Reduced isotope dose and imaging time with a high-efficiency CZT SPECT camera

Duvall, W. Lane; Croft, Lori B.; Ginsberg, Eric; Einstein, Andrew J.; Guma, Krista A.; George, Titus; Henzlova, Milena J.

doi:10.1007/s12350-011-9379-7

Cited by 137 publications

(78 citation statements)

References 27 publications

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“…Also, the image quality was graded as "good" or "excellent" in the vast majority of the studies by both expert readers. These results are consistent with those shown by Duvall et al [13], confirming that high image quality can be obtained also with low administered activity. Even though the two expert readers performed the image quality grading separately and the scale used is subjective, the inter-observer variability was low.…”

Section: Discussionsupporting

confidence: 93%

“…An effective dose of 5.8 mSv for a 79 kg patient means a dose reduction of 63 % compared to the 15.7 mSv recommended by the EANM guidelines. A total effective dose of 5.8 mSv is consistent with the effective dose shown by Duvall et al [13].…”

Section: Discussionsupporting

confidence: 89%

“…Instead of using the advantages with the CZT camera systems to perform fast myocardial perfusion imaging [3,[5][6][7], this technology could be used to reduce the administered activity to decrease the effective dose to the patient. One previous study [13] indicates that reduced activity could be used but further validation is needed.…”

Section: Introductionmentioning

confidence: 99%

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Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera

Oddstig

Hedeer

Jögi

et al. 2013

Journal of Nuclear Cardiology

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Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera. Link to publication Citation for published version (APA): Oddstig, J., Hedeer, F., Jögi, J., Carlsson, M., Hindorf, C., & Engblom, H. (2013). Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera. Journal of Nuclear Cardiology, 20(1), 38-44. DOI: 10.1007/s12350-012-9634-6 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Abstract BackgroundFor a 1-day myocardial perfusion SPECT (MPS) the recommendations for administered activity stated in the EANM guidelines results in an effective dose of up to 16 mSv per patient. Recently, a gamma camera system, based on cadmium zinc telluride (CZT) technology, was introduced. This technique has the potential to reduce the effective dose and scan time compared to the conventional NaI gamma camera. The aim of this study was to investigate if the effective dose can be reduced with a preserved image quality using CZT-technology in MPS. MethodsIn total, 150 patients were included in the study. All underwent a 1-day 99m Tc-tetrofosmin stress-rest protocol and were divided into three subgroups (n=50 in each group) with 4 MBq/kg, 3 MBq/kg and 2.5 MBq/kg body weight of administered activity in the stress examination, respectively. The acquisition time was increased in proportion to the decrease in administered activity. All examinations were analysed for image quality by visual grading on a 4-point scale (1 = poor, 2 = adequate, 3 = good, 4 = excellent), by two expert readers. ResultsThe total effective dose (stress + rest) decreased from 9.3 mSv to 5.8 mSv comparing 4 MBq/kg to 2.5 MBq/kg body weight. For the patients undergoing stress examination only (35%) the effective dose, administrating 2.5 MBq/kg, was 1.4 mSv. The image acquisition times for 2.5 MBq/kg body weight were 475 s and 300 s (stress and rest) compared to 900 s for each when using conventional MPS. The average image quality was 3.7±0.5, 3.8±0.5 and 3.8±0.4 for the stress images and 3.5±0.6, 3.6±0.6 and 3.5±0.6 for the rest images and showed no statistically significant difference (p=0.62) between the 4 MBq/kg, 3 MBq/kg and 2.5 MBq/kg groups. ConclusionsThe new CZT technology can be used to considerably decrease the effective dose and acquisition time for MPS with preserved high image quality. KeywordsMyocardial perfusion imaging, SPECT, CZT detector, effective dose, image quality 2 Background Myocardial p...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 89%

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Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera

