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Verger A, Cecchin D, Guedj E, Albert NL, Brendel M, Fraioli F, Tolboom N, Traub-Weidinger T, Yakushev I, Van Weehaeghe D, Fernandez PA, Garibotto V, Imbert L. EANM perspectives for CZT SPECT in brain applications. Eur J Nucl Med Mol Imaging 2024; 51:3680-3684. [PMID: 38858281 DOI: 10.1007/s00259-024-06788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Affiliation(s)
- Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Allée du Morvan, Nancy, 54500, France.
| | - Diego Cecchin
- Department of Medicine, Unit of Nuclear Medicine, University Hospital of Padova, Padova, Italy
| | - Eric Guedj
- Département de Médecine Nucléaire, Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Hôpital de La Timone, CERIMED, Marseille, France
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Tatjana Traub-Weidinger
- Department of Diagnostic and Therapeutic Nuclear Medicine, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum Rechts dr Isar, Technical University of Munich, Munich, Germany
| | - Donatienne Van Weehaeghe
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Pablo Aguiar Fernandez
- CIMUS, Universidade Santiago de Compostela & Nuclear Medicine Department, Univ. Hospital IDIS, Santiago de Compostela, Spain
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland
- NIMTLab, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Allée du Morvan, Nancy, 54500, France
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Shibutani T, Onoguchi M, Kanno T, Kinuya S. Influence of spill-over for 99mTc images and the effect of scatter correction for dual-isotope simultaneous acquisition with 99mTc and 18F using small-animal SPECT-PET/CT system. Phys Eng Sci Med 2024; 47:135-142. [PMID: 37902935 DOI: 10.1007/s13246-023-01348-y] [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: 03/12/2023] [Accepted: 10/16/2023] [Indexed: 11/01/2023]
Abstract
A dual-isotope simultaneous acquisition (DISA) of 99mTc and 18F affects the image quality of 99mTc by crosstalk and spill-over from 18F. We demonstrated the influence of spill-over and crosstalk on image quality and its correction effect for DISA SPECT with 99mTc and 18F. A fillable cylindrical chamber of 30 mm with NEMA-NU4 image quality phantom was filled with 99mTc only or a mixed 99mTc and 18F solution (C100). Two small-region chambers were filled with 99mTc only or a mixed 99mTc and 18F solution made at half the radioactivity concentration of C100 (C50) and non-radioactive water (C0). The 18F/99mTc ratio for DISA was set at approximately 0.4-12. Two types of 99mTc transverse images with and without scatter correction (SC and nonSC) were created. The 99mTc images of single-isotope acquisition (SIA) were created as a reference. The DISA/SIA ratio and contrast of 99mTc were compared between SIA and DISA. Although the DISA/SIA ratios with nonSC of C100, C50 and C0 gradually increased with increasing 18F/99mTc ratio, it was nearly constant by SC. The contrasts of C100 and C50 were similar to a reference value for both nonSC and SC. In conclusion, DISA images showed lower image quality as the 18F/99mTc ratio increased. The image quality in hot-spot regions such as C100 and C50 was improved by SC, whereas cold-spot regions such as C0 could not completely remove the influence of spill-over even with SC.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
| | - Takayuki Kanno
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
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Sweet C, Shmuel N, Shoaf JN, Stoecklein M, Muthukrishnan A, Stern E, Nguyen NC. A Pictorial Review of I-123 MIBG Imaging of Neuroblastoma Utilizing a State-of-the-Art CZT SPECT/CT System. Nucl Med Mol Imaging 2024; 58:1-8. [PMID: 38250182 PMCID: PMC10796310 DOI: 10.1007/s13139-023-00825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 01/23/2024] Open
Abstract
The field of nuclear medicine is entering a new era of gamma-camera technology. Solid-state SPECT/CT systems will gradually replace the thallium-activated sodium-iodide NaI(Tl) systems. This digital technology allows drastic improvements in image quality, radiotracer dose reduction, and procedure efficiency. This pictorial review presents our initial experience on an NM/CT 870 CZT system (GE Healthcare), equipped with dual-head cadmium zinc telluride (CZT) detectors, for I-123 metaiodobenzylguanidine (MIBG) imaging in pediatric neuroblastoma. On planar imaging, CZT shows greater image quality than at conventional gamma-camera using the Infinia Hawkeye (GE Healthcare). Physiologic structures such as salivary glands and myocardium show sharper borders with a more notable signal-to-noise ratio at CZT than conventional gamma camera. On SPECT imaging, the CZT scanner, combined with resolution recovery, demonstrates either comparable or greater image quality at 80% of the conventional gamma camera’s acquisition time. Due to the 2.46-mm detector pixel with fully registered collimator holes matching each pixel and direct conversion of photons into electrical signals, the CZT gamma camera system provides significant advantages in photon localization and energy resolution.
