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Kamerman M, van Dijk JD, Timmer JR, Ottervanger JP, Knollema S, Jager PL, Mouden M. The incremental value of coronary artery calcium score in predicting long-term prognosis and defining the warranty period of normal adenosine stress-only myocardial perfusion imaging using CZT SPECT. J Nucl Cardiol 2023; 30:2692-2701. [PMID: 37592058 DOI: 10.1007/s12350-023-03349-6] [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: 04/13/2023] [Accepted: 07/12/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Normal stress-only (SO) myocardial perfusion imaging (MPI) using SPECT reduces imaging time and radiation dose with a good prognosis. However, the long-term prognostic value of combining coronary artery calcium score (CACS) with SO MPI to determine the warranty period remains unknown. Hence, we assessed the incremental prognostic value of CACS and its impact on the warranty period of normal SO MPI using SPECT. METHODS We retrospectively included 1375 symptomatic patients without a history of coronary artery disease (CAD) and a normal SO MPI using adenosine who underwent simultaneous CAC scoring. Annual major adverse cardiac events (MACE) rates were calculated for CACS categories: 0, 1-399, 400-999, and ≥1000. RESULTS The mean age was 60.0 ± 11.8 years (66.9% female) with a median follow-up of 10.3 [IQR 9.6-10.9] years. The warranty period for annual MACE rate for normal SO SPECT extended the total follow-up time in years. MACE rate categorized by CAC categories demonstrated an increase in MACE rates with increasing CACS; CACS 0 and CACS 1-399 were associated with a 10-year warranty period, CACS 400-999 had a warranty period of 4 years and no warranty period could be given for CACS≥1000 (5.9 % at 1 year). CONCLUSIONS CACS as an adjunct to normal pharmacological SO MPI provides additional prognostic information and aids in determining a warranty period.
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Affiliation(s)
- Mandy Kamerman
- Department of Cardiology, Isala Clinics, Zwolle, The Netherlands.
- Department of Nuclear Medicine, Isala Clinics, Zwolle, The Netherlands.
| | - Joris D van Dijk
- Department of Nuclear Medicine, Isala Clinics, Zwolle, The Netherlands
| | - Jorik R Timmer
- Department of Cardiology, Isala Clinics, Zwolle, The Netherlands
| | | | - Siert Knollema
- Department of Nuclear Medicine, Isala Clinics, Zwolle, The Netherlands
| | - Pieter L Jager
- Department of Nuclear Medicine, Isala Clinics, Zwolle, The Netherlands
| | - Mohamed Mouden
- Department of Cardiology, Isala Clinics, Zwolle, The Netherlands
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2
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Cantoni V, Green R, Acampa W, Zampella E, Assante R, Nappi C, Gaudieri V, Mannarino T, Cuocolo R, Di Vaia E, Petretta M, Cuocolo A. Diagnostic performance of myocardial perfusion imaging with conventional and CZT single-photon emission computed tomography in detecting coronary artery disease: A meta-analysis. J Nucl Cardiol 2021; 28:698-715. [PMID: 31089962 DOI: 10.1007/s12350-019-01747-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND We performed a meta-analysis to compare the diagnostic performance of conventional SPECT (C-SPECT) and cadmium-zinc-telluride (CZT)-SPECT systems in detecting angiographically proven coronary artery disease (CAD). METHODS Studies published between January 2000 and February 2018 were identified by database search. We included studies assessing C-SPECT or CZT-SPECT as a diagnostic test to evaluate patients for the presence of CAD, defined as at least 50% diameter stenosis on invasive coronary angiography. A study was eligible regardless of whether patients were referred for suspected or known CAD. RESULTS We identified 40 eligible articles (25 C-SPECT and 15 CZT-SPECT studies) including 7334 patients (4997 in C-SPECT and 2337 in CZT-SPECT studies). The pooled sensitivity and specificity were 85% and 66% for C-SPECT and 89% and 69% for CZT-SPECT imaging studies. The area under the curve was slightly higher for CZT-SPECT (0.89) compared to C-SPECT (0.83); accordingly, the summary diagnostic OR was 17 for CZT-SPECT and 11 for C-SPECT. The accuracy of the two tests slightly differs between C-SPECT and CZT-SPECT (chi-square 11.28, P < .05). At meta-regression analysis, no significant association between both sensitivity and specificity and demographical and clinical variables considered was found for C-SPECT and CZT-SPECT studies. CONCLUSIONS C-SPECT and CZT-SPECT have good diagnostic performance in detecting angiographic proven CAD, with a slightly higher accuracy for CZT-SPECT. This result supports the use of the novel gamma cameras in clinical routine practices also considering the improvements in acquisition time and radiation exposure reduction.
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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
| | - 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
| | - Emilia Zampella
- 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
| | - 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
| | - Renato Cuocolo
- 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
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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3
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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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4
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Barone-Rochette G, Zoreka F, Djaileb L, Piliero N, Calizzano A, Quesada JL, Broisat A, Riou L, Machecourt J, Fagret D, Vanzetto G, Ghezzi C. Diagnostic value of stress thallium-201/rest technetium-99m-sestamibi sequential dual isotope high-speed myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis. J Nucl Cardiol 2019; 26:1269-1279. [PMID: 29380286 DOI: 10.1007/s12350-018-1189-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 01/04/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of this study was to determine the diagnostic accuracy of stress thallium-201/rest technetium-99m-sestamibi sequential dual-isotope high-speed myocardial perfusion imaging (DI-HS-MPI) against invasively determined fractional flow reserve (FFR). METHODS Fifty-four consecutive patients prospectively underwent DI-HS-MPI before invasive coronary angiography. Perfusion was scored visually by summed stress score on a patient and coronary territory basis. Significant coronary artery disease (CAD) was defined by the presence of ≥ 90% stenosis/occlusion or fractional flow reserve ≤ 0.80 for coronary stenosis ≥ 50%. RESULTS FFR was measured in 69 of 162 coronary vessels, with 1.28 ± 0.56 vessels assessed/patient. Sensitivity, specificity, and diagnostic accuracy of MPI for the detection of significant CAD were 92.8%, 69.2%, and 81.4%, on a patient basis, and 83.7%, 90.4%, and 88.8% by coronary territory. CONCLUSIONS DI-HS-MPI accurately detects functionally significant CAD as defined by using FFR.