Oddstig

Hedeer

Jögi

et al. 2013

Journal of Nuclear Cardiology

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“…13,43 High-efficiency SPECT cameras have been shown to reduce radiation exposure to 5.8 mSv for a full rest-stress study and to 1 mSv for a stress-only study. 44,45 The use of time imaging software which incorporates iterative image reconstruction with resolution recovery thereby improving count statistics can decrease imaging time or decrease injected activity. 46 Stress protocol changes such as performing more ETTs, 47 developing a provisional isotope injection protocol, 38 and stress-first imaging 10 will all decrease radiation exposure to the patient by not giving it in the first place.…”

Section: 6mentioning

confidence: 99%

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

Duvall

Savino

Levine

et al. 2014

Journal of Nuclear Cardiology

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Background. Recent studies have compared CTA to stress testing and MPI using older Na-I SPECT cameras and traditional rest-stress protocols, but are limited by often using optimized CTA protocols but suboptimal MPI methodology. We compared CTA to stress testing with modern SPECT MPI using high-efficiency CZT cameras and stress-first protocols in an ED population.Methods. In a retrospective, non-randomized study, all patients who underwent CTA or stress testing (ETT or Tc-99m sestamibi SPECT MPI) as part of their ED assessment in 2010-2011 driven by ED attending preference and equipment availability were evaluated for their disposition from the ED (admission vs discharge, length of time to disposition), subsequent visits to the ED and diagnostic testing (within 3 months), and radiation exposure. CTA was performed using a 64-slice scanner (GE Lightspeed VCT) and MPI was performed using a CZT SPECT camera (GE Discovery 530c). Data were obtained from prospectively acquired electronic medical records and effective doses were calculated from published conversion factors. A propensity-matched analysis was also used to compare outcomes in the two groups.Results. A total of 1,458 patients underwent testing in the ED with 192 CTAs and 1,266 stress tests (327 ETTs and 939 MPIs). The CTA patients were a lower-risk cohort based on age, risk factors, and known heart disease. A statistically similar proportion of patients was discharged directly from the ED in the stress testing group (82% vs 73%, P 5 .27), but their time to disposition was longer (11.0 ± 5 vs 20.5 ± 7 hours, P < .0001). There was no significant difference in cardiac return visits to the ED (5.7% CTA vs 4.3% stress testing, P 5 .50), but more patients had follow-up studies in the CTA cohort compared to stress testing (14% vs 7%, P 5 .001). The mean effective dose of 12.6 ± 8.6 mSv for the CTA group was higher (P < .0001) than 5.0 ± 4.1 mSv for the stress testing group (ETT and MPI). A propensity score-matched cohort showed similar results to the entire cohort.Conclusions. Stress testing with ETT, high-efficiency SPECT MPI, and stress-only protocols had a significantly lower patient radiation dose and less follow-up diagnostic testing than CTA with similar cardiac return visits. CTA had a shorter time to disposition, but there was a trend toward more revascularization than with stress testing. (J Nucl Cardiol 2014;21:305-18.)

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“…The use of CZT camera technology enables a significant reduction in both radiation exposure and acquisition time without loss of image quality. 13 Previous studies have demonstrated excellent agreement between CZT SPECT and CMR imaging for the measurement of LVEF, although significant differences were found in the measurement of ventricular volumes. 14 For the determination of LVEF and regional wall motion estimation, 16-frame reformatted images appear to be more accurate than 8-frame images.…”

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confidence: 91%

Real-time gated-SPECT myocardial perfusion imaging with CZT detectors: A promising tool for monitoring left ventricular function

Assante

Cuocolo

2019

Journal of Nuclear Cardiology

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Reduced isotope dose and imaging time with a high-efficiency CZT SPECT camera

Abstract: New SPECT camera technology with low isotope dose significantly reduces ionizing radiation exposure and imaging times compared to traditional protocols while maintaining image quality and diagnostic accuracy.

Cited by 137 publications

References 27 publications

Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera

Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

Real-time gated-SPECT myocardial perfusion imaging with CZT detectors: A promising tool for monitoring left ventricular function

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