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Affiliation(s)
- Cassidy Sweet
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | | | - Jennifer N. Shoaf
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | - Marcy Stoecklein
- Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | | | | | - Nghi C. Nguyen
- Department of Radiology, University of Texas, Southwestern Medical Center, Dallas, TX USA
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4
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Assante R, D'Antonio A, Mannarino T, Nappi C, Gaudieri V, Zampella E, Buongiorno P, Cantoni V, Green R, Frega N, Verberne HJ, Petretta M, Cuocolo A, Acampa W. Simultaneous assessment of myocardial perfusion and adrenergic innervation in patients with heart failure by low-dose dual-isotope CZT SPECT imaging. J Nucl Cardiol 2022; 29:3341-3351. [PMID: 35378694 PMCID: PMC9834348 DOI: 10.1007/s12350-022-02951-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/06/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND In patients with heart failure (HF) sequential imaging studies have demonstrated a relationship between myocardial perfusion and adrenergic innervation. We evaluated the feasibility of a simultaneous low-dose dual-isotope 123I/99mTc-acquisition protocol using a cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) camera. METHODS AND RESULTS Thirty-six patients with HF underwent simultaneous low-dose 123I-metaiodobenzylguanidine (MIBG)/99mTc-sestamibi gated CZT-SPECT cardiac imaging. Perfusion and innervation total defect sizes and perfusion/innervation mismatch size (defined by 123I-MIBG defect size minus 99mTc-sestamibi defect size) were expressed as percentages of the total left ventricular (LV) surface area. LV ejection fraction (EF) significantly correlated with perfusion defect size (P < .005), innervation defect size (P < .005), and early (P < .05) and late (P < .01) 123I-MIBG heart-to-mediastinum (H/M) ratio. In addition, late H/M ratio was independently associated with reduced LVEF (P < .05). Although there was a significant relationship (P < .001) between perfusion and innervation defect size, innervation defect size was larger than perfusion defect size (P < .001). At multivariable linear regression analysis, 123I-MIBG washout rate (WR) correlated with perfusion/innervation mismatch (P < .05). CONCLUSIONS In patients with HF, a simultaneous low-dose dual-isotope 123I/99mTc-acquisition protocol is feasible and could have important clinical implications.
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Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy.
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Cantoni
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Green
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Nicola Frega
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, 80131, Naples, Italy
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Yamada Y, Nakano S, Gatate Y, Okano N, Muramatsu T, Nishimura S, Kuji I, Fukushima K, Matsunari I. Feasibility of simultaneous 99mTc-tetrofosmin and 123I-BMIPP dual-tracer imaging with cadmium-zinc-telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction. J Nucl Cardiol 2021; 28:187-195. [PMID: 30603890 DOI: 10.1007/s12350-018-01585-9] [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: 10/22/2018] [Accepted: 12/17/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simultaneous dual-tracer imaging using isotopes with close photo-peaks may benefit from improved properties of cadmium-zinc-telluride (CZT)-based scanners. METHODS Thirty patients having undergone primary percutaneous coronary intervention for acute myocardial infarction underwent single-(99mTc-tetrofosmin (TF) or 123I-BMIPP first) followed by simultaneous 99mTc-TF /123I-BMIPP dual-tracer imaging using a Discovery NM/CT 670 CZT. The values for the quantitative gated-SPECT (QGS) and the quantitative perfusion SPECT (QPS) were assessed. RESULTS The intra-class correlation (ICC) coefficients between the single- and dual-tracer imaging were high in all the QGS and QPS data (Summed motion score: 0.95, summed thickening score: 0.94, ejection fraction: 0.98, SRS for 99mTc-TF: 0.97/ for 123I-BMIPP: 0.95). Wall motion, wall thickening and rest scores per coronary-territory-based regions were also comparable between the single- and dual imaging (ICC coefficient > 0.91). The interrater concordance in the visual analysis for the infarction and perfusion-metabolism mismatch was significant for the global and regional left ventricle (P < 0.001). CONCLUSION The quantitative/semi-quantitative values for global and regional left-ventricular function, perfusion, and fatty acid metabolism were closely comparable between the dual-tracer imaging and the single-tracer mode. These data suggests the feasibility of the novel CZT-based scanner for the simultaneous 99mTc-TF /123I-BMIPP dual-tracer acquisitions in clinical settings.
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Affiliation(s)
- Yoshihiro Yamada
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shintaro Nakano
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan.
| | - Youdou Gatate
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Nanami Okano
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
| | - Toshihiro Muramatsu
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shigeyuki Nishimura
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
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Shortened acquisition time in simultaneous 99mTc-tetrofosmin and 123