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Affiliation(s)
- Gilles Barone-Rochette
- Department of Cardiology, University Hospital, Grenoble Alpes, France.
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France.
- French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Paris, France.
| | - Feras Zoreka
- Department of Cardiology, University Hospital, Grenoble Alpes, France
| | - Loïc Djaileb
- Department of Nuclear medicine, University Hospital, Grenoble Alpes, France
| | - Nicolas Piliero
- Department of Cardiology, University Hospital, Grenoble Alpes, France
| | - Alex Calizzano
- Department of Nuclear medicine, University Hospital, Grenoble Alpes, France
| | - Jean Louis Quesada
- Center of Clinical Investigations, Grenoble Alpes University Hospital, Grenoble, France
| | - Alexis Broisat
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France
| | - Laurent Riou
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France
| | | | - Daniel Fagret
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France
- Department of Nuclear medicine, University Hospital, Grenoble Alpes, France
| | - Gerald Vanzetto
- Department of Cardiology, University Hospital, Grenoble Alpes, France
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France
- French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Paris, France
| | - Catherine Ghezzi
- INSERM U1039, Bioclinic Radiopharmaceutics Laboratory, Grenoble Alpes, France
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Comparison of diagnostic accuracy of stress myocardial perfusion imaging for detecting hemodynamically significant coronary artery disease between cardiac magnetic resonance and nuclear medical imaging: A meta-analysis. Int J Cardiol 2019; 293:278-285. [PMID: 31303392 DOI: 10.1016/j.ijcard.2019.06.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/03/2019] [Accepted: 06/18/2019] [Indexed: 11/22/2022]
Abstract
AIMS This study aimed to compare the diagnostic accuracy of stress myocardial perfusion imaging between cardiac magnetic resonance (CMR) and nuclear medical imaging, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET), for the diagnosis of hemodynamically significant coronary artery disease (CAD) with fractional flow reserve (FFR) as the reference standard. METHODS AND RESULTS We searched PubMed and Embase for all published studies that evaluated the diagnostic accuracy of stress myocardial perfusion imaging modalities, including CMR, SPECT, and PET, to diagnose hemodynamically significant CAD with FFR as the reference standard. A total of 28 articles met the inclusion criteria and were included in the meta-analysis: 14 CMR, 13 SPECT, and 5 PET articles. The results demonstrated a pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.80-0.93), 0.69 (95% CI: 0.56-0.79), and 0.83 (95% CI: 0.70-0.91), and a pooled specificity of 0.89 (95% CI: 0.85-0.93), 0.85 (95% CI, 0.80-0.89), and 0.89 (95% CI, 0.86-0.91) for CMR, SPECT, and PET, respectively. The area under the curve (AUC) of CMR, PET, and SPECT was 0.94 (95% CI, 0.92-0.96), 0.92 (95% CI, 0.89-0.94), and 0.87 (95% CI, 0.83-0.89), respectively. CONCLUSIONS CMR and PET both have high accuracy and SPECT has moderate accuracy to detect hemodynamically significant CAD with FFR as the reference standard. Furthermore, the diagnostic accuracy of CMR at 3.0 T is superior to 1.5 T.
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6
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Nudi F, Biondi-Zoccai G, Romagnoli A, Schillaci O, Nudi A, Versaci F. Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components. J Nucl Cardiol 2019; 26:752-762. [PMID: 30565061 DOI: 10.1007/s12350-018-01562-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 09/19/2018] [Indexed: 02/05/2023]
Abstract
Coronary artery disease (CAD) is the most common and important cause of ischemic heart disease, with major implications on global morbidity and mortality. Non-invasive testing is crucial in the diagnostic and prognostic work-up of patients with or at risk of CAD, and also to guide decision making in terms of pharmacologic and revascularization therapy. The traditional paradigm is to view anatomic (i.e., coronary computed tomography) and functional imaging (e.g., myocardial perfusion scintigraphy) tests as opposing alternatives. Such approach is too reductionist and does not capitalize on the strengths of each type of test while risking to overlook the inherent limitations. The combination of anatomic and functional tests in a logic of hybrid imaging holds the promise of overcoming the limitations inherent to anatomic and functional testing, enabling more accurate diagnosis, prognosis, and guidance for revascularization in patients with CAD.
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Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna Della Fiducia Clinic, Rome, Italy.
- Ostia Radiologica, Rome, Italy.
- Replycare, Viale Africa 36, 00144, Rome, Italy.
