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Hedeer F, Akil S, Oddstig J, Hindorf C, Arheden H, Carlsson M, Engblom H. Diagnostic accuracy for CZT gamma camera compared to conventional gamma camera technique with myocardial perfusion single-photon emission computed tomography: Assessment of myocardial infarction and function. J Nucl Cardiol 2023; 30:1935-1946. [PMID: 36913172 PMCID: PMC10558368 DOI: 10.1007/s12350-022-03185-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/23/2022] [Indexed: 03/14/2023]
Abstract
BACKGROUND The solid-state cadmium-zinc-telluride (CZT) gamma camera for myocardial perfusion single-photon emission computed tomography (MPS) has theoretical advantages compared to the conventional gamma camera technique. This includes more sensitive detectors and better energy resolution. We aimed to explore the diagnostic performance of gated MPS with a CZT gamma camera compared to a conventional gamma camera for detection of myocardial infarct (MI) and assessment of left ventricular (LV) volumes and ejection fraction (LVEF), using cardiac magnetic resonance (CMR) as the reference method. METHODS Seventy-three patients (26% female) with known or suspected chronic coronary syndrome were examined with gated MPS using both a CZT gamma camera and a conventional gamma camera as well as with CMR. Presence and extent of MI on MPS and late gadolinium enhancement (LGE) CMR was evaluated. For LV volumes, LVEF and LV mass, gated MPS images and cine CMR images were evaluated. RESULTS MI was found in 42 patients on CMR. The overall sensitivity, specificity, positive and negative predictive values for the CZT and the conventional gamma camera were the same (67%, 100%, 100% and 69%). For infarct size > 3% on CMR, the sensitivity was 82% for the CZT and 73% for the conventional gamma camera, respectively. LV volumes were significantly underestimated by MPS compared to CMR (P ≤ .002 for all measures). The underestimation was slightly less pronounced for the CZT compared to the conventional gamma camera (2-10 mL, P ≤ .03 for all measures). For LVEF, however, accuracy was high for both gamma cameras. CONCLUSION Differences between a CZT and a conventional gamma camera for detection of MI and assessment of LV volumes and LVEF are small and do not appear to be clinically significant.
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Affiliation(s)
- Fredrik Hedeer
- Department of Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Shahnaz Akil
- Department of Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jenny Oddstig
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Cecilia Hindorf
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Håkan Arheden
- Department of Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Marcus Carlsson
- Department of Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Henrik Engblom
- Department of Clinical Physiology, Skåne University Hospital, Lund University, Lund, Sweden
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2
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Mansour N, Nekolla SG, Reyes E, Angelidis G, Georgoulias P, Anagnostopoulos C, Bravo P, Bruno I, Flotats A, Fuentes-Ocampo F, Sciagrà R, Keng F, Kessler L, Papathanasiou M, Soman P, Rischpler C. Multi-center study of inter-rater reproducibility, image quality, and diagnostic accuracy of CZT versus conventional SPECT myocardial perfusion imaging. J Nucl Cardiol 2023; 30:528-539. [PMID: 35799039 PMCID: PMC10125926 DOI: 10.1007/s12350-022-03054-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Cadmium-zinc-telluride (CZT)-based detectors exhibit higher diagnostic sensitivity in myocardial perfusion imaging (MPI) than conventional Anger-MPI for detection of coronary artery disease (CAD); however, reduced specificity and diagnostic accuracy of CZT-MPI were observed. This study aims to compare these different camera systems and to examine the degree of inter-rater reproducibility among readers with varying experience in MPI. METHODS 83 patients who underwent double stress/rest examinations using both a CZT and conventional SPECT cameras within one visit were included. Anonymized and randomized MPI-images were distributed to 15 international readers using a standardized questionnaire. Subsequent coronary angiography findings of ten patients served as a reference for analysis of sensitivity and specificity. RESULTS Image quality was significantly better in CZT-MPI with significantly lower breast attenuation (P < 0.05). CZT-MPI exhibited higher sensitivity than Anger-MPI (87.5% vs. 62.5%) and significantly reduced specificity (40% vs. 100%). Readers experienced with both camera systems had the highest inter-rater agreement indicating higher reproducibility (CZT 0.54 vs. conv. 0.49, P < 0.05). CONCLUSIONS Higher diagnostic sensitivity of CZT-MPI offers advantages in detection of CAD yet potentially of at the cost of reduced specificity, therefore it requires special training and a differentiated evaluation approach, especially for non-experienced readers with such camera systems.
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Affiliation(s)
- Nabeel Mansour
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| | - Stephan G Nekolla
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Eliana Reyes
- Royal Brompton and Harefield NHS Trust, London, UK
| | - George Angelidis
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | | | - Paco Bravo
- Divisions of Nuclear Medicine and Cardiology, Departments of Radiology and Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Isabella Bruno
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Albert Flotats
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Fuentes-Ocampo
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roberto Sciagrà
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - Felix Keng
- National Heart Centre, Singapore, Singapore
| | - Lukas Kessler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Maria Papathanasiou
- Department of Cardiology, West German Heart and Vascular Center, University Hospital, Essen, Germany
| | - Prem Soman
- Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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3
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Jiang Q, Liu B, Yang L, Wang Y, Yu W, Zhang F, Shi Y, Wang Y. The value of regional and global CACS combined with SPECT MPI in detecting obstructive CAD: a retrospective real-world comparative study. BMC Cardiovasc Disord 2023; 23:12. [PMID: 36631747 PMCID: PMC9832744 DOI: 10.1186/s12872-023-03051-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Previous studies have shown that global coronary artery calcium score (CACS) can improve single photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) to detect obstructive coronary artery disease (CAD). Whether regional CACS can improve SPECT MPI to detect obstructive CAD remains unclear. The aim of this study was to verify whether regional CACS has additional diagnostic value for obstructive CAD in suspected patients, compared to SPECT MPI and global CACS. METHODS The study included 321 suspected CAD patients who underwent one-stop rest-stress SPECT MPI and low-dose computed tomography (CT) scan. All patients underwent coronary angiography within one month after examination. MPI images were visually analyzed by 2 experienced nuclear cardiologists. The regional CACS of left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), right coronary artery (RCA) and global CACS were calculated. Obstructive CAD was defined as ≥ 70% narrowing of the inner diameter of the LAD, LCX, RCA or their main branches and ≥ 50% narrowing of the left main coronary artery (LM). RESULTS Among the 321 patients, 86 (26.8%, 86/321) had obstructive CAD. With the increased in global and regional CACS, there was an increasing trend of patients with obstructive CAD (P for trend < 0.001). Regional CACS had a better diagnostic performance in RCA territories (AUC 0.856, P < 0.001) compared with LAD, LCX territories (AUC 0.690, 0.674, respectively). The AUC of combined regional CACS and MPI was significantly higher than that of MPI alone (0.735 vs. 0.600, P < 0.001). However, based on MPI, the AUC of combined regional CACS was not significantly higher than that of global CACS (0.735 vs. 0.732, P = 0.898). The sensitivity and specificity of regional CACS combined with MPI for detecting obstructive CAD were 64.0% and 72.8%, respectively. CONCLUSIONS Regional CACS was effective in detecting obstructive CAD in RCA territory. Based on SPECT MPI, regional CACS improved the detection of obstructive CAD, but was not superior to global CACS.
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Affiliation(s)
- Qi Jiang
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China ,grid.268415.cYangzhou University, Yangzhou, Jiangsu Province China
| | - Bao Liu
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Le Yang
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Yufeng Wang
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Wenji Yu
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Feifei Zhang
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Yunmei Shi
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China
| | - Yuetao Wang
- grid.452253.70000 0004 1804 524XDepartment of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003 Jiangsu Province China ,grid.268415.cYangzhou University, Yangzhou, Jiangsu Province China
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4
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Taillefer R. Scintillation cameras: A new clinical era has come. J Nucl Cardiol 2022; 29:1942-1945. [PMID: 34254249 DOI: 10.1007/s12350-021-02660-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Raymond Taillefer
- Department of Nuclear Medicine, Hôpital du Haut-Richelieu, CISSS de la Montérégie Centre, 920 Boulevard du Séminaire Nord, Saint-Jean-sur-Richelieu, Quebec, J3A 1B7, Canada.
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5
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Liu B, Yu W, Wang J, Shao X, Zhang F, Zhou M, Shi Y, Wang B, Xu Y, Wang Y. A model combining rest-only ECG-gated SPECT myocardial perfusion imaging and cardiovascular risk factors can effectively predict obstructive coronary artery disease. BMC Cardiovasc Disord 2022; 22:268. [PMID: 35705898 PMCID: PMC9202088 DOI: 10.1186/s12872-022-02712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022] Open
Abstract
Objective The rest-only single photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had low sensitivity in diagnosing obstructive coronary artery disease (CAD). Improving the efficacy of resting MPI in diagnosing CAD has important clinical significance for patients with contraindications to stress. The purpose of this study was to develop and validate a model predicting obstructive CAD in suspected CAD patients, based on rest-only MPI and cardiovascular risk factors. Methods A consecutive retrospective cohort of 260 suspected CAD patients who underwent rest-only gated SPECT MPI and coronary angiography was constructed. All enrolled patients had stress MPI contraindications. Clinical data such as age and gender were collected. Automated quantitative analysis software QPS and QGS were used to evaluate myocardial perfusion and function parameters. The least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression were used to select the variables and build the prediction model. Results Among the enrolled 260 patients with suspected CAD, there were 95 (36.5%, 95/260) patients with obstructive CAD. The prediction model was presented in the form of a nomogram and developed based on selected predictors, including age, sex, SRS ≥ 4, SMS ≥ 2, STS ≥ 2, hypertension, diabetes, and hyperlipidemia. The AUC of the prediction model was 0.795 (95% CI: 0.741–0.843), which was better than the traditional models. The AUC calculated by enhanced bootstrapping validation (500 bootstrap resamples) was 0.785. Subsequently, the calibration curve (intercept = − 0.106; slope = 0.843) showed a good calibration of the model. The decision curve analysis (DCA) shows that the constructed clinical prediction model had good clinical applications. Conclusions In patients with suspected CAD and contraindications to stress MPI, a prediction model based on rest-only ECG-gated SPECT MPI and cardiovascular risk factors have been developed and validated to predict obstructive CAD effectively.
