Reduced stress dose with rapid acquisition CZT SPECT MPI in a non-obese clinical population: Comparison to coronary angiography

Duvall, W. Lane; Sweeny, Joseph; Croft, Lori B.; Ginsberg, Eric; Guma, Krista A.; Henzlova, Milena J.

doi:10.1007/s12350-011-9480-y

Cited by 58 publications

(28 citation statements)

References 28 publications

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“…4,[21][22][23][24] The use of Cadmium Zinc Telluride (CZT) technology in nuclear cardiology in the past decade allowed fast SPECT imaging combined with a considerable reduction in injected radioisotope dose and patient radiation exposure. [25][26][27][28] Compared to conventional SPECT cameras, CZT-SPECT systems are characterized by improved photon sensitivity and higher spatial resolution with a factor of 2, which translates into improved image quality. 25 However, the higher intrinsic spatial resolution of CZT cameras might attenuate the countdensity myocardial thickness relationship, characteristic of the low-resolution conventional SPECT systems, and limit this effect to smaller wall thickness values.…”

Section: See Related Article Pp 742-753mentioning

confidence: 99%

What is the value of motion and thickening in gated myocardial perfusion SPECT?

Sharir

2018

Journal of Nuclear Cardiology

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Myocardial perfusion SPECT imaging (MPI) is a stress imaging modality, widely used in the detection and evaluation of coronary artery disease (CAD). This method is unique in providing simultaneous bi-modal functional imaging of relative myocardial perfusion and left ventricular (LV) function.1 While perfusion images identify regions with relative hypoperfusion, gated SPECT allows assessment of global and regional LV function. The added prognostic information gained by global LV function to myocardial perfusion findings has been extensively shown.2,3 However, accurate regional assessment of contractile function is also of great importance, since it could enhance the detection of CAD, 4 and provide additional prognostic information in predicting cardiac events. 5,6 Similar to myocardial perfusion, regional motion and thickening can be assessed using semi-quantitative visual methods, based on segmental scoring. While motion score simply reflects the extent of inward shift of the ventricular wall, thickening is assessed as systolic brightening of the myocardium occurring due to the partial volume effect. This systolic apparent increase in count density occurs since myocardial thickness is commonly in the range up to 2 cm, less than twice the full width at half maximum of the point spread function of conventional gamma cameras with intrinsic spatial resolution of *1 cm.7 Visual assessment of regional LV contractile function is expert dependent, and suffers from limited reproducibility with high inter-and intraobserver variability. 8 Therefore, several methods have been developed and validated, which automatically quantify motion and thickening, and provide useful and reproducible assessment of regional function.9,10 Whether visually or automatically assessed, regional motion and thickening have been shown as important adjunctive parameters to perfusion in the diagnosis of CAD.In the current issue of the Journal of Nuclear Cardiology, Yang et al. used resting gated SPECT MPI to demonstrate the relationship between myocardial thickening and LV remodeling among patients with history of myocardial infarction (MI). The 92 patients included in the analysis were divided into subacute MI (3-6 months before nuclear testing, n = 54) and old MI ([6 months before nuclear testing, n = 38) subgroups. In addition, all patients underwent FDG-PET imaging to identify myocardial viability as metabolic perfusion mismatch, and a scar score was calculated. LV remodeling was defined as end-diastolic volume index [62.53 ml/m 2 , derived as mean value ?2 standard deviations from gated SPECT of another 95 patients who had normal SPECT MPI and no evidence of CAD. Compared to patients with subacute MI, those with old MI had larger LV volume and worse cardiac function, larger perfusion deficit, and higher summed thickening score (STS). Interestingly, of all the demographic, clinical, perfusion, and metabolic imaging parameters evaluated, only the STS and the % of segments with reduced thickening among segments with normal perfusion were independ...

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Section: See Related Article Pp 742-753mentioning

confidence: 99%

What is the value of motion and thickening in gated myocardial perfusion SPECT?

Sharir

2018

Journal of Nuclear Cardiology

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“…Nakazato et al (49) recently simulated low-dose rest and stress SPECT MPI in 79 patients (mean body mass index, 30.0 6 6.6; range, 20.2-54.0 kg/m 2 ) and showed that image quality is adequate even with very low-count images (;1 million) and comparable to standard fullcount images. Finally, low-dose 99m Tc MPI with dedicated cardiac scanners is accurate for detecting obstructive CAD on invasive angiography (e.g., in one study visual analysis sensitivity was 92%, specificity 56%, and normalcy 98%) (50)(51)(52). Although the novel scanners offer significant advantages and high-quality imaging with a low radiation dose, they are expensive, at this time, with clinical imaging applications limited to cardiac imaging.…”

Section: Novel Reconstructionmentioning

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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“…[4][5][6] It improved image quality and patient comfort. Its diagnostic performances compare favorably with those of conventional SPECT.…”

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confidence: 99%

Dedicated cardiac CZT SPECT is steadily moving to achieve its destiny

Daou

2019

Journal of Nuclear Cardiology

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Reduced stress dose with rapid acquisition CZT SPECT MPI in a non-obese clinical population: Comparison to coronary angiography

Abstract: In this group of non-obese patients undergoing low stress dose imaging, high-efficiency CZT SPECT imaging demonstrated a high sensitivity, specificity, and accuracy for detecting obstructive epicardial CAD with a greatly reduced imaging time.

Cited by 58 publications

References 28 publications

What is the value of motion and thickening in gated myocardial perfusion SPECT?

What is the value of motion and thickening in gated myocardial perfusion SPECT?

Approaches to Reducing Radiation Dose from Radionuclide Myocardial Perfusion Imaging

Dedicated cardiac CZT SPECT is steadily moving to achieve its destiny

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