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- IRCCS NEUROMED, Pozzilli, Italy
| | | | - Orazio Schillaci
- IRCCS NEUROMED, Pozzilli, Italy
- Department of Nuclear Medicine, Tor Vergata University, Rome, Italy
| | - Alessandro Nudi
- Service of Hybrid Cardio Imaging, Madonna Della Fiducia Clinic, Rome, Italy
- Replycare, Viale Africa 36, 00144, Rome, Italy
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7
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Zhang YQ, Jiang YF, Hong L, Chen M, Zhang NN, Yang HJ, Zhou YF. Diagnostic value of cadmium-zinc-telluride myocardial perfusion imaging versus coronary angiography in coronary artery disease: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2019; 98:e14716. [PMID: 30817614 PMCID: PMC6831125 DOI: 10.1097/md.0000000000014716] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Rapid progress has been made in research of cadmium-zinc-telluride (CZT) technology in the last few years, which might serve as a new method to diagnose coronary artery disease. However, compared with coronary angiography, the diagnostic value of CZT is still controversial. We aimed to evaluate diagnosis value of coronary angiography versus CZT in coronary artery disease. METHODS We searched the database for eligible researches associated with CZT- myocardial perfusion imaging (MPI) and invasive coronary angiography, extracted the relevant data, and rigorously screened it according to the inclusion and exclusion criteria. The accuracy indicators included sensitivity, specificity, accuracy, positive and negative likelihood ratios. RESULTS According to the inclusion and exclusion criteria, we finally found 20 studies containing 2350 patients in this search. Pooled results showed that sensitivity of CZT-MPI was 0.84% and 95% confidence interval (95% CI): 0.78 to 0.89, specificity was 0.72, 95% CI (0.62-0.76), the specificity was lower apparently. The positive likelihood ratio was 3.0, 95% CI (2.4-3.8), the negative likelihood ratio was 0.22, 95% CI (0.16-0.31), diagnostic odds ratio was 14, 95% CI (7.84-17.42). CONCLUSION This meta-analysis showed that CZT-MPI had satisfactory sensitivity and specificity for diagnosing coronary artery disease. Larger studies are required for further evaluation.
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8
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Fang W, Liu S. New 99mTc Radiotracers for Myocardial Perfusion Imaging by SPECT. Curr Radiopharm 2019; 12:171-186. [PMID: 30727939 DOI: 10.2174/1874471012666190206102214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Myocardial Perfusion Imaging (MPI) with radiotracers is an integral component in evaluation of the patients with known or suspected coronary artery diseases (CAD). 99mTc-Sestamibi and 99mTc-Tetrofosmin are commercial radiopharmaceuticals for MPI by single photon-emission computed tomography (SPECT). Despite their widespread clinical applications, they do not meet the requirements of an ideal perfusion imaging agent due to their inability to linearly track the regional myocardial blood flow rate at >2.5 mL/min/g. With tremendous development of CZT-based SPECT cameras over the past several years, the nuclear cardiology community has been calling for better perfusion radiotracers with improved extraction and biodistribution properties. METHODS This review will summarize recent research efforts on new cationic and neutral 99mTc radiotracers for SPECT MPI. The goal of these efforts is to develop a 99mTc radiotracer that can be used to detect perfusion defects at rest or under stress, determine the regional myocardial blood flow, and measure the perfusion and left ventricular function. RESULTS The advantage of cationic radiotracers (e.g. 99mTc-Sestamibi) is their long myocardial retention because of the positive molecular charge and fast liver clearance kinetics. 99mTc-Teboroxime derivatives have a high initial heart uptake (high first-pass extraction fraction) due to their neutrality. 99mTc- 3SPboroxime is the most promising radiotracer for future clinical translation considering its initial heart uptake, myocardial retention time, liver clearance kinetics, heart/liver ratios and SPECT image quality. CONCLUSION 99mTc-3SPboroximine is an excellent example of perfusion radiotracers, the heart uptake of which is largely relies on the regional blood flow. It is possible to use 99mTc-3SPboroximine for detection of perfusion defect(s), accurate quantification and determination of regional blood flow rate. Development of such a 99mTc radiotracer is of great clinical benefit for accurate diagnosis of CAD and assessing the risk of future hard events (e.g. heart attack and sudden death) in cardiac patients.
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Affiliation(s)
- Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing, China
| | - Shuang Liu
- School of Health Sciences, Purdue University, Beijing, IN 47907, United States
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9
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The prognostic value of ultra low-dose thallium myocardial perfusion protocol using CZT SPECT. Int J Cardiovasc Imaging 2019; 35:1163-1167. [PMID: 30680654 DOI: 10.1007/s10554-019-01535-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/14/2019] [Indexed: 01/07/2023]
Abstract
The purpose of this study was to assess the prognostic value of ultra-low dose thallium myocardial perfusion imaging. Three hundred and sixty-six patients (245 men) underwent ultra-low dose stress-redistribution imaging on CZT SPECT camera GE Discovery NM 530c. The stress test was performed by bicycle ergometry or regadenoson injection. The activity of 0.5 MBq (0.014 mCi) Tl-201 chloride per kilogram of body weight was administered. The stress images were acquired immediately and redistribution images were taken after 3 h. Patient follow-up was focused on combined end-point (death, myocardial infarction, unstable angina, revascularization and hospitalization for heart failure). Data analysis was performed from hospital database, with a mean period 23 months. Patients with revascularization within 1 month after SPECT was excluded as revascularization for diagnosis. Ischaemia on SPECT was found in 72 patients, 294 patients were without ischaemia. In patients with ischaemia there were 21 (29.2%) subjects with cardiac events, and 23 (7.9%) in patients without ischaemia (HR 4.15, 95% CI 2.30-7.51, p < 0.0001). Ultra-low dose thallium perfusion imaging using CZT camera provides very good prognostic results in assessment of myocardial ischaemia.