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Affiliation(s)
- Bao Liu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Wenji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Mingge Zhou
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Yunmei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China
| | - Bing Wang
- The Nuclear Medicine and Molecular Imaging Clinical Translation Institute of Soochow University, Changzhou, Jiangsu Province, China
| | - Yiduo Xu
- The Nuclear Medicine and Molecular Imaging Clinical Translation Institute of Soochow University, Changzhou, Jiangsu Province, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China.
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Cantoni V, Green R, Ricciardi C, Assante R, Zampella E, Nappi C, Gaudieri V, Mannarino T, Genova A, De Simini G, Giordano A, D'Antonio A, Acampa W, Petretta M, Cuocolo A. A machine learning-based approach to directly compare the diagnostic accuracy of myocardial perfusion imaging by conventional and cadmium-zinc telluride SPECT. J Nucl Cardiol 2022; 29:46-55. [PMID: 32424676 DOI: 10.1007/s12350-020-02187-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/29/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND We evaluated the performance of conventional (C) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride (CZT)-SPECT in a large cohort of patients with suspected or known coronary artery disease (CAD) and compared the diagnostic accuracy of the two systems using machine learning (ML) algorithms. METHODS AND RESULTS A total of 517 consecutive patients underwent stress myocardial perfusion imaging (MPI) by both C-SPECT and CZT-SPECT. In the overall population, an excellent correlation between stress MPI data and left ventricular (LV) functional parameters measured by C-SPECT and by CZT-SPECT was observed (all P < .001). ML analysis performed through the implementation of random forest (RF) and k-nearest neighbors (NN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for k-NN) was greater than that of C-SPECT (88% for RF and 53% for k-NN). CONCLUSIONS MPI data and LV functional parameters obtained by CZT-SPECT are highly reproducible and provide good correlation with those obtained by C-SPECT. ML approach showed that the accuracy and sensitivity of CZT-SPECT is greater than C-SPECT in detecting CAD.
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Affiliation(s)
- Valeria Cantoni
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carlo Ricciardi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Andrea Genova
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Giovanni De Simini
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Alessia Giordano
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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7
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Impact of reconstruction parameters on spatial resolution and its comparison between cadmium-zinc-telluride SPECT/CT and conventional SPECT/CT. Nucl Med Commun 2022; 43:8-16. [PMID: 34559760 DOI: 10.1097/mnm.0000000000001484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of reconstruction parameters on the spatial resolution of the tomographic image in single photon emission computed tomography (SPECT)/computed tomography (CT), and compare spatial resolution between a new polyvalent whole-body Cadmium-Zinc-Telluride camera (CZT-SPECT/CT) and a conventional dual-head Anger camera (conventional SPECT/CT). METHODS Spatial resolution was evaluated with four-line sources filled with 99mTc in tomographic images reconstructed by varying reconstruction parameters. Ordered-subset expectation maximization (OSEM) algorithm was performed with varying iterations (1-20), the number of subsets was fixed at 10. Butterworth filter, Gauss filter and no-filter were selected, respectively. Computed tomography-based attenuation correction (CTAC), scatter correction, resolution recovery and no correction (NC) were adopted for image correction. Filtered back projection (FBP) with Butterworth filter and CTAC was performed in image reconstruction. Spatial resolution was expressed by the full width at half-maximum (FWHM) value. RESULTS The impact of reconstruction parameters on the spatial resolution was identical in both cameras: FWHM values decreased with the increase of iterations and converged uniformly when the number of iterations was over 4. FWHM values decreased with the increase of cutoff frequency of the Butterworth filter and increased with the increase of the Gauss filter. scatter correction and resolution recovery improved spatial resolution, whereas CTAC had a negligible effect on spatial resolution when reconstructed by OSEM. FWHM was generally lower with OSEM reconstruction than FBP reconstruction. On the whole, under the same reconstruction conditions, CZT-SPECT/CT had a lower FWHM value than conventional SPECT/CT. CONCLUSION The spatial resolution was improved with the increase of iterations. Increasing the cutoff frequency of the Butterworth filter and decreasing the Gauss filter enhanced spatial resolution. The spatial resolution was better reconstructed by OSEM associated with attenuation correction, scatter correction and resolution recovery than FBP. CZT-SPECT/CT had better spatial resolution than conventional SPECT/CT.
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8
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Case JA. 3D iterative reconstruction can do so much more than reduce dose. J Nucl Cardiol 2021; 28:2633-2637. [PMID: 31376003 DOI: 10.1007/s12350-019-01827-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
Recent advances in software and hardware for cardiac SPECT have the potential to revolutionize nuclear cardiology. It is easy to use these technologies to maintain the status quo and lower radiation dose, despite the fact there is very little evidence that lowering patient dose in already low dose imaging protocols confers any benefit to patients. Cardiac SPECT has tremendous potential for risk stratification, molecular tracers, and high temporal resolution management of patients with electrophysiological disorders. In addition, these new reconstruction techniques can offer spatial resolution that is comparable and sometimes even superior to PET. Lastly, recent research has also held out the potential for performing absolute blood flow qualification using SPECT instrumentation. As these new technologies become available, the goal should be to make images better and improve patient care first, then optimize the dose.
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Affiliation(s)
- James A Case
- Cardiovascular Imaging Technologies, 4320 Wornall Road Suite 114, Kansas City, MO, 64111, USA.
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Miller RJH, Han D, Rozanski A, Gransar H, Friedman JD, Hayes S, Thomson L, Tamarappoo B, Slomka PJ, Berman DS. CZT camera systems may provide better risk stratification for low-risk patients. J Nucl Cardiol 2021; 28:2927-2936. [PMID: 32500175 DOI: 10.1007/s12350-020-02128-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The photon sensitivity and spatial resolution of single-photon emission-computed tomography (SPECT) has been significantly improved by solid-state camera systems using cadmium zinc telluride (CZT) detectors. While the diagnostic accuracy of these systems is well established, there is little evidence directly comparing the prognostic utility to conventional NaI cameras. METHODS AND RESULTS Retrospective analysis of patients undergoing SPECT between 2008 and 2012. Visual SPECT assessment was performed utilizing the 17-segment model to determine summed stress scores (SSS). We identified 12,830 consecutive patients, mean age 63.2 ± 13.7 and 56.1% male, 5072 of whom underwent CZT and 7758 NaI imaging. During a median follow-up duration of 7.0 years (IQR 5.5-8.2), a total of 2788 (21.7%) patients died. Compared to SSS 0, minimal perfusion abnormality (SSS 1-3) was associated with increased all-cause mortality with CZT camera (adjusted HR 1.32, P = .017) and NaI camera (adjusted HR 1.29, P = .001, interaction P = .803). Increasing stress abnormality was associated with a similar increase in risk with CZT or NaI imaging (interaction P > .500). In a propensity matched analysis, patients with normal perfusion stress perfusion assessed with a CZT was associated with decreased mortality compared to normal perfusion assessed by a NaI camera system (hazard ratio .88, 95% CI .78-.99, P = .040). CONCLUSIONS Increasing stress perfusion abnormality was associated with similar increase in all-cause mortality with CZT or NaI cameras. CZT and NaI camera systems provide similar risk stratification, however, normal myocardial perfusion may be associated with a more benign prognosis when assessed with a CZT camera system.
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Affiliation(s)
- Robert J H Miller
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
| | - Donghee Han
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Rozanski
- Division of Cardiology, Mount Sinai St. Luke's Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Heidi Gransar
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John D Friedman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sean Hayes
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Louise Thomson
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Balaji Tamarappoo
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Piotr J Slomka
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
- , Room 1258, 8700 Beverly Boulevard, Los Angeles, CA, 90048, USA.
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Błaszczyk M, Adamczewski Z, Płachcińska A. Capabilities of Modern Semiconductor Gamma Cameras in Radionuclide Diagnosis of Coronary Artery Disease. Diagnostics (Basel) 2021; 11:diagnostics11112130. [PMID: 34829477 PMCID: PMC8620025 DOI: 10.3390/diagnostics11112130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022] Open
Abstract
This paper presents a review of the literature concerning the clinical application of modern semiconductor (CZT) gamma cameras in the radioinuclide diagnosis of coronary artery disease. It contains information on the diagnostic efficacy of myocardial perfusion studies performed with those cameras compared with the widely used scintillation (Anger) cameras, an overview of their effectiveness in comparison with coronary angiography (also fractional flow reserve) and currently available clinical results of a myocardial flow reserve measured with a dynamic SPECT study. Introduction of this imaging modality to the measurement of a myocardial flow reserve aims to facilitate access to this type of study compared to the less available and more expensive PET method used so far.
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Affiliation(s)
- Michał Błaszczyk
- Department of Quality Control and Radiological Protection, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland; (M.B.); (A.P.)
| | - Zbigniew Adamczewski
- Department of Nuclear Medicine, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland
- Correspondence:
| | - Anna Płachcińska
- Department of Quality Control and Radiological Protection, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland; (M.B.); (A.P.)
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11
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Cantoni V, Green R, Ricciardi C, Assante R, Donisi L, Zampella E, Cesarelli G, Nappi C, Sannino V, Gaudieri V, Mannarino T, Genova A, De Simini G, Giordano A, D'Antonio A, Acampa W, Petretta M, Cuocolo A. Comparing the Prognostic Value of Stress Myocardial Perfusion Imaging by Conventional and Cadmium-Zinc Telluride Single-Photon Emission Computed Tomography through a Machine Learning Approach. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:5288844. [PMID: 34697554 PMCID: PMC8541857 DOI: 10.1155/2021/5288844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/18/2022]
Abstract
We compared the prognostic value of myocardial perfusion imaging (MPI) by conventional- (C-) single-photon emission computed tomography (SPECT) and cadmium-zinc-telluride- (CZT-) SPECT in a cohort of patients with suspected or known coronary artery disease (CAD) using machine learning (ML) algorithms. A total of 453 consecutive patients underwent stress MPI by both C-SPECT and CZT-SPECT. The outcome was a composite end point of all-cause death, cardiac death, nonfatal myocardial infarction, or coronary revascularization procedures whichever occurred first. ML analysis performed through the implementation of random forest (RF) and k-nearest neighbors (KNN) algorithms proved that CZT-SPECT has greater accuracy than C-SPECT in detecting CAD. For both algorithms, the sensitivity of CZT-SPECT (96% for RF and 60% for KNN) was greater than that of C-SPECT (88% for RF and 53% for KNN). A preliminary univariate analysis was performed through Mann-Whitney tests separately on the features of each camera in order to understand which ones could distinguish patients who will experience an adverse event from those who will not. Then, a machine learning analysis was performed by using Matlab (v. 2019b). Tree, KNN, support vector machine (SVM), Naïve Bayes, and RF were implemented twice: first, the analysis was performed on the as-is dataset; then, since the dataset was imbalanced (patients experiencing an adverse event were lower than the others), the analysis was performed again after balancing the classes through the Synthetic Minority Oversampling Technique. According to KNN and SVM with and without balancing the classes, the accuracy (p value = 0.02 and p value = 0.01) and recall (p value = 0.001 and p value = 0.03) of the CZT-SPECT were greater than those obtained by C-SPECT in a statistically significant way. ML approach showed that although the prognostic value of stress MPI by C-SPECT and CZT-SPECT is comparable, CZT-SPECT seems to have higher accuracy and recall.
