation artifacts in the inferior wall and may reduce misregistration artifacts between SPECT and AC CT images. 7 Although the use of AC in SPECT MPI is emerging and there is evidence of superiority in diagnostic confidence and accuracy of AC over non-corrected SPECT MPI, information on the prognostic value of AC on SPECT MPI studies are limited, particularly when using stress-only imaging. [8][9][10] Hence, the work of van Dijk and co-workers is an important step forward in the direction of patient-centered care promoting stress-only imaging using the latest SPECT technology.…”

Section: See Related Article Pp 395-401mentioning

confidence: 99%

Attenuation correction in stress-only myocardial perfusion imaging

Pazhenkottil

Kaufmann

Gaemperli

2017

Journal of Nuclear Cardiology

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Despite several technical advances in single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), attenuation artifacts remain an important concern affecting image quality and diagnostic accuracy. Attenuation artifacts are the result of non-uniform photon attenuation by the human body. Although gender and body habitus may be associated with certain characteristic patterns of attenuation, the large variety in individual anatomy renders photon attenuation often unpredictable. Several strategies have been developed to suppress or correct for non-uniform attenuation in SPECT MPI including prone imaging, integrating findings from gated SPECT, and correction by attenuation maps generated from either external line sources (most commonly Gd-153) or transmission computed tomography (CT) scans. Although attenuation correction (AC) has been demonstrated to improve diagnostic accuracy over non-corrected (NC) images and has advantages over prone imaging with regard to patient comfort, only a limited proportion of cameras in the United States and Europe are equipped with AC. Reasons for this are increased complexity of protocols, higher maintenance costs, and lack of reimbursement. Nonetheless, the use of CT-based AC is growing due to the increased availability of hybrid SPECT/CT scanners worldwide. Compared to line sources, CT-based attenuation correction prevents low-count AC maps and truncation artifacts (obese) or cross-talk with emission data, and allows detailed anatomical evaluation of incidental findings and (if ECG-gating is performed) coronary calcium. The latter may add crucial information on coronary atherosclerosis to complement perfusion findings and improve risk stratification of the patient.AC is particularly valuable in the setting of stressonly MPI as the corrected images improve the interpretative confidence of the reader and reduce the perceived need for an additional rest study, thereby reducing radiation exposure and improving patient logistics. Hence, the use of AC is strongly advocated for stress-only MPI by US and European recommendations.1,2 Several reports of stress-only protocols with conventional sodium iodide cameras have demonstrated that the use of AC reduces the need of additional rest imaging by roughly one-third. The use of novel smallfootprint cardiac SPECT cameras equipped with ultrafast cadmium zinc telluride (CZT) detectors has further improved patient comfort and throughput by reducing image acquisition time considerably.3 Several studies have been conducted to assess different strategies for implementing and evaluating this new detector technology in daily clinical routine-most of them concerning diagnostic accuracy, acquisition time, image quality, and radiation dose. [4][5][6] However, their use in stress-only protocols and the effect of CT-based AC on interpretative confidence have been only scarcely investigated yet.In the current issue of the Journal of Nuclear Cardiology, van Dijk and colleagues evaluate the value of CT-based AC in stress-only myocardia...

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Real-time breath-hold triggering of myocardial perfusion imaging with a novel cadmium-zinc-telluride detector gamma camera

Cited by 38 publications

References 16 publications

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

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

Moving ahead with CZT technology

Attenuation correction in stress-only myocardial perfusion imaging

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