Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera

Duvall, W. Lane; Croft, Lori B.; Godiwala, Tapan; Ginsberg, Eric; George, Titus; Henzlova, Milena J.

doi:10.1007/s12350-010-9215-5

Cited by 114 publications

(74 citation statements)

References 15 publications

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“…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.…”

Section: See Related Article Pp 395-401mentioning

confidence: 99%

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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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Section: See Related Article Pp 395-401mentioning

confidence: 99%

“…[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.…”

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confidence: 99%

Attenuation correction in stress-only myocardial perfusion imaging

Pazhenkottil

Kaufmann

Gaemperli

2017

Journal of Nuclear Cardiology

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“…A growing body of literature supports the utility of stress-first SPECT imaging (24,(27)(28)(29)(30)(31)(32)(33)(34). If the stress MPI results are normal, the rest scan can be avoided, with significant savings in cost, time, and radiotracer exposure to the patient (35% dose reduction) and to the laboratory staff (40% dose reduction) (35).…”

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confidence: 99%

Approaches to Reducing Radiation Dose from Radionuclide Myocardial Perfusion Imaging

et al. 2015

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the application of appropriate use criteria for SPECT and PET myocardial perfusion imaging, (2) apply stress-only/stress-first myocardial perfusion imaging in clinical practice, and (3) list methods to perform lowradiation-dose myocardial perfusion imaging using traditional and novel technology.Financial Disclosure: Dr. Dorbala was supported by NIH-NHLBI K23HL092299, has received a research grant from Astellas Pharma (unrelated to this work), and has investment interest with General Electric. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through April 2018.Radionuclide myocardial perfusion imaging (MPI) plays a vital role in the evaluation and management of patients with coronary artery disease. However, because of a steep growth in MPI in the mid 2000s, concerns about inappropriate use of MPI and imaging-related radiation exposure increased. In response, the professional societies developed appropriate-use criteria for MPI. Simultaneously, novel technology, image-reconstruction software for traditional scanners, and dedicated cardiac scanners emerged and facilitated the performance of MPI with low-dose and ultra-low-dose radiotracers. This paper provides a practical approach to performing low-radiationdose MPI using traditional and novel technologies.

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“…In this camera, the conventional sodium iodide crystals have been replaced by CZT semiconductors, which directly convert radiation into electric signals (4). The energy resolution and spatial resolution have been significantly improved and the reduction of the acquisition time or radiotracer dose has been reported compared to conventional Anger camera system based on several studies (5,6). Until now, 2 types of the CZT camera system have been introduced in Japan: Discovery NM530c (GE Healthcare, Haifa, Israel) and D-SPECT (Spectrum Dynamics, Caesarea, Israel).…”

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confidence: 99%

A Novel Cadmium-Zinc-Telluride SPECT System

Chikamori

2016

Annals of Nuclear Cardiology

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Indeed, nuclear cardiologists are required to become accustomed to the new appearance of SPECT image derived from a CZT camera. In addition, they have to construct a new study protocol specialized to a CZT camera system, which should also be validated appropriately.In this issue of Annals of Nuclear Cardiology, Hida reported application of the Discovery NM530c in his institution (7). At first, they prospectively compared MPI findings between a conventional Anger camera and CZT semiconductor systems in the same Japanese patients. With a 1-day stress/rest 99m Tcradiotracer imaging protocol, image acquisition for a standard gamma camera was 15 min each for stress and at rest while the scan time was 5 min for stress and 3 min for at rest using the CZT camera. Based on the observations showing strong correlations between the CZT camera and the standard camera for perfusion and function analyses, they reported that the novel CZT camera provides excellent image quality, which is

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Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera

Abstract: New SPECT CZT camera technology allows significantly reduced radiation exposure and acquisition time without loss of image quality.

Cited by 114 publications

References 15 publications

Attenuation correction in stress-only myocardial perfusion imaging

Attenuation correction in stress-only myocardial perfusion imaging

Approaches to Reducing Radiation Dose from Radionuclide Myocardial Perfusion Imaging

A Novel Cadmium-Zinc-Telluride SPECT System

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