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Affiliation(s)
- Valeria Cantoni
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
- Bioengineering Unit, Institute of Care and Scientific Research Maugeri, Telese Terme, Campania, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Leandro Donisi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Cesarelli
- Bioengineering Unit, Institute of Care and Scientific Research Maugeri, Telese Terme, Campania, Italy
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Vincenzo Sannino
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Andrea Genova
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni De Simini
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessia Giordano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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12
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Otaki Y, Manabe O, Miller RJH, Manrique A, Nganoa C, Roth N, Berman DS, Germano G, Slomka PJ, Agostini D. Quantification of myocardial blood flow by CZT-SPECT with motion correction and comparison with 15O-water PET. J Nucl Cardiol 2021; 28:1477-1486. [PMID: 31452085 PMCID: PMC7042031 DOI: 10.1007/s12350-019-01854-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/16/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND We compared quantification of MBF and myocardial flow reserve (MFR) with a 99mTc-sestamibi CZT-SPECT to 15O-water PET. METHODS SPECT MBF for thirty patients in the WATERDAY study was re-analyzed by QPET software with motion correction and optimal placement of the arterial input function. 15O-water PET MBF was re-quantified using dedicated software. Inter-operator variability was assessed using repeatability coefficients (RPC). RESULTS Significant correlations were observed between global (r = 0.91, P < 0.001) and regional MBF (r = 0.86, P < 0.001) with SPECT compared to PET. Global MBF (rest 0.95 vs 1.05 ml/min/g, P = 0.07; stress 2.62 vs 2.68 mL/min/g, P = 0.17) and MFR (2.65 vs 2.75, P = 0.86) were similar between SPECT and PET. Rest (0.81 vs 0.98 mL/min/g, P = 0.03) and stress MBF (1.98 vs 2.61 mL/min/g, P = 0.01) in right coronary artery (RCA) were lower with SPECT compared to PET. However, MFR in the RCA territory was similar (2.54 vs 2.77, P = 0.21). The SPECT-PET RPC for global MBFs and MFR were 0.95 mL/min/g and 0.94, with inter-observer RPC of 0.59 mL/min/g and 0.74, respectively. CONCLUSIONS MBF and MFR derived from CZT-SPECT with motion correction and optimal placement of the arterial input function showed good agreement with 15O-water PET, as well as low inter-operator variability.
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Affiliation(s)
- Yuka Otaki
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Osamu Manabe
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Nuclear Medicine, Hokkaido University of Graduate School of Medicine, Sapporo, Japan
| | - Robert J H Miller
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alain Manrique
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
| | - Catherine Nganoa
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
| | | | - Daniel S Berman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Guido Germano
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Piotr J Slomka
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Denis Agostini
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
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13
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Slomka P. Do we need dedicated cardiac SPECT systems? J Nucl Cardiol 2021; 28:1331-1333. [PMID: 31650495 DOI: 10.1007/s12350-019-01921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
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14
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Kawamura I, Tanigaki T, Omori H, Mizukami T, Hirata T, Kikuchi J, Ota H, Sobue Y, Miyake T, Kawase Y, Okubo M, Kamiya H, Kawasaki M, Tsuchiya K, Nakagawa M, Kondo T, Suzuki T, Matsuo H. Stress Myocardial Perfusion Imaging Interpretation From the Viewpoint of Fractional Flow Reserve. Circ J 2021; 85:2043-2049. [PMID: 34148928 DOI: 10.1253/circj.cj-21-0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Myocardial perfusion imaging (MPI) and fractional flow reserve (FFR) are established approaches to the assessment of myocardial ischemia. Recently, various FFR cutoff values were proposed, but the diagnostic accuracy of MPI in identifying positive FFR using various cutoff values is not well established.Methods and Results:We retrospectively studied 273 patients who underwent stress MPI and FFR within a 3-month period. Results for FFR were obtained from 218 left anterior descending artery (LAD) lesions and 207 non-LAD lesions. Stress MPI and FFR demonstrated a good correlation in the detection of myocardial ischemia. However, the positive predictive value (PPV) of FFR for detecting MPI-positive lesions at the optimal FFR thresholds was insufficient (44% for LAD and 65% for non-LAD lesions). This was caused by a sharp drop in PPV at an FFR threshold of 0.7 or more. Notably, 41% of the lesions with normal MPI demonstrated FFRs <0.80. However, MPI-negative lesions had an extremely low lesion rate with FFR <0.65 (6%). Conversely, 78% and 41% of MPI-positive lesions had FFR <0.80 and <0.65, respectively. CONCLUSIONS The data confirmed that decisions based on MPI are reasonable because MPI-negative patients have an extremely low rate of lesions with a FFR below the cutoff point for a hard event, and MPI-positive lesions include many lesions with FFR <0.65.
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Affiliation(s)
- Itta Kawamura
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Toru Tanigaki
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Hiroyuki Omori
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Takuya Mizukami
- Department of Cardiovascular Medicine, Gifu Heart Center.,Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University
| | - Tetsuo Hirata
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Jun Kikuchi
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Hideaki Ota
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Yoshihiro Sobue
- Department of Cardiovascular Medicine, Gifu Heart Center.,Department of Cardiology, Fujita Health University Bantane Hospital
| | - Taiji Miyake
- Department of Cardiovascular Medicine, Gifu Heart Center
| | | | - Munenori Okubo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Hiroki Kamiya
- Department of Cardiovascular Medicine, Gifu Heart Center
| | | | | | | | - Takeshi Kondo
- Department of Cardiovascular Medicine, Gifu Heart Center
| | - Takahiko Suzuki
- Department of Cardiovascular Medicine, Gifu Heart Center.,Department of Cardiovascular Medicine, Toyohashi Heart Center
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center
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15
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Baumgarten R, Cerci RJ, de Nadai Costa A, Pereira-Neto CC, Prado P, Zapparoli M, Masukawa M, Cerci JJ, Vitola JV, Fernandes-Silva MM. Radiation exposure after myocardial perfusion imaging with Cadmium-Zinc-Telluride camera versus conventional camera. J Nucl Cardiol 2021; 28:992-999. [PMID: 32410061 DOI: 10.1007/s12350-020-02146-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patient exposure to radiation during the management of coronary heart disease (CHD) can be reduced with more efficient technologies in nuclear medicine, such as the Cadmium-Zinc-Telluride (CZT) gamma-camera for myocardial perfusion imaging (MPI) studies. However, it has been suggested that CZT has lower specificity, which might lead to more downstream radiological procedures, particularly among obese individuals. METHODS AND RESULTS We evaluated 244 patients with suspected CHD who underwent CZT-SPECT and matched 1:1 according to sex, age, and body mass index (BMI) with those undergoing MPI study with the Anger gamma-camera (Anger-SPECT). The outcome was the total radiation exposure from the MPI study added to the radiation exposure from all subsequent cardiac examinations during a 90-day follow-up. The total radiation dose after 90 days was significantly lower in the CZT-SPECT group (6.4 ± 4.8 vs 9.5±4.9 mSv, P < .001). After adjusting for potential confounders, CZT-SPECT remained associated with lower total radiation dose, but it significantly attenuated among obese individuals (Beta coefficient - 3.73 ± 0.86 for BMI < 30 vs - 2.30 ± 0.92 for BMI ≥ 30 Kg/m2, P for interaction < 0.032). CONCLUSIONS CZT-SPECT was associated with lower total radiation doses compared to Anger-SPECT, albeit this benefit may be attenuated in obese individuals.
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Affiliation(s)
- Ricardo Baumgarten
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - Rodrigo Julio Cerci
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - Amanda de Nadai Costa
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | | | - Pedro Prado
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - Marcello Zapparoli
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - Margaret Masukawa
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - Juliano Julio Cerci
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
| | - João Vicente Vitola
- Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil
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16
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Mannarino T, Assante R, Ricciardi C, Zampella E, Nappi C, Gaudieri V, Mainolfi CG, Di Vaia E, Petretta M, Cesarelli M, Cuocolo A, Acampa W. Head-to-head comparison of diagnostic accuracy of stress-only myocardial perfusion imaging with conventional and cadmium-zinc telluride single-photon emission computed tomography in women with suspected coronary artery disease. J Nucl Cardiol 2021; 28:888-897. [PMID: 31222530 DOI: 10.1007/s12350-019-01789-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Breast attenuation may impact the diagnostic accuracy of stress myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT). We compared the performance of conventional (C)-SPECT and cadmium-zinc-telluride (CZT)-SPECT systems in women with low-intermediate likelihood of coronary artery disease (CAD). METHODS AND RESULTS A total of 109 consecutive women underwent stress-optional rest MPI by both C-SPECT and CZT-SPECT. In the overall study population, a weak albeit significant correlation between total perfusion defect (TPD) measured by C-SPECT and CZT-SPECT was observed (r = 0.38, P < .001) and at Bland-Altman analysis the mean difference in TPD (C-SPECT minus CZT-SPECT) was 2.40% (P < .001). Overall concordance of semi-quantitative diagnostic performance between C-SPECT and CZT-SPECT was observed in 52 (48%) women with a κ value of 0.09. Normalcy rate was significantly higher using CZT-SPECT compared to C-SPECT (P < .001). Machine learning analysis performed through the implementation of J48 algorithm proved that CZT-SPECT has higher sensitivity, specificity, and accuracy than C-SPECT. CONCLUSIONS In women with low-intermediate likelihood of CAD, there is a poor concordance of diagnostic performance between C-SPECT and CZT-SPECT, and CZT-SPECT allows better normalcy rate detection compared to C-SPECT.