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10
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Daou D, Sabbah R, Coaguila C, Boulahdour H. Impact of data-driven cardiac respiratory motion correction on the extent and severity of myocardial perfusion defects with free-breathing CZT SPECT. J Nucl Cardiol 2018; 25:1299-1309. [PMID: 28160264 DOI: 10.1007/s12350-017-0806-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/24/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND We previously reported the clinical feasibility and positive impact on image characteristics of a data-driven cardiac respiratory motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). Here, we evaluate its impact on the extent and severity of myocardial perfusion defects (MPD). METHODS We included 25 patients having a 1-day 99mTc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT. Acquisitions were processed with REGAT to generate mean RM gated SPECT. These were summed either after (R-SPECT) or without realignment (NR-SPECT). We noted the maximal cardiac RM shift in the 3 axes of the left ventricle (LV). Both visual and semi-quantitative analyses of myocardial tracer uptake were realized. Studies were classified as having an impact on the extent/severity of MPD with REGAT if ≥1 segment presented a severity score changing by ≥1 level between NR-SPECT and R-SPECT. An impact on the extent of MPD was considered present if at least 1 segment shifted from normal (score = 0) to abnormal (score different from 0) or inversely. RESULTS Cardiac RM was >10 mm in 55% of studies. With visual and semi-quantitative analyses, an impact on the extent/severity MPD was observed in 14% of all studies (7/49) and 60% of studies with cardiac RM >15 mm. An impact on the extent of MPD was observed in 5 of the 7 upper listed studies. All studies presenting an impact on MPD had RM in the anterior to inferior LV axis >10 mm. CONCLUSIONS A substantial number of MPI studies presented significant cardiac RM. Cardiac RM compensation showed a frequent impact on the extent/severity of MPD.
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Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
| | - Rémy Sabbah
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
| | - Carlos Coaguila
- Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France
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11
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Pellicano M, De Bruyne B, Toth GG, Casselman F, Wijns W, Barbato E. Fractional flow reserve to guide and to assess coronary artery bypass grafting. Eur Heart J 2018; 38:1959-1968. [PMID: 28025191 DOI: 10.1093/eurheartj/ehw505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/30/2016] [Indexed: 11/14/2022] Open
Abstract
The aim of this review is to highlight the role of invasive functional evaluation in patients in whom coronary artery bypass graft (CABG) is indicated, and to examine the clinical evidence available in favour of fractional flow reserve (FFR) adoption in these patients, outline appropriate use, as well as point out potential pitfalls. FFR after CABG will also be reviewed, highlighting its correct interpretation and adoption when applied to both native coronary arteries and bypass grafts. Practice European guidelines support the use of FFR to complement coronary angiography with the highest degree of recommendation (Class IA) for the assessment of coronary stenosis before undertaking myocardial revascularization when previous non-invasive functional evaluation is unavailable or not conclusive. As a result, FFR has been adopted in routine clinical practice to guide clinicians decision as to whether or not perform a revascularization. Of note, due to the increasing confidence of the interventional cardiologists, FFR guidance is also being implemented to indicate or guide CABG. This is in anticipation of supportive clear-cut evidence, since recommendations for FFR adoption were based on randomized clinical trials investigating percutaneous coronary intervention (PCI) strategies in which patients with typical indications for CABG were excluded (e.g. left main disease, valvular disease, and coronary anatomy unsuitable for PCI). Based on the critical appraisal of the literature, FFR can play an important role in risk stratification and determining management strategy of patients either before or after CABG.
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Affiliation(s)
- Mariano Pellicano
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium.,Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Bernard De Bruyne
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium
| | - Gabor G Toth
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium.,University Heart Center Graz, Medical University Graz, Graz, Austria
| | - Filip Casselman
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium
| | - William Wijns
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium.,The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Galway, Ireland
| | - Emanuele Barbato
- Cardiovascular Research Center Aalst, OLV Clinic, Moorselbaan n 164, B 9300 Aalst, Belgium.,Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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12
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Benz DC, Fuchs TA. Breathless or breathtaking: Respiratory motion correction. J Nucl Cardiol 2018; 25:429-432. [PMID: 27435279 DOI: 10.1007/s12350-016-0590-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Dominik C Benz
- Department of Nuclear Medicine, University Hospital Zurich, Ramistr 100, 8091, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, University Hospital Zurich, Ramistr 100, 8091, Zurich, Switzerland.
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13
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van Dijk JD, van Dalen JA, Mouden M, Ottervanger JP, Knollema S, Slump CH, Jager PL. Value of automatic patient motion detection and correction in myocardial perfusion imaging using a CZT-based SPECT camera. J Nucl Cardiol 2018; 25:419-428. [PMID: 27406376 PMCID: PMC5869883 DOI: 10.1007/s12350-016-0571-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/01/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Correction of motion has become feasible on cadmium-zinc-telluride (CZT)-based SPECT cameras during myocardial perfusion imaging (MPI). Our aim was to quantify the motion and to determine the value of automatic correction using commercially available software. METHODS AND RESULTS We retrospectively included 83 consecutive patients who underwent stress-rest MPI CZT-SPECT and invasive fractional flow reserve (FFR) measurement. Eight-minute stress acquisitions were reformatted into 1.0- and 20-second bins to detect respiratory motion (RM) and patient motion (PM), respectively. RM and PM were quantified and scans were automatically corrected. Total perfusion deficit (TPD) and SPECT interpretation-normal, equivocal, or abnormal-were compared between the noncorrected and corrected scans. Scans with a changed SPECT interpretation were compared with FFR, the reference standard. Average RM was 2.5 ± 0.4 mm and maximal PM was 4.5 ± 1.3 mm. RM correction influenced the diagnostic outcomes in two patients based on TPD changes ≥7% and in nine patients based on changed visual interpretation. In only four of these patients, the changed SPECT interpretation corresponded with FFR measurements. Correction for PM did not influence the diagnostic outcomes. CONCLUSION Respiratory motion and patient motion were small. Motion correction did not appear to improve the diagnostic outcome and, hence, the added value seems limited in MPI using CZT-based SPECT cameras.
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Affiliation(s)
- Joris D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands.
