Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis

Abstract

AimsHigh-energy resolution and sensitivity of novel cadmium-zinc-telluride (CZT) detector equipped SPECT systems facilitate simultaneous imaging of multiple isotopes and may enhance the detection of molecular/cellular signals. This may refine the detection of endocarditis. This study was designed to determine the feasibility and diagnostic accuracy of simultaneous imaging of inflammation with 111 In-labeled white blood cells (WBCs) and myocardial perfusion with 99m Tc-sestamibi, for localization of WBCs relative to the valve plane in suspected endocarditis. Methods and resultsA dedicated cardiac CZT camera (Discovery 530c, GE Healthcare) was employed. Anthropomorphic thorax phantom studies were followed by clinical studies in 34 patients with suspected infection of native valves (n ¼ 12) or implants (n ¼ 22 In activity as high as 2.5* 99m Tc activity. In patients, image quality was superior for CZT imaging vs. conventional SPECT-CT and planar scintigraphy (P , 0.01). Cadmium-zinc-telluride dual isotope imaging improved reader confidence for detection of inflammatory foci. Diagnostic accuracy based on surgery or Duke Criteria during follow-up was highest for CZT imaging (P , 0.001). ConclusionNovel CZT SPECT technology improves the accuracy of molecular/cellular cardiac imaging. Simultaneous multi-isotope imaging with 111 In and 99m Tc is feasible and aids in the workup of suspected endocarditis.--

Nuklearmedizinische Bildgebung bei infektiöser Endokarditis und Device-Infektionen

“…Durch eine gute Lokalisierung der Klappenebene mithilfe der Perfusionsinformation konnte der Infektionsort bestimmt werden [5].…”

Radionuclide Imaging of Infective Endocarditis: State of Art and Future Perspective

“…), development and validation of new pathogen-specific probes (bacteria-targeted imaging approaches), and implementation of technologies that are capable of specific IE detection (targeted molecular imaging), combine molecular imaging to anatomical imaging with high soft-tissue contrast such as PET/ MRI (magnetic resonance imaging) and/or providing detectors with higher sensitivity and spatial resolution (i.e. digital PET/ CT and cadium-zinc-telluride camera) [35,36].…”

Novel SPECT Technologies and Approaches in Cardiac Imaging

“…The feasibility of simultaneous imaging of inflammation with 111 In-labeled white cells and myocardial perfusion with technetium (99mTc) sestamibi was demonstrated in the phantom and in 34 patients [42]. Simultaneous imaging of fatty metabolism with 123I-β-methyliodophenylpentadecanoic acid and perfusion with technetium (99mTc) sestamibi has been shown in 30 patients [43].…”