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Affiliation(s)
- Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carlo Ricciardi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Eugenio Di Vaia
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Mario Cesarelli
- Department of Electrical Engineering and Information Technology, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
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17
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The setting of heartbeat acceptance windows on gated myocardial perfusion single-photon emission computed tomography using CZT camera: effect of left ventricular functional parameters in patients with arrhythmia. Nucl Med Commun 2021; 42:1005-1010. [PMID: 33852532 DOI: 10.1097/mnm.0000000000001417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Consistently variable with several peaks in heart rate histogram (e.g. bigeminy and trigeminy) is one of the arrhythmia types. We investigated the effects of gating error by consistently variable patients on left ventricular (LV) functional with cadmium zinc telluride (CZT) camera. The purpose of this study is to evaluate LV functional parameters by setting different heartbeat acceptance windows on gated myocardial perfusion single-photon emission computed tomography (SPECT) (MPS) in consistently variable patients, using echocardiography (echo) as a reference. MATERIALS AND METHODS Sixteen consistently variable patients underwent the gated MPS using a D-SPECT. The MPS images were obtained by setting two different types of heartbeat acceptance windows. The heartbeat acceptance windows were set to include only one peak and two peaks of the maximum count peaks, respectively. RESULTS Mean end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF) were 112.7 mL, 62.2 mL and 51.3% for one peak, 114.5 mL, 66.1 mL and 47.1% for two peak, and 113.0 mL, 54.2 mL and 54.1% for echo, respectively. The mean differences between two peaks and echo in LVEF were larger than those of between one peak and echo. CONCLUSION Our study suggests that setting the heartbeat acceptance window of one peak was suitable for accurate measurement of LV function in consistently variable patients.
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18
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Tsuboi K, Nagaki A, Shibutani T, Onoguchi M. Optimal choice of OSEM and SD reconstruction algorithms in CZT SPECT for hypertrophic cardiomyopathy patients. J Nucl Cardiol 2021; 28:236-244. [PMID: 30847855 DOI: 10.1007/s12350-019-01677-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/21/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The spectrum dynamics (SD) algorithm is a cardiac reconstruction algorithm of D-SPECT, which improves spatial resolution compared with the ordered-subsets expectation maximization (OSEM) algorithm. We evaluated the wall thickness and left ventricular (LV) volume in patients with hypertrophic cardiomyopathy (HCM) using the SD algorithm. METHODS In a phantom study, the myocardial wall was scanned with varying wall thicknesses (10-40 mm). In the clinical study, 30 and 27 normal and HCM patients underwent myocardial perfusion imaging. RESULTS In a phantom study, LV volume using the SD algorithm was increased by thickening the wall of the phantom. In the clinical study, the wall thickness and LV volume of OSEM and SD algorithms showed a difference between HCM and normal groups. The wall thickness using OSEM and SD algorithms were 19.4 ± 2.0 and 16.7 ± 1.5 mm in patients with normal, and 27.9 ± 4.9 and 21.8 ± 2.6 mm in patients with HCM. CONCLUSION The SD algorithm in cases of HCM may not be able to correctly assess wall thickness and LV volume. Our study suggests that the OSEM is more suitable in cases of HCM than the SD algorithm.
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Affiliation(s)
- Kunihito Tsuboi
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan.
| | - Akio Nagaki
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
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19
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Kovalski G, Sharir T. Myocardial blood flow assessment with SPECT systems: The renovation continues. J Nucl Cardiol 2020; 27:2303-2305. [PMID: 30820816 DOI: 10.1007/s12350-019-01666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Affiliation(s)
| | - Tali Sharir
- Department of Nuclear Cardiology, Assuta Medical Centers, Tel Aviv, Israel, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
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20
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Incremental value of regional wall motion abnormalities for detecting obstructive coronary artery disease by rest-only electrocardiogram-gated single-photon emission computerized tomography myocardial perfusion imaging in suspected coronary artery disease patients. Nucl Med Commun 2020; 42:276-283. [PMID: 33252509 DOI: 10.1097/mnm.0000000000001335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether regional wall motion (WM) abnormalities by rest-only 99mtechnetium-sestamibi (99mTc-MIBI) electrocardiogram (ECG)-gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had incremental diagnostic value for detecting obstructive coronary artery disease (CAD) in suspected CAD patients. METHODS This study retrospectively studied 255 consecutive suspected CAD patients who underwent rest-only ECG-gated SPECT MPI and were performed coronary angiography within 3 months. Obstructive CAD was defined as ≥70% narrowing of the inner diameter of the left anterior descending coronary artery, left circumflex coronary artery and right coronary artery or their main branches and ≥50% narrowing of the left main coronary artery. QPS and QGS were used to assess rest perfusion and WM. Summed rest score ≥4 and summed motion score ≥2 exhibited in two consecutive segments in one territory was considered abnormal. RESULTS The sensitivity of the combination of perfusion and regional WM abnormalities was significantly higher than perfusion alone for detecting obstructive CAD (46.8% vs. 30.9%; P < 0.001), with similar specificity (91.9% vs. 95.0; P = 0.063). The global chi-square value of combination of perfusion and WM increased from 31.40 to 50.71 (P < 0.001) compared to perfusion. The sensitivity of combination of perfusion and WM for detecting obstructive CAD in patients with multivessel disease was higher than single-vessel disease (56.1% vs. 25.0%; P < 0.001), with similar specificity. CONCLUSION Regional WM abnormalities at rest, as shown by rest-only 99mTc-MIBI ECG-gated SPECT MPI, have additional diagnostic value over perfusion alone for detecting obstructive CAD in suspected CAD patients.
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21
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Goldkorn R, Naimushin A, Rozen E, Freimark D. Early post-stress decrease in cardiac performance by impedance cardiography and its relationship to the severity and extent of ischemia by myocardial perfusion imaging. BMC Cardiovasc Disord 2020; 20:354. [PMID: 32736524 PMCID: PMC7394672 DOI: 10.1186/s12872-020-01639-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background While single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is a well-established noninvasive procedure for the evaluation of patients with coronary artery disease (CAD), it is unable to detect the presence of, or underestimates the extent of CAD in certain patients. We aimed to show that a bio-impedance device can detect early post-stress changes in several hemodynamic parameters, thereby serving as a potential marker for the presence of significant ischemia. Methods Prospectively enrolled patients, referred to our Medical Center for clinically-indicated MPI, underwent testing using a Non-Invasive Cardiac System (NICaS) before and immediately after exercise. The differences between rest and stress hemodynamic parameters were compared with the severity and extent of myocardial ischemia by MPI. The study included 198 patients; mean age was 62 years, 26% were women, 54% had hypertension, and 29% diabetes mellitus. Of them, 188 patients had ≤10%, and 10 had > 10% of myocardial ischemia. Results In the first group, there was a significantly greater increase in post-exercise stroke index, stroke work index, cardiac index and cardiac power index (19.2, 29.1, 90.5 and 107%, respectively) compared with the second group (− 2.7, 3.8, 43.7 and 53.5%, respectively), as well as a significantly greater decrease in total peripheral resistance index (− 38.7% compared with − 16.3%), with corresponding p values of 0.015, 0.017, 0.040, 0.016, and < 0.001, respectively. Conclusions Our data suggest that immediate post-stress changes in several hemodynamic parameters, detected by the NICaS, can be used as an important adjunct to SPECT MPI for the early detection of myocardial ischemia.
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Affiliation(s)
- Ronen Goldkorn
- Leviev Heart Center, Sheba Medical Center, 52621, Tel Hashomer, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Alexey Naimushin
- Leviev Heart Center, Sheba Medical Center, 52621, Tel Hashomer, Israel
| | - Eli Rozen
- Leviev Heart Center, Sheba Medical Center, 52621, Tel Hashomer, Israel
| | - Dov Freimark
- Leviev Heart Center, Sheba Medical Center, 52621, Tel Hashomer, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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22
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Songy B, Guernou M, Lussato D, Queneau M, Bonardel G, Grellier JF, Flahaut L, Nguyen D. Feasibility of simultaneous dual isotope acquisition for myocardial perfusion imaging with a cadmium zinc telluride camera. J Nucl Cardiol 2020; 27:737-747. [PMID: 30478657 DOI: 10.1007/s12350-018-1452-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/10/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND We studied the impact of technetium-99m (99mTc) in the thallium-201 (201Tl) energy window (70 keV) to determine if CZT cardiac cameras allow us to perform simultaneous dual-isotope acquisition for myocardial perfusion imaging. METHODS We included 117 consecutive patients. We injected 0.7 MBq/kg of 201Tl at stress, performed the first scan (image T1), then injected at rest 2 MBq/kg of 99mTc-tetrofosmin and immediately acquired a second scan with reconstruction in the energy window of thallium (image T2). A corrected thallium image was created by the subtraction of 99mTc downscattered photons (image TS). We compared spectra, image quality, and semiquantitative scores on T1, T2, and TS images. RESULTS Though T2 images were of worse quality, TS images were of equal quality compared to T1 images in most cases. Scores show an underestimation of abnormalities in 20% of patients on T2 images and in 10% on TS images. CONCLUSIONS Despite the improved energy resolution of CZT cameras, downscatter of technetium in the 201Tl window leads to an underestimation of the pathological territory in 10% to 20% of cases. It does not allow us to use simultaneous dual-isotope acquisition in clinical practice without additional tools for scatter correction.
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Affiliation(s)
- Bernard Songy
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France.
| | - Mohamed Guernou
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - David Lussato
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Mathieu Queneau
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Gerald Bonardel
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | | | - Ludovic Flahaut
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
| | - Duc Nguyen
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Saint-Denis, Paris, France
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23
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Hyafil F, Chequer R, Sorbets E, Estellat C, Ducrocq G, Rouzet F, Alfaiate T, Regaieg H, Abtan J, Leygnac S, Milliner M, Imbert L, Burg S, Ben Azzouna R, Potier L, Laouénan C, Quintin C, Roussel R, Hartemann A, Montalescot G, Marie PY, Steg G, Le Guludec D. Head-to-head comparison of the diagnostic performances of Rubidium-PET and SPECT with CZT camera for the detection of myocardial ischemia in a population of women and overweight individuals. J Nucl Cardiol 2020; 27:755-768. [PMID: 30574676 DOI: 10.1007/s12350-018-01557-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/11/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The aim of this study was to compare the diagnostic performances for the detection of myocardial ischemia of 82-Rb-PET-MPS and 99m-Tc-SPECT-MPS in overweight individuals and women. METHODS AND RESULTS Men with BMI ≥ 25 and women referred for MPS were considered for inclusion. All individuals underwent 99m-Tc-SPECT-MPS with CZT cameras and 82-Rb-PET-MPS in 3D-mode. Individuals with at least one positive MPS were referred for coronary angiography (CA) with FFR measurements. A criterion for positivity was a composite endpoint including significant stenosis on CA or, in the absence of CA, the occurrence of acute coronary event during the following year. 313 patients (46% women) with mean BMI of 31.8 ± 6.5 were included. Sensitivity for the detection of myocardial ischemia was higher with 82-Rb-PET-MPS compared with 99m-Tc-SPECT-MPS (85% vs. 57%, P < .05); specificity was equally high with both imaging techniques (93% vs. 94%, P > .05). 82-Rb-PET allowed for a more accurate detection of patients with a high-risk coronary artery disease (HR-CAD) than 99m-Tc-SPECT-MPS (AUC = 0.86 vs. 0.75, respectively; P = .04). CONCLUSIONS In women and overweight individuals, 82-Rb-PET-MPS provides higher sensitivity for the detection of myocardial ischemia than 99m-Tc-SPECT-MPS thanks to a better image quality and an improved detection of HR-CAD.