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - Jorn A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
| | - Mohamed Mouden
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | | | - Siert Knollema
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands
| | - Cornelis H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Pieter L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands
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14
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Zhao ZQ, Liu M, Fang W, Liu S. Sulfonyl-Containing Boronate Caps for Optimization of Biological Properties of 99mTc(III) Radiotracers [99mTcCl(CDO)(CDOH)2B-R] (CDOH2 = Cyclohexanedione Dioxime). J Med Chem 2017; 61:319-328. [PMID: 29186661 DOI: 10.1021/acs.jmedchem.7b01412] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Zuo-Quan Zhao
- Department of
Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical
College, No.167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Min Liu
- School
of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Wei Fang
- Department of
Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical
College, No.167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Shuang Liu
- School
of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
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15
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Liu M, Zhao ZQ, Fang W, Liu S. Novel Approach for 99mTc-Labeling of Red Blood Cells: Evaluation of 99mTc-4SAboroxime as a Blood Pool Imaging Agent. Bioconjug Chem 2017; 28:2998-3006. [PMID: 29148726 DOI: 10.1021/acs.bioconjchem.7b00601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Angiography with radiolabeled red blood cells (RBCs) plays an important role in diagnosis and prognosis in vascular diseases. Both in vitro and in vivo methods have been developed for 99mTc-labeling of RBCs. However, these methods are complicated and lack reproducibility. Therefore, it is highly desirable to develop an alternative method for routine 99mTc-labeling of RBCs. In this report, we present a novel approach for 99mTc-labeling of RBCs. We prepared a new 99mTc(III) radiotracer [99mTcCl(CDO)(CDOH)2B-4AS] (99mTc-4ASboroxime: 4AS-B(OH)2 = 4-aminosulfonylphenyl)boronic acid, and CDOH2 = cyclohexanedione dioxime) in >95% radiochemical purity. Imaging and biodistribution studies were performed in Sprague-Dawley (SD) rats. It was found that the blood radioactivity was ∼6.0%ID/g (∼90% injected dose for 200-225 g SD rats) for 99mTc-4ASboroxime with low uptake in the myocardium, kidneys, liver, lungs, and muscle, most likely due to lack of leakage of 99mTc-labeled RBCs from the intravascular space. The blood radioactivity was almost unchanged over the 2 h period, suggesting that the binding of 99mTc-4ASboroxime to blood components (cells, proteins, and plasma) is stable. The results from γ-counting of the isolated blood components showed that 99mTc-4ASboroxime had >95% of blood radioactivity binding to RBCs, ∼1% to albumin, and ∼3% remaining free in blood plasma, demonstrating its RBC-specificity. The results from imaging studies in SD rats indicated that 99mTc-4ASboroxime is predominantly distributed in the blood pool. Main blood vessels were well delineated in the head/neck and abdominal regions. This statement was further substantiated by the results from imaging studies in pigs. 99mTc-4ASboroxime is an excellent blood pool agent with the potential for diagnosis and prognosis of vascular diseases.
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Affiliation(s)
- Min Liu
- School of Health Sciences, Purdue University , West Lafayette, Indiana 47907, United States
| | - Zuo-Quan Zhao
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Shuang Liu
- School of Health Sciences, Purdue University , West Lafayette, Indiana 47907, United States
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16
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Daou D, Sabbah R, Coaguila C, Boulahdour H. Feasibility of data-driven cardiac respiratory motion correction of myocardial perfusion CZT SPECT: A pilot study. J Nucl Cardiol 2017; 24:1598-1607. [PMID: 27170338 DOI: 10.1007/s12350-016-0493-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 03/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND We developed a data-driven respiratory motion (RM) correction method (REGAT program) for multiple-pinhole detector CZT SPECT. We verified its clinical feasibility with myocardial perfusion imaging (MPI) and studied its impact on image characteristics. METHODS This retrospective study included 18 patients having stress/rest 99mTc-Tetrofosmin MPI SPECT. List mode was acquired on CZT SPECT and processed with REGAT. REGAT generates reconstructed RM-gated volumes that are summed either without realignment (NR-SPECT) or after realignment (R-SPECT). For both stress and rest, we calculated the maximal RM in the 3 axis, and image characteristics of both R-SPECT and NR-SPECT: minimum left ventricular (LV) cavity counts (LV-Min), maximum LV myocardial counts (LV-Max), LV contrast, and FWHM of both anterior (FWHM-ant) and inferior (FWHM-inf) LV myocardial walls. RESULTS At both stress and rest, cranio-caudal motion was the dominant axial movement and REGAT had a positive impact on image characteristics as reflected by variations between R-SPECT and NR-SPECT in LV-Min, LV-Max, FWHM-ant, FWHM-inf, and contrast. These latter were well correlated to the amplitude of cranio-caudal motion at both stress and rest. CONCLUSIONS Data-driven RM correction of MPI acquired with CZT SPECT is clinically feasible and easily applicable. It presents interesting impact on image characteristics.