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Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France.
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France.
| | - Renata Chequer
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Emmanuel Sorbets
- Department of Cardiology, Avicenne University Hospital, AP-HP, University Paris 13, 9300, Bobigny, France
| | - Candice Estellat
- Département de Biostatistiques, Hôpital Pitié-Salpêtrière, AP-HP, Santé Publique et Informatique Médicale, 75013, Paris, France
- INSERM, CIC-EC 1425, ECEVE UMR 1123, 75018, Paris, France
| | - Gregory Ducrocq
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - François Rouzet
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Toni Alfaiate
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Hamza Regaieg
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Jérémie Abtan
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - Sébastien Leygnac
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Milan Milliner
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Laetitia Imbert
- Department of Nuclear Medicine, Brambois University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Samuel Burg
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Rana Ben Azzouna
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
| | - Louis Potier
- Department of Diabetology, DHU FIRE, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Cédric Laouénan
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Caroline Quintin
- Département d'Epidémiologie, Hôpital Bichat, AP-HP, Biostatistique et Recherche Clinique, 75018, Paris, France
| | - Ronan Roussel
- Department of Diabetology, DHU FIRE, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
| | - Agnès Hartemann
- Department of Diabetology, Pitié-Salpétriêre University Hospital, AP-HP, Sorbonne University Paris 6, 75006, Paris, France
| | - Gilles Montalescot
- ACTION Study Group, Department of Cardiology, Pitié-Salpétriêre, Sorbonne Université-Paris 6, 75006, Paris, France
| | - Pierre-Yves Marie
- Department of Nuclear Medicine, Brambois University Hospital, Lorraine University, 54500, Vandœuvre-Lès-Nancy, France
| | - Gabriel Steg
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
- Department of Cardiology, Bichat University Hospital, AP-HP, 75018, Paris, France
- French Alliance for Cardiovascular Trials, and F-CRIN Network, Paris, France
| | - Dominique Le Guludec
- Department of Nuclear Medicine, Bichat University Hospital, AP-HP, University Diderot, 75018, Paris, France
- INSERM, U-1148, DHU FIRE, University Diderot, 75018, Paris, France
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Ishihara M, Onoguchi M, Shibutani T. Accuracy of washout rate analysis for thallium-201 single-photon emission computed tomography myocardial perfusion imaging using cadmium zinc telluride detectors: A phantom study. JRSM Cardiovasc Dis 2020; 9:2048004019900600. [PMID: 31976070 PMCID: PMC6958653 DOI: 10.1177/2048004019900600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 11/12/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study was to assess the accuracy of washout rate (WOR) analysis for thallium-201 chloride (201Tl) single-photon emission computed tomography myocardial perfusion imaging data acquired using cadmium zinc telluride detectors and a myocardial phantom. Methods A myocardial phantom was injected with 10.5 MBq 201Tl, and 10-min acquisitions were performed at 0, 24, 46, and 62 h to accommodate natural radioactive decay over time. Global myocardial WOR (global-WOR) and regional WOR (regional-WOR, left anterior descending artery [LAD], right coronary artery [RCA], and left circumflex artery [LCX]) were analyzed between 0 and 24 h (infarction model), 0 and 46 h (ischemia model), and 0 and 62 h (normal model), respectively. We compared the calculated radioactive decay-rate as a reference standard and phantom imaging WOR (phantom-WOR). Results Decay-rate versus phantom-WOR were 20.4% vs. 20.8% (global-WOR), 21.3% (LAD), 21.2% (RCA), and 19.7% (LCX) for the infarction model; 35.4% vs. 35.6% (global-WOR), 35.5% (LAD), 36.2% (RCA), and 35.2% (LCX) for the ischemia model; and 44.5% vs. 45.1% (global-WOR), 45.4% (LAD), 44.7% (RCA), and 43.5% (LCX) for the normal model. Conclusion WOR analysis for 201Tl single-photon emission computed tomography myocardial perfusion imaging using cadmium zinc telluride detectors is a reliable analysis method.
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Affiliation(s)
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
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25
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Gambhir S, Ora M. Nuclear investigative techniques and their interpretation in the heart and vascular disease. Ann Card Anaesth 2020; 23:262-271. [PMID: 32687080 PMCID: PMC7559955 DOI: 10.4103/aca.aca_54_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Over the last several decades, myocardial perfusion imaging with single photon emission tomography and positron emission tomography has been a mainstay for the evaluation of patients with known or suspected coronary artery disease non-invasively. Technical advances in imaging modalities and radiopharmaceutical have revolutionaries the understanding of pathogenesis and management of various diseases. In this article, we shall discuss the various available imaging nuclear medicine techniques, radiopharmaceutical, and common indications. In the era of “precision medicine,” imaging has to be patient centered. We will briefly review the upcoming areas of nuclear medicine imaging apart from perfusion imaging, such as advances in myocardial blood flow quantitation and molecular imaging.
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26
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Oddstig J, Martinsson E, Jögi J, Engblom H, Hindorf C. Differences in attenuation pattern in myocardial SPECT between CZT and conventional gamma cameras. J Nucl Cardiol 2019; 26:1984-1991. [PMID: 29796975 PMCID: PMC6908561 DOI: 10.1007/s12350-018-1296-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/26/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND In myocardial perfusion imaging (MPI), single-photon emission tomography (SPECT) soft-tissue attenuation by the abdomen, breasts, and lateral chest wall may create artifacts that mimic true perfusion defects. This may cause misdiagnosis of myocardial perfusion. The aim of the present study was to compare the localization, extent, and depth of attenuation artifacts in MPI SPECT for a multi-pinhole cadmium zinc telluride (CZT) camera vs a conventional gamma camera. METHODS Phantom and patient measurements were performed using a CZT camera (GE NM 530c) and a conventional gamma camera (GE Ventri). All images were attenuation corrected with externally acquired low-dose computed tomography. The localization, extent, and depth of the attenuation artifact were quantified by comparing attenuation-corrected and non-attenuation-corrected images. RESULTS Attenuation artifacts were shifted from the inferolateral wall to the lateral wall using the CZT camera compared to a conventional camera in both the patient and the phantom. The extent of the attenuation artifact was significantly larger for the CZT camera compared to the conventional camera (23 ± 5% vs 15 ± 5%, P < .001) for patients and the result was similar for the phantom (28% vs 19%). Furthermore, the depth of the attenuation artifact (percent of maximum counts) was less pronounced for the CZT camera than for the conventional camera, both for phantom measurements (73% vs 67%) and patients (72 ± 3% vs 68 ± 4%, P < .001). CONCLUSIONS Attenuation artifacts are found in different locations to different extents and depths when using a CZT camera vs a conventional gamma camera for MPI SPECT. This should be taken into consideration when evaluating MPI SPECT studies to avoid misinterpretation of myocardial perfusion distribution.
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Affiliation(s)
- Jenny Oddstig
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden.
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
| | - Elin Martinsson
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, 221 85, Lund, Sweden
| | - Henrik Engblom
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, 221 85, Lund, Sweden
| | - Cecilia Hindorf
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
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27
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Haro Alonso D, Wernick MN, Yang Y, Germano G, Berman DS, Slomka P. Prediction of cardiac death after adenosine myocardial perfusion SPECT based on machine learning. J Nucl Cardiol 2019; 26:1746-1754. [PMID: 29542015 PMCID: PMC6138585 DOI: 10.1007/s12350-018-1250-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/19/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND We developed machine-learning (ML) models to estimate a patient's risk of cardiac death based on adenosine myocardial perfusion SPECT (MPS) and associated clinical data, and compared their performance to baseline logistic regression (LR). We demonstrated an approach to visually convey the reasoning behind a patient's risk to provide insight to clinicians beyond that of a "black box." METHODS We trained multiple models using 122 potential clinical predictors (features) for 8321 patients, including 551 cases of subsequent cardiac death. Accuracy was measured by area under the ROC curve (AUC), computed within a cross-validation framework. We developed a method to display the model's rationale to facilitate clinical interpretation. RESULTS The baseline LR (AUC = 0.76; 14 features) was outperformed by all other methods. A least absolute shrinkage and selection operator (LASSO) model (AUC = 0.77; p = .045; 6 features) required the fewest features. A support vector machine (SVM) model (AUC = 0.83; p < .0001; 49 features) provided the highest accuracy. CONCLUSIONS LASSO outperformed LR in both accuracy and simplicity (number of features), with SVM yielding best AUC for prediction of cardiac death in patients undergoing MPS. Combined with presenting the reasoning behind the risk scores, our results suggest that ML can be more effective than LR for this application.
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Affiliation(s)
- David Haro Alonso
- Medical Imaging Research Center, Illinois Institute of Technology, 3440 S. Dearborn St., Suite 100, Chicago, IL, 60616, USA
| | - Miles N Wernick
- Medical Imaging Research Center, Illinois Institute of Technology, 3440 S. Dearborn St., Suite 100, Chicago, IL, 60616, USA.
| | - Yongyi Yang
- Medical Imaging Research Center, Illinois Institute of Technology, 3440 S. Dearborn St., Suite 100, Chicago, IL, 60616, USA
| | - Guido Germano
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Piotr Slomka
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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28
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Slomka P. Leveraging latest computer science tools to advance nuclear cardiology. J Nucl Cardiol 2019; 26:1501-1504. [PMID: 31489585 DOI: 10.1007/s12350-019-01873-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/23/2022]
Abstract
Nuclear cardiology has unique advantages compared to other modalities, since the image analysis is already much more automated compared to what is currently clinically performed for CT, MR, or echocardiography imaging. The diverse image and clinical data available to assess coronary disease function, perfusion, flow, and associated CT data provide new opportunities, but logistically these additional assessments increase the overall complexity of SPECT/PET reporting, necessitating additional expertise and time. The advances in artificial intelligence software can be leveraged to obtain comprehensive risk predictions and diagnoses from all available data. They will allow nuclear cardiology to retain competitive edge compared to other modalities and improve its overall clinical utility. These tools will enhance diagnosis and risk prediction beyond what is possible by subjective visual analysis and mental integration of data by physicians.
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Affiliation(s)
- Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Ste. A047N, Los Angeles, CA, 90048, USA.
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29
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Abbott BG, Case JA, Dorbala S, Einstein AJ, Galt JR, Pagnanelli R, Bullock-Palmer RP, Soman P, Wells RG. Contemporary Cardiac SPECT Imaging-Innovations and Best Practices: An Information Statement from the American Society of Nuclear Cardiology. Circ Cardiovasc Imaging 2019; 11:e000020. [PMID: 30354679 DOI: 10.1161/hci.0000000000000020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Brian G Abbott
- Warren Alpert Medical School, Brown University, Providence, RI (B.G.A.)
| | - James A Case
- Cardiovascular Imaging Technologies, Kansas City, MO (J.A.C.)
| | - Sharmila Dorbala
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA (S.D.)
| | - Andrew J Einstein
- Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY (A.J.E.)
| | - James R Galt
- Emory University School of Medicine, Atlanta, GA (J.R.G.)
| | | | | | - Prem Soman
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA (P.S.)
| | - R Glenn Wells
- University of Ottawa Heart Institute, Ottawa, Canada (R.G.W.)
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30
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Slomka PJ, Miller RJ, Hu LH, Germano G, Berman DS. Solid-State Detector SPECT Myocardial Perfusion Imaging. J Nucl Med 2019; 60:1194-1204. [DOI: 10.2967/jnumed.118.220657] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/18/2019] [Indexed: 02/07/2023] Open
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31
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Massalha S, Almufleh A, Small G, Marvin B, Keidar Z, Israel O, Kennedy JA. Strategies for Minimizing Occupational Radiation Exposure in Cardiac Imaging. Curr Cardiol Rep 2019; 21:71. [PMID: 31227929 DOI: 10.1007/s11886-019-1157-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Radiation safety has been at the center of interest of both researchers and healthcare institutions. This review will summarize and shed light on the various techniques adapted to reduce staff exposure to ionizing radiation (IR) in the field of cardiac imaging. RECENT FINDINGS In the last years, with the advance of awareness and the development of new technologies, there have been several tools and techniques adapted. The breakthrough of several technologies to lower radiation dose and shorten the duration of diagnostic tests associated with IR, the use of protection devices by staff members, and mostly the awareness of exposure to IR are the hallmark of these advances. Using all these measures has led to a significant decrease in staff exposure to IR. Reducing staff exposure to meet the "As Low As Reasonably Achievable" principle is feasible. This review introduces the most important strategies applied in cardiac imaging.
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Affiliation(s)
- Samia Massalha
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada. .,Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. .,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.
| | - Aws Almufleh
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Garry Small
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Brian Marvin
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Zohar Keidar
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Ora Israel
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - John A Kennedy
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.,Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
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32
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Lee JS, Kovalski G, Sharir T, Lee DS. Advances in imaging instrumentation for nuclear cardiology. J Nucl Cardiol 2019; 26:543-556. [PMID: 28718074 DOI: 10.1007/s12350-017-0979-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/08/2017] [Indexed: 12/22/2022]
Abstract
Advances in imaging instrumentation and technology have greatly contributed to nuclear cardiology. Dedicated cardiac SPECT cameras incorporating novel, highly efficient detector, collimator, and system designs have emerged with the expansion of nuclear cardiology. Solid-state radiation detectors incorporating cadmium zinc telluride, which directly convert radiation to electrical signals and yield improved energy resolution and spatial resolution and enhanced count sensitivity geometries, are increasingly gaining favor as the detector of choice for application in dedicated cardiac SPECT systems. Additionally, hybrid imaging systems in which SPECT and PET are combined with X-ray CT are currently widely used, with PET/MRI hybrid systems having also been recently introduced. The improved quantitative SPECT/CT has the potential to measure the absolute quantification of myocardial blood flow and flow reserve. Rapid development of silicon photomultipliers leads to enhancement in PET image quality and count rates. In addition, the reduction of emission-transmission mismatch artifacts via application of accurate time-of-flight information, and cardiac motion de-blurring aided by anatomical images, are emerging techniques for further improvement of cardiac PET. This article reviews recent advances such as these in nuclear cardiology imaging instrumentation and technology, and the corresponding diagnostic benefits.
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Affiliation(s)
- Jae Sung Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | | | - Tali Sharir
- Department of Nuclear Cardiology, Assuta Medical Centers, 96 Igal Alon, C Building, 67891, Tel Aviv, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Korea.
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Kawamura I, Kajiura R, Motoji Y, Okamoto S, Tanigaki T, Omori H, Hirata T, Kikuchi J, Ota H, Sobue Y, Miyake T, Tsunekawa T, Kato T, Kawase Y, Okubo M, Kamiya H, Tsuchiya K, Tomita S, Hirakawa A, Kondo T, Suzuki T, Matsuo H. Diagnostic Performance of the Simultaneous Acquisition Rest <sup>99 m</sup>Tc-Tetrofosmin/Stress <sup>201</sup>Tl Dual-Isotope Protocol With a Semiconductor Camera ― Comparison With the Rest-Stress <sup>99 m</sup>Tc-Tetrofosmin Protocol ―. Circ J 2018; 82:2837-2844. [DOI: 10.1253/circj.cj-18-0363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Akihiro Hirakawa
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo
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34
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Abbott BG, Case JA, Dorbala S, Einstein AJ, Galt JR, Pagnanelli R, Bullock-Palmer RP, Soman P, Wells RG. Contemporary Cardiac SPECT Imaging-Innovations and Best Practices: An Information Statement from the American Society of Nuclear Cardiology. J Nucl Cardiol 2018; 25:1847-1860. [PMID: 30143954 DOI: 10.1007/s12350-018-1348-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This information statement from the American Society of Nuclear Cardiology highlights advances in cardiac SPECT imaging and supports the incorporation of new technology and techniques in laboratories performing nuclear cardiology procedures. The document focuses on the application of the latest imaging protocols and the utilization of newer hardware and software options to perform high quality, state-of-the-art SPECT nuclear cardiology procedures. Recommendations for best practices of cardiac SPECT imaging are discussed, highlighting what imaging laboratories should be doing as the standard of care in 2018 to achieve optimal results (based on the ASNC 2018 SPECT guideline [Dorbala et al., J Nucl Cardiol. 2018. https://doi.org/10.1007/s12350-018-1283-y ]).
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Affiliation(s)
- Brian G Abbott
- Warren Alpert Medical School, Brown University, Providence, RI, USA.
| | - James A Case
- Cardiovascular Imaging Technologies, Kansas City, MO, USA
| | - Sharmila Dorbala
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew J Einstein
- Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - James R Galt
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Prem Soman
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - R Glenn Wells
- University of Ottawa Heart Institute, Ottawa, Canada
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Ishihara M, Onoguchi M, Shibutani T. An Exploratory Study of Washout Rate Analysis for Thallium-201 Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging Using Cadmium Zinc Telluride Detectors. Mol Imaging 2018; 17:1536012118782322. [PMID: 29952215 PMCID: PMC6077886 DOI: 10.1177/1536012118782322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the washout rate (WOR) for thallium-201-chloride single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) using cadmium zinc telluride detectors for SPECT (CZT SPECT) versus conventional Anger-type SPECT (conventional SPECT). A total of 52 Japanese patients were examined using CZT SPECT and conventional SPECT, and the global WORs were compared. Additionally, the MPI WORs were compared for patients with a normal MPI versus those in whom MPI reflected the patients’ multivessel disease (MVD) MPI. Washout rates were similar when approximated by CZT SPECT versus conventional SPECT 12.59 ± 2.26%/h vs 12.57 ± 2.27%/h (P = .997), respectively. The WOR values for CZT SPECT versus conventional SPECT were 13.42%/h (1.53%/h) vs 13.93%/h (1.24%/h) (P = .337), respectively, for 7 normal MPI patients, and 10.64 ± 2.20%/h vs 10.84 ± 2.26%/h (P = .848), respectively, for 7 MVD-MPI patients. The WOR values for normal MPI versus MVD-MPI patients for CZT SPECT were 13.42 ± 1.53%/h vs 10.64 ± 2.20%/h (P = .025), respectively. Thallium-201-chloride WOR values obtained with high-efficiency CZT SPECT, which enabled significantly reduced imaging times and use of a low-dose protocol, were similar to those obtained with conventional SPECT.
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Affiliation(s)
- Masaru Ishihara
- Department of Radiology, Hyogo Cancer Center, Akashi, Japan
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
- Masahisa Onoguchi, Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Ishihara M, Taniguchi Y, Onoguchi M, Shibutani T. Optimal thallium-201 dose in cadmium-zinc-telluride SPECT myocardial perfusion imaging. J Nucl Cardiol 2018; 25:947-954. [PMID: 28008559 DOI: 10.1007/s12350-016-0749-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND We aimed to determine the optimal thallium 201 chloride (thallium-201) dose using a novel ultrafast cardiac gamma camera with cadmium-zinc-telluride (CZT) solid-state semiconductor detectors (D-SPECT). METHODS AND RESULTS The optimal thallium-201 dose for obtaining left ventricular (LV) myocardial counts was determined from a phantom study. Consecutive 292 patients underwent stress myocardial perfusion imaging with a thallium-201 injection. Stress test comprised exercise or pharmacological (adenosine) provocation. We calculated an optimal thallium-201 dose that resulted in better LV myocardial counts during 6 minutes of acquisition time. We corrected the respective values according to the patient's age, sex, body mass index (BMI), and type of stress test. The lowest thallium-201 dose for obtaining acceptable imaging was 1.2 million counts. Radiopharmaceutical doses showed a positive correlation with the patient's age (P < .001), sex (P = .012), BMI (P < .001), and type of stress test (P < .001). Multivariate analysis revealed that the patient's BMI and the type of stress test were statistically significant factors for determining the correct radiopharmaceutical dose (P < .001 for both). CONCLUSIONS For clinical use of the CZT SPECT system, the optimal individual thallium-201 doses can be determined based on the patient's BMI and type of stress test.