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Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
| | - Rémy Sabbah
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
| | - Carlos Coaguila
- Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France
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17
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Coronary artery stenoses more often overestimated in older patients. Int J Cardiol 2017; 241:46-49. [DOI: 10.1016/j.ijcard.2017.02.134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/27/2017] [Indexed: 11/23/2022]
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18
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Nudi F, Iskandrian AE, Schillaci O, Peruzzi M, Frati G, Biondi-Zoccai G. Diagnostic Accuracy of Myocardial Perfusion Imaging With CZT Technology: Systemic Review and Meta-Analysis of Comparison With Invasive Coronary Angiography. JACC Cardiovasc Imaging 2017; 10:787-794. [PMID: 28330657 DOI: 10.1016/j.jcmg.2016.10.023] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/29/2016] [Accepted: 10/05/2016] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study sought to summarize the evidence on stress myocardial perfusion imaging (MPI) using cadmium-zinc-telluride (CZT) technology for the diagnosis of obstructive coronary artery disease (CAD). The CZT cameras are newly introduced, and comparative data with the conventional Anger technology (Anger-MPI) are lacking. BACKGROUND The diagnostic accuracy of Anger-MPI for detection of angiographically significant CAD is well established; however, less evidence is available on the diagnostic accuracy of CZT-MPI. METHODS Clinical studies comparing CZT-MPI and invasive coronary angiography were systematically searched and abstracted. Calculations of diagnostic accuracy, including sensitivity, specificity, likelihood ratios, and diagnostic odds ratio, were obtained with fixed and random effects, reporting point estimates and 95% confidence intervals. RESULTS Based on our search, a total of 16 studies (N = 2,092) were included. The sensitivity of CZT-MPI was 0.84 (95% confidence interval [CI]: 0.78 to 0.89), whereas the specificity of 0.69 (95% CI: 0.62 to 0.76) was significantly reduced. The positive likelihood ratio was 2.73 (95% CI: 2.21 to 3.39), the negative likelihood ratio was 0.24 (95% CI: 0.17 to 0.31), and the diagnostic odds ratio was 11.93 (95% CI: 7.84 to 17.42). At subgroup and meta-regression analyses, the diagnostic accuracy between D-SPECT and Discovery cameras was similar (p = 0.711) and not impacted upon by smaller sample size studies (p = 0.573). CONCLUSIONS CZT-MPI has satisfactory sensitivity for angiographically significant CAD, but its suboptimal specificity warrants further development and research.
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Affiliation(s)
- Francesco Nudi
- Service of Hybrid Cardio Imaging, Madonna della Fiducia Clinic, Rome, Italy; Ostia Radiologica, Ostia, Italy; Etisan, Rome, Italy
| | - Ami E Iskandrian
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama
| | - Orazio Schillaci
- Department of Nuclear Medicine, Tor Vergata University, Rome, Italy
| | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Giacomo Frati
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.
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19
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Gregoire B, Pina-Jomir G, Bontemps L, Janier M, Scheiber C. The value of local normal limits in quantitative Thallium-201 CZT MPI SPECT. J Nucl Cardiol 2017; 24:672-682. [PMID: 26936035 DOI: 10.1007/s12350-016-0430-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/15/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Considering the distinctive characteristics of CZT detectors, automatic quantification of ischemia using normal limits included with software package may deliver suboptimal results for CAD detection. The present study aims to evaluate the benefits of creating normal limits specific to a local population and laboratory protocol. METHODS AND RESULTS Two groups were selected from patients who had undergone a CZT MPI. Normal limits were generated with the QPS application based on the population with low likelihood of CAD. Using the vendor-supplied and the population-specific normal limits i-TPD and vessel-specific SDS results obtained for patients who had subsequently undergone coronary angiography were compared with coronary angiography data. A weak correlation was observed for low i-TPD (stress TPD minus rest TPD) and SDS values. Both databases gave similar values for the area under the ROC curve concerning i-TPD (0.75 to 0.74) and SDS results (0.72 to 0.75 for the LAD, 0.62 to 0.64 for the LCx, and 0.63 to 0.67 for the RCA). Sensitivity (60%), specificity (78%), and predictive positive (84%) and negative (52%) values were also similar with a diagnostic and prognostic threshold value. CONCLUSION The use of a population-specific created database did not influence the diagnostic value of thallium-201 MPI QPS results using a CZT camera.
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Affiliation(s)
- Bastien Gregoire
- Centre de Medicine Nucléaire, Hôpital Louis Pradel, 28, Avenue Doyen Lépine, 69500, Bron, France.
- Université Claude Bernard LYON 1, Faculté de Médecine de Lyon Est., 8 avenue Rockefeller, 69008, Lyon, France.
| | - Géraldine Pina-Jomir
- Centre de Medicine Nucléaire, Hôpital Louis Pradel, 28, Avenue Doyen Lépine, 69500, Bron, France
- Université Claude Bernard LYON 1, Faculté de Médecine de Lyon Est., 8 avenue Rockefeller, 69008, Lyon, France
| | - Laurence Bontemps
- Centre de Medicine Nucléaire, Hôpital Louis Pradel, 28, Avenue Doyen Lépine, 69500, Bron, France
- Université Claude Bernard LYON 1, Faculté de Médecine de Lyon Est., 8 avenue Rockefeller, 69008, Lyon, France
| | - Marc Janier
- Centre de Medicine Nucléaire, Hôpital Louis Pradel, 28, Avenue Doyen Lépine, 69500, Bron, France
- Université Claude Bernard LYON 1, Faculté de Médecine de Lyon Est., 8 avenue Rockefeller, 69008, Lyon, France
| | - Christian Scheiber
- Centre de Medicine Nucléaire, Hôpital Louis Pradel, 28, Avenue Doyen Lépine, 69500, Bron, France
- Université Claude Bernard LYON 1, Faculté de Médecine de Lyon Est., 8 avenue Rockefeller, 69008, Lyon, France
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20
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Angiographic underestimation of disease severity in the left anterior descending artery: a fractional flow reserve analysis. Coron Artery Dis 2017; 27:556-60. [PMID: 27385481 DOI: 10.1097/mca.0000000000000407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study compared the prevalence of angiographic underestimation of left anterior descending artery (LAD) lesions with non-LAD lesions. BACKGROUND Coronary angiography cannot assess the functional severity of a coronary stenosis. Previous studies suggested that lesions of the LAD are more often angiographically underestimated, but evidence is limited. MATERIALS AND METHODS Fractional flow reserve (FFR) was performed in 335 coronary lesions (187 LAD lesions and 148 non-LAD lesions). A visually estimated diameter stenosis of at least 70% was considered functionally significant. An FFR value of up to 0.80 was considered significant. Multivariable analyses were carried out. RESULTS Angiographically, LAD lesions as well as non-LAD lesions were considered functionally significant in 29% (P=0.94). FFR showed significant stenosis of the LAD in 52% compared with 24% in non-LAD lesions (P<0.001). Underestimation was observed in 30% of LAD lesions compared with 11% in non-LAD lesions (P<0.001). The adjusted odds ratio for underestimation in LAD lesions in comparison with non-LAD lesions was 3.48 (95% confidence interval 1.89-6.41; P<0.001). CONCLUSION Underestimation of the functional severity of a coronary stenosis is more common in LAD lesions. FFR should be performed more often for intermediate stenosis of the LAD.