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Affiliation(s)
- Masaru Ishihara
- Department of Radiology, Hyogo Brain and Heart Center at Himeji, Himeji, Japan
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
| | - Yasuyo Taniguchi
- Department of Cardiology, Hyogo Brain and Heart Center at Himeji, Himeji, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan
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Myocardial flow reserve derived by dynamic perfusion single-photon emission computed tomography reflects the severity of coronary atherosclerosis. Int J Cardiovasc Imaging 2018; 34:1493-1501. [DOI: 10.1007/s10554-018-1358-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 04/16/2018] [Indexed: 11/25/2022]
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38
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Aggarwal NR, Bond RM, Mieres JH. The role of imaging in women with ischemic heart disease. Clin Cardiol 2018; 41:194-202. [PMID: 29505091 DOI: 10.1002/clc.22913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/28/2018] [Accepted: 01/30/2018] [Indexed: 12/24/2022] Open
Abstract
Substantial advances and insights in medical technology and treatment strategies, and the focus on sex-specific research have contributed to a reduction in cardiovascular mortality in women. Despite these advances, ischemic heart disease (IHD) remains the leading cause of cardiovascular morbidity and mortality of women in the Western world. Advances in cardiovascular imaging, over the past 4 decades, have significantly improved the evaluation and management of the full spectrum of coronary atherosclerosis, which contributes to ischemic heart disease. The development of contemporary and novel diagnostic imaging techniques and tools have assumed an expanded role in the evaluation of symptomatic women to detect not only flow-limiting epicardial coronary stenosis and nonobstructive atherosclerosis, but also ischemia resulting from microvascular dysfunction. IHD is now diagnosed early and with greater accuracy, leading to improved risk assessment and timely therapies in women. In this article, we review the available evidence on the role of contemporary diagnostic imaging techniques in the evaluation of women with suspected IHD.
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Affiliation(s)
| | - Rachel M Bond
- Zucker School of Medicine at Hofstra Northwell, New York
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39
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Songy B, Guernou M, Hivoux D, Attias D, Lussato D, Queneau M, Bonardel G, Bertaux M. Prognostic value of one millisievert exercise myocardial perfusion imaging in patients without known coronary artery disease. J Nucl Cardiol 2018; 25:120-130. [PMID: 27506702 DOI: 10.1007/s12350-016-0601-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to assess the prognostic value of normal ultra-low-dose exercise MPI with a CZT camera. METHODS 1901 consecutive patients without known CAD referred for exercise MPI with 1.8 MBq/kg (0.05 mCi) of Tc99m sestamibi or tetrofosmin and a CZT camera were included prospectively. Patients with an abnormal scan requiring an additional resting image (230) or a submaximal exercise test (271) were excluded. The 1400 remaining patients were followed for 39 months. The primary end-point was cardiac events (cardiac death, nonfatal myocardial infarction, and revascularization). The secondary end-point was noncardiac death. RESULTS The mean injected activity was 145 ± 37 MBq (3.9 ± 1 mCi), the mean acquisition duration was 10 ± 0.7 minutes, and the mean effective dose was 0.91 ± 0.13 mSv. 1288 patients (92%) achieved full follow-up. We observed 22 cardiac events and 16 noncardiac deaths. The annualized rates were equivalent to 0.55% for cardiac events and 0.37% for noncardiac mortality. CONCLUSIONS Normal ultra-low-dose exercise MPI with a CZT camera has a high negative predictive value. The effective dose was less than 1 mSv, and the study thus allays concerns about radiation burden.
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Affiliation(s)
- Bernard Songy
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France.
| | - Mohamed Guernou
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - Daniel Hivoux
- Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - David Attias
- Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - David Lussato
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - Mathieu Queneau
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - Gerald Bonardel
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
| | - Marc Bertaux
- Nuclear Cardiology, Centre Cardiologique du Nord (CCN), Paris, France
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40
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Abstract
OPINION STATEMENT Early identification of atherosclerosis and at-risk lesions plays a critical role in reducing the burden of cardiovascular disease. While invasive coronary angiography serves as the gold standard for diagnosing coronary artery disease, non-invasive imaging techniques provide visualization of both anatomical and functional atherosclerotic processes prior to clinical presentation. The development of cardiac positron emission tomography (PET) has greatly enhanced our capability to diagnose and treat patients with early stages of atherosclerosis. Cardiac PET is a powerful, versatile non-invasive diagnostic tool with utility in the identification of high-risk plaques, myocardial perfusion defects, and viable myocardial tissue. Cardiac PET allows for comparisons of myocardial function both at time of rest and stress, providing accurate assessments of both myocardial perfusion and viability. Furthermore, novel PET techniques with unique radiotracers yield clinically relevant data on high-risk plaques in active progressive atherosclerosis. While PET exercise stress tests were previously difficult to perform given short radiotracer half-life, the development of the novel radiotracer Flurpiridaz F-18 provides a promising future for PET exercise stress imaging. In addition, hybrid imaging with computed tomography angiography (CTA) and cardiac magnetic resonance (CMR) provides integration of cardiac function and structure. In this review article, we discuss the principles of cardiac PET, the clinical applications of PET in diagnosing and prognosticating patients at risk for future cardiovascular events, compare PET with other non-invasive cardiac imaging modalities, and discuss future applications of PET in CVD evaluation and management.
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Affiliation(s)
- Brian M Salata
- Weill Cornell Medicine, 520 E 70th Street, M-507, New York, NY, 10021, USA
| | - Parmanand Singh
- Department of Cardiology, Weill Cornell Medicine, 520 E 70th Street Starr Pavilion, 4th Floor, New York, NY, 10021, USA.
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Gimelli A, Achenbach S, Buechel RR, Edvardsen T, Francone M, Gaemperli O, Hacker M, Hyafil F, Kaufmann PA, Lancellotti P, Nieman K, Pontone G, Pugliese F, Verberne HJ, Gutberlet M, Bax JJ, Neglia D, Gerber B, Donal E, Flachskampf F, Haugaa K, Delgado V, Knuuti J, Knaapen P, Maurovich-Horvat P, Schroeder S. Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR). Eur Heart J 2017; 39:286-296. [DOI: 10.1093/eurheartj/ehx582] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/26/2017] [Indexed: 12/23/2022] Open
Affiliation(s)
- Alessia Gimelli
- Fondazione Toscana/CNR Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Stephan Achenbach
- Department of Internal Medicine 2 (Cardiology), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Thor Edvardsen
- Oslo University Hospital, Department of Cardiology, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique—Hôpitaux de Paris, Inserm 1148, DHU FIRE, University Paris 7 Diderot, Paris, France
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Patrizio Lancellotti
- Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Koen Nieman
- Departments of Cardiovascular Medicine and Radiology, Stanford University, School of Medicine, Stanford, CA, USA
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Yonsei University Health System, Seoul, South Korea
| | - Francesca Pugliese
- NIHR Barts BRC, Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany
| | - Jeroen J Bax
- Heart Lung Center Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana/CNR Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
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Nakaya K, Onoguchi M, Nishimura Y, Kiso K, Otsuka H, Nouno Y, Shibutani T, Yasuda E. Comparison Between Prone and Upright Imaging of the Inferior Wall Using 201TlCl Myocardial Perfusion SPECT. J Nucl Med Technol 2017; 45:304-308. [PMID: 29042470 DOI: 10.2967/jnmt.117.197632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/11/2017] [Indexed: 11/16/2022] Open
Abstract
Because it suppresses attenuation artifacts from the diaphragm, prone SPECT is suitable for evaluating the cardiac inferior wall. A solid-state dedicated cardiac camera allows upright imaging, which can also be used to avoid attenuation artifacts from the diaphragm. We compared prone and upright imaging for inferior wall evaluation using 201TlCl myocardial perfusion SPECT (MPS). Methods: The study targeted 45 patients. The prone imaging group included 23 subjects who underwent additional prone imaging because supine imaging indicated that the inferior wall had reduced uptake. The upright imaging group included 22 subjects who, in the past, had shown reduced uptake in the inferior wall during supine imaging. Using the MPS stress images and analysis software, we created a polar map showing the incorporation of the radioisotope throughout the whole of the myocardium; this polar map was then classified into 17 segments. The percentage uptake ratios of the inferior/anterior wall were calculated for the prone and upright acquisitions. These ratios were used as the ratio of percentage uptake in each segment of the anterior wall to percentage uptake in each segment of the inferior wall. In addition, 6 reviewers visually evaluated the uniformity within the inferior wall for both the prone and the upright imaging. Results: There was a significant difference in percentage uptake ratios between the prone and upright images in segments 4/1 (basal inferior/basal anterior; P < 0.05), 11/12 (mid inferolateral/mid anterolateral; P < 0.001), and 15/13 (apical inferior/apical anterior; P < 0.05). There were no significant differences between the prone and upright images in visual evaluations of uniformity within the inferior wall. Conclusion: In comparison with upright imaging, prone imaging has a higher rate of suppression of attenuation artifacts from the diaphragm. However, this difference does not seem to affect the images visually. Therefore, upright and prone imaging can be used interchangeably to evaluate the inferior wall.
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Affiliation(s)
- Koji Nakaya
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.,Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science, Mie, Japan.,Department of Radiology and Nuclear Medicine, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan; and
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
| | - Yoshihiro Nishimura
- Department of Radiology and Nuclear Medicine, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan; and
| | - Keisuke Kiso
- Department of Radiology and Nuclear Medicine, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan; and
| | - Hideki Otsuka
- Department of Medical Imaging/Nuclear Medicine, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshifumi Nouno
- Department of Radiology and Nuclear Medicine, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan; and
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
| | - Eisuke Yasuda
- Department of Radiological Technology, Faculty of Health Science, Suzuka University of Medical Science, Mie, Japan
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43
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Jameria ZA, Abdallah M, Dwivedi A, Washburn E, Khan N, Khaleghi M, Kalakota N, Gerson MC. Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position. J Nucl Cardiol 2017; 24:1702-1708. [PMID: 27311453 DOI: 10.1007/s12350-016-0515-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/11/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging. METHODS TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD. RESULTS With treadmill exercise, an upright TID ratio ≥1.16 provided a positive predictive value of 50% and a negative predictive value of 85.4% for the identification of extensive CAD. In the regadenoson group, an upright TID ratio of 1.29 provided a positive predictive value of 20% and a negative predictive value of 75.9%. Although not an independent predictor of extensive CAD in all subjects, in subjects with a normal upright LVEF, it provided a predictive value by receiver operating characteristics comparable to the SSS. CONCLUSIONS Increased upright TID measurements on a CZT camera are associated with extensive CAD. The upright TID measurements can serve in an adjunctive role to SSS, and may be most effective in patients with a normal upright exercise LVEF.
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Affiliation(s)
- Zenith A Jameria
- Division of Cardiology, Department of Internal Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Mouhamad Abdallah
- Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA
| | - Alok Dwivedi
- Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX, USA
| | - Erica Washburn
- Division of Nuclear Medicine, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Naseer Khan
- Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA
| | - Mahyar Khaleghi
- Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA
| | - Nischelle Kalakota
- University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Myron C Gerson
- Division of Cardiology, Department of Internal Medicine, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267-0542, USA.
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44
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Brambilla M, Lecchi M, Matheoud R, Leva L, Lucignani G, Marcassa C, Zoccarato O. Comparative analysis of iterative reconstruction algorithms with resolution recovery and new solid state cameras dedicated to myocardial perfusion imaging. Phys Med 2017; 41:109-116. [DOI: 10.1016/j.ejmp.2017.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/27/2017] [Accepted: 03/17/2017] [Indexed: 11/28/2022] Open
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45
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Meyer C, Weinmann P. Validation of early image acquisitions following Tc-99 m sestamibi injection using a semiconductors camera of cadmium-zinc-telluride. J Nucl Cardiol 2017; 24:1149-1156. [PMID: 27098337 DOI: 10.1007/s12350-016-0499-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cadmium-zinc-telluride (CZT) cameras allow to decrease significantly the acquisition time of myocardial perfusion imaging (MPI), but the duration of the examination is still long. Therefore, this study was performed to test the feasibility of early imaging following injection of Tc-99 m sestamibi using a CZT camera. METHODS Seventy patients underwent both an early and a delayed image acquisition after exercise stress test (n = 30), dipyridamole stress test (n = 20), and at rest (n = 20). After injection of Tc-99 m sestamibi, the early image acquisition started on average within 5 minutes for the exercise and rest groups, and 3 minutes 30 seconds for the dipyridamole group. Two independent observers evaluated image quality and extracardiac uptake on four-point scales. The difference between early and later images for each patient was scored on a five-point scale. RESULTS The image quality and extracardiac uptake of early and delayed image acquisitions were not different for the three groups (P > .05). There was no significant difference between early and delayed image acquisitions in the exercise, dipyridamole, and rest groups, respectively, in 63%, 40%, and 80% of cases. In the exercise group and rest group, a defect was only present in early MPI, respectively, in 13% and 20% of cases. A defect was only present in delayed images in 10% of cases in the exercise group and in 45% of cases in the dipyridamole group. CONCLUSIONS There was no difference between early and later image acquisitions in terms of quality. This protocol reduces the length of the procedure for the patient. Beginning with early image acquisitions may help to overcome the artifacts that are observed at the delayed time.
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Affiliation(s)
- Celine Meyer
- European Hospital Georges Pompidou, AP-HP, Nuclear Medicine, Université Paris Descartes, Paris, France.
| | - Pierre Weinmann
- European Hospital Georges Pompidou, AP-HP, Nuclear Medicine, Université Paris Descartes, Paris, France
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46
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Ishihara M, Onoguchi M, Taniguchi Y, Shibutani T. Comparison of conventional and cadmium-zinc-telluride single-photon emission computed tomography for analysis of thallium-201 myocardial perfusion imaging: an exploratory study in normal databases for different ethnicities. Int J Cardiovasc Imaging 2017; 33:2057-2066. [PMID: 28664481 DOI: 10.1007/s10554-017-1205-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/22/2017] [Indexed: 02/02/2023]
Abstract
The aim of this study was to clarify the differences in thallium-201-chloride (thallium-201) myocardial perfusion imaging (MPI) scans evaluated by conventional anger-type single-photon emission computed tomography (conventional SPECT) versus cadmium-zinc-telluride SPECT (CZT SPECT) imaging in normal databases for different ethnic groups. MPI scans from 81 consecutive Japanese patients were examined using conventional SPECT and CZT SPECT and analyzed with the pre-installed quantitative perfusion SPECT (QPS) software. We compared the summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for the two SPECT devices. For a normal MPI reference, we usually use Japanese databases for MPI created by the Japanese Society of Nuclear Medicine, which can be used with conventional SPECT but not with CZT SPECT. In this study, we used new Japanese normal databases constructed in our institution to compare conventional and CZT SPECT. Compared with conventional SPECT, CZT SPECT showed lower SSS (p < 0.001), SRS (p = 0.001), and SDS (p = 0.189) using the pre-installed SPECT database. In contrast, CZT SPECT showed no significant difference from conventional SPECT in QPS analysis using the normal databases from our institution. Myocardial perfusion analyses by CZT SPECT should be evaluated using normal databases based on the ethnic group being evaluated.
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Affiliation(s)
- Masaru Ishihara
- Department of Radiology, Hyogo Cancer Center, 13-70 Kitaoji, Akashi, Hyogo, 673-8558, Japan.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
| | - Yasuyo Taniguchi
- Department of Cardiology, Hyogo Brain and Heart Center at Himeji, 520 Saisho-ko, Himeji, Hyogo, 670-0981, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
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47
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Blaire T, Bailliez A, Ben Bouallegue F, Bellevre D, Agostini D, Manrique A. Determination of the Heart-to-Mediastinum Ratio of 123I-MIBG Uptake Using Dual-Isotope ( 123I-MIBG/ 99mTc-Tetrofosmin) Multipinhole Cadmium-Zinc-Telluride SPECT in Patients with Heart Failure. J Nucl Med 2017. [PMID: 28646015 DOI: 10.2967/jnumed.117.194373] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this retrospective study was to compare the heart-to-mediastinum ratio (HMR) of 123I-metaiodobenzylguanidine (123I-MIBG) uptake obtained using a multipinhole cadmium-zinc-telluride (CZT) camera with that obtained using conventional planar imaging. Methods: Forty consecutive heart failure patients underwent planar acquisition 4 h after 123I-MIBG injection (191 ± 41 [mean ± SD] MBq). To localize the heart using the CZT camera, 99mTc-tetrofosmin (358 ± 177 MBq) was administered and dual-isotope acquisition was performed. The HMRs were calculated with conventional planar imaging (HMRplanar), with anterior reprojection images using the CZT camera (HMRreproj), and with transaxial reconstructed images using the CZT camera (HMRtransaxial). In a phantom study, we estimated a linear model fitting the CZT camera data to the planar data, and we applied it to provide corrected CZT camera-determined HMRs in patients (cHMRreproj and cHMRtransaxial). Results: Thirty-four men and 6 women (71 ± 9 y old) with ischemic (22 patients) and nonischemic (18 patients) heart failure completed the study. For 22 of the 40 patients (55%), the New York Heart Association classification was class II and the ejection fraction was 35% ± 9%. HMRreproj (1.12 ± 0.19) and HMRtransaxial (1.35 ± 0.34) were lower than HMRplanar (1.44 ± 0.14) (P < 0.0001 and P < 0.01, respectively). cHMRreproj (1.54 ± 0.09) and cHMRtransaxial (1.45 ± 0.14) were significantly different (P < 0.0001). Lin concordance correlation and Bland-Altman analysis demonstrated an almost perfect concordance and a high agreement between HMRplanar and cHMRtransaxial (P was not significant) but not between HMRplanar and cHMRreproj (P < 0.0001). Conclusion: This study demonstrated that determination of the late HMR of cardiac 123I-MIBG uptake using dual-isotope (123I and 99mTc) acquisition on a multipinhole CZT camera was feasible in patients with heart failure. However, this determination should be performed using transaxial reconstructed images and linear correction based on phantom data acquisitions.
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Affiliation(s)
- Tanguy Blaire
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France .,Signalisation, Électrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, UNICAEN, Normandie Université, Caen, France.,Department of Nuclear Medicine, IRIS, Polyclinique du Bois, Lille, France
| | - Alban Bailliez
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France.,Signalisation, Électrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, UNICAEN, Normandie Université, Caen, France.,Department of Nuclear Medicine, IRIS, Polyclinique du Bois, Lille, France
| | | | | | - Denis Agostini
- Signalisation, Électrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, UNICAEN, Normandie Université, Caen, France.,Department of Nuclear Medicine, CHU Cote de Nacre, Caen, France
| | - Alain Manrique
- Signalisation, Électrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, UNICAEN, Normandie Université, Caen, France.,Department of Nuclear Medicine, CHU Cote de Nacre, Caen, France
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Akers SR, Panchal V, Ho VB, Beache GM, Brown RK, Ghoshhajra BB, Greenberg SB, Hsu JY, Kicska GA, Min JK, Stillman AE, Stojanovska J, Abbara S, Jacobs JE. ACR Appropriateness Criteria ® Chronic Chest Pain—High Probability of Coronary Artery Disease. J Am Coll Radiol 2017; 14:S71-S80. [DOI: 10.1016/j.jacr.2017.01.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 11/29/2022]
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Dendy JM, Tilkemeier P. Successful innovation: A time for change? J Nucl Cardiol 2017; 24:134-137. [PMID: 27220878 DOI: 10.1007/s12350-016-0533-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 12/20/2022]
Abstract
Innovation plays an important role in the advancement of nuclear cardiology, meeting the need for reduced exposure to radiation, and maintaining and improving image quality. As we innovate, it is important to understand the impact of these improvements on the clinical and research knowledge base that has made nuclear cardiology such a powerful clinical tool. The need for comparative studies insuring stability in the clinical applicability of our current guidelines and use of the prognostic power of radionuclide myocardial perfusion imaging in clinical practice is essential for new and innovative techniques. The existing data demonstrating the significant differences that can occur with the innovative techniques is explored. The need for tools to insure comparable data is available as we begin to utilize registries to inform our clinical practice and research will be an important part of the future of nuclear cardiology.
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Affiliation(s)
- Jeffrey M Dendy
- Department of Medicine, Greenville Health System, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, SC, 29605, USA
| | - Peter Tilkemeier
- Department of Medicine, Greenville Health System, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, SC, 29605, USA.
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Chikamori T, Goto K, Hida S, Miyagawa M, Ishimura H, Uchida K, Fukuyama T, Mochizuki T, Yamashina A. Diagnostic performance of a semiconductor gamma-camera system as studied by multicenter registry. J Cardiol 2017; 69:449-455. [DOI: 10.1016/j.jjcc.2016.02.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/02/2016] [Accepted: 02/23/2016] [Indexed: 11/28/2022]
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