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21
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Liu M, Liu S. 99mTc-3Cboroxime: a novel 99mTc(iii) complex [99mTcCl(CDO)(CDOH)2B-3C] (CDOH2 = cyclohexanedione dioxime; 3C-B(OH)2 = 3-(carbamoylphenyl)boronic acid) with high heart uptake and long myocardial retention. Dalton Trans 2017; 46:14509-14518. [DOI: 10.1039/c7dt01292f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this study, we found that 99mTc-3Cboroxime has the myocardial retention longer than that of 99mTc-Teboroxime, and its heart washout kinetics follows a regressive linear relationship over the 60 min period.
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Affiliation(s)
- Min Liu
- Department of Radiation Medicine and Protection
- Medical College
- Soochow University
- China
- School of Health Sciences
| | - Shuang Liu
- School of Health Sciences
- Purdue University
- USA
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22
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Liu M, Zheng Y, Avcibasi U, Liu S. Novel 99mTc(III)-azide complexes [ 99mTc(N 3)(CDO)(CDOH) 2B-R] (CDOH 2=cyclohexanedione dioxime) as potential radiotracers for heart imaging. Nucl Med Biol 2016; 43:732-741. [PMID: 27632344 DOI: 10.1016/j.nucmedbio.2016.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In this study, novel 99mTc(III)-azide complexes [99mTc(N3)(CDO)(CDOH)2B-R] (99mTc-ISboroxime-N3: R=IS; 99mTc-MPboroxime-N3: R=MP; 99mTc-PAboroxime-N3: R=PA; 99mTc-PYboroxime-N3: R=PY; and 99mTc-Uboroxime-N3: R=5U) were evaluated as heart imaging agents. METHODS Complexes [99mTc(N3)(CDO)(CDOH)2B-R] (R=IS, MP, PA, PY and 5U) were prepared by ligand exchange between NaN3 and [99mTcCl(CDO)(CDOH)2B-R]. Biodistribution and imaging studies were carried out in Sprague-Dawley rats. Image quantification was performed to compare their initial heart uptake and myocardial retention. RESULTS 99mTc-ISboroxime-N3, 99mTc-PYboroxime-N3 and 99mTc-Uboroxime-N3 were prepared with high RCP (93-98%) while the RCP of 99mTc-MPboroxime-N3 and 99mTc-PAboroxime-N3 was 80-85%. The myocardial retention curves of 99mTc-ISboroxime-N3, 99mTc-PYboroxime-N3 and 99mTc-Uboroxime-N3 were best fitted to the bi-exponential decay function. The half-time of the fast component was 1.6±0.4min for 99mTc-ISboroxime-N3, 0.7±0.1min for 99mTc-PYboroxime-N3 and 0.9±0.4min for 99mTc-Uboroxime-N3. The 2-min heart uptake from biodistribution studies followed the ranking order of 99mTc-ISboroxime-N3 (3.60±0.68%ID/g)>99mTc-PYboroxime-N3 (2.35±0.37%ID/g)≫99mTc-Uboroxime-N3 (1.29±0.06%ID/g). 99mTc-ISboroxime-N3 had the highest 2-min heart uptake among 99mTc radiotracers revaluated in SD rats. High quality SPECT images were obtained with the right and left ventricular walls being clearly delineated. The best image acquisition window was 0-5min for 99mTc-ISboroxime-N3. CONCLUSION Both azide coligand and boronate caps had significant impact on the heart uptake and myocardial retention of complexes [99mTc(N3)(CDO)(CDOH)2B-R]. Among the radiotracers evaluated in SD rats, 99mTc-ISboroxime-N3 has the highest initial heart uptake with the heart retention comparable to that of 99mTc-Teboroxime. 99mTc-ISboroxime-N3 is a promising alternative to 99mTc-Teboroxime for SPECT MPI.
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Affiliation(s)
- Min Liu
- Department of Radiation Medicine and Protection, Medical College, Soochow University, China; School of Health Sciences, Purdue University, IN, 47907, USA
| | - Yumin Zheng
- Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, 100037, China
| | - Ugur Avcibasi
- School of Health Sciences, Purdue University, IN, 47907, USA; Department of Chemistry, Faculty of Arts and Science, Celal Bayar University, 45040, Yunusemre/Manisa, Turkey
| | - Shuang Liu
- School of Health Sciences, Purdue University, IN, 47907, USA.
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23
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Liu M, Fang W, Liu S. Novel 99mTc(III) Complexes [99mTcCl(CDO)(CDOH)2B–R] (CDOH2 = Cyclohexanedione Dioxime) Useful as Radiotracers for Heart Imaging. Bioconjug Chem 2016; 27:2770-2779. [DOI: 10.1021/acs.bioconjchem.6b00552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Min Liu
- Department
of Radiation Medicine and Protection, Medical College, Soochow University, China
- School
of Health Sciences, Purdue University, Indiana 47907, United States
| | - Wei Fang
- Department
of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Liu
- School
of Health Sciences, Purdue University, Indiana 47907, United States
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24
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Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2016; 43:2423-2432. [PMID: 27542010 DOI: 10.1007/s00259-016-3467-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
The trade-off between resolution and count sensitivity dominates the performance of standard gamma cameras and dictates the need for relatively high doses of radioactivity of the used radiopharmaceuticals in order to limit image acquisition duration. The introduction of cadmium-zinc-telluride (CZT)-based cameras may overcome some of the limitations against conventional gamma cameras. CZT cameras used for the evaluation of myocardial perfusion have been shown to have a higher count sensitivity compared to conventional single photon emission computed tomography (SPECT) techniques. CZT image quality is further improved by the development of a dedicated three-dimensional iterative reconstruction algorithm, based on maximum likelihood expectation maximization (MLEM), which corrects for the loss in spatial resolution due to line response function of the collimator. All these innovations significantly reduce imaging time and result in a lower patient's radiation exposure compared with standard SPECT. To guide current and possible future users of the CZT technique for myocardial perfusion imaging, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, has decided to examine the current literature regarding procedures and clinical data on CZT cameras. The committee hereby aims 1) to identify the main acquisitions protocols; 2) to evaluate the diagnostic and prognostic value of CZT derived myocardial perfusion, and finally 3) to determine the impact of CZT on radiation exposure.
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25
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Ben-Haim S, Kennedy J, Keidar Z. Novel Cadmium Zinc Telluride Devices for Myocardial Perfusion Imaging—Technological Aspects and Clinical Applications. Semin Nucl Med 2016; 46:273-85. [DOI: 10.1053/j.semnuclmed.2016.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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26
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Goto K, Takebayashi H, Yamane H, Hagikura A, Kobayashi K, Morimoto Y, Kikuta Y, Sato K, Taniguchi M, Hiramatsu S, Haruta S. The diagnosis of intermediate coronary artery stenosis by myocardial perfusion imaging using an ultrafast cardiac gamma camera: Comparison with fractional flow reserve. Int J Cardiol 2016; 210:66-7. [PMID: 26930640 DOI: 10.1016/j.ijcard.2016.02.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 02/16/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Kenji Goto
- Fukuyama Cardiovascular Hospital, Fukuyama, Japan.
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Hung GU, Wang YF, Su HY, Hsieh TC, Ko CL, Yen RF. New Trends in Radionuclide Myocardial Perfusion Imaging. ACTA CARDIOLOGICA SINICA 2016; 32:156-66. [PMID: 27122946 DOI: 10.6515/acs20150803a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
UNLABELLED Radionuclide myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) has been widely used clinically as one of the major functional imaging modalities for patients with coronary artery disease (CAD) for decades. Ample evidence has supported the use of MPI as a useful and important tool in the diagnosis, risk stratification and treatment planning for CAD. Although popular in the United States, MPI has become the most frequently used imaging modality among all nuclear medicine tests in Taiwan. However, it should be acknowledged that MPI SPECT does have its limitations. These include false-positive results due to certain artifacts, false-negative due to balanced ischemia, complexity and adverse reaction arising from current pharmacological stressors, time consuming nature of the imaging procedure, no blood flow quantitation and relatively high radiation exposure. The purpose of this article was to review the recent trends in nuclear cardiology, including the utilization of positron emission tomography (PET) for MPI, new stressor, new SPECT camera with higher resolution and higher sensitivity, dynamic SPECT protocol for blood flow quantitation, new software of phase analysis for evaluation of LV dyssynchrony, and measures utilized for reducing radiation exposure of MPI. KEY WORDS Coronary artery disease • Myocardial flow reserve • Myocardial perfusion imaging • Phase analysis • PET • SPECT.
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Affiliation(s)
- Guang-Uei Hung
- Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi; ; School of Medicine, Tzu Chi University, Hualian
| | - Hung-Yi Su
- Department of Nuclear Medicine, Cathay General Hospital, Taipei
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital; ; Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung
| | - Chi-Lun Ko
- Department of Nuclear Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin
| | - Ruoh-Fang Yen
- Department of Nuclear Medicine, National Taiwan University Hospital; ; Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
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29
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Yang Z, Zheng H, Zhou T, Yang LF, Hu XF, Peng ZH, Jiang YZ, Li M, Sun G. Diagnostic performance of myocardial perfusion imaging with SPECT, CT and MR compared to fractional flow reserve as reference standard. Int J Cardiol 2015; 190:103-5. [PMID: 25920018 DOI: 10.1016/j.ijcard.2015.04.091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 04/14/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Zhen Yang
- Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China
| | - Hong Zheng
- The Forth Department of Cadreward, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China
| | - Tao Zhou
- Department of Medical Imaging, Lai Wu City People's Hospital, No. 001, Changshaobei Road, Laiwu, Shandong Province 271100, China
| | - Lin-feng Yang
- Department of Radiology, Jinan Maternity and Child Care Hospital, No. 2, Jianguoxiaojingsan Road, Jinan, Shandong Province 250001, China
| | - Xiao-fang Hu
- Department of Neurosurgery, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China
| | - Zhao-hui Peng
- Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China
| | - Yu-zhu Jiang
- Institute of Drug and Instrument Control of Jinan Military Area Command, No. 36, Wenhuadong Road, Jinan, Shandong Province 250001, China
| | - Min Li
- Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China.
| | - Gang Sun
- Department of Medical Imaging, Jinan Military General Hospital, No. 25, Shifan Road, Jinan, Shandong Province 250031, China.
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Blankstein R. Can advances in nuclear cardiology hardware overcome the challenges of imaging obese patients? J Nucl Cardiol 2015; 22:276-8. [PMID: 25294434 DOI: 10.1007/s12350-014-0005-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ron Blankstein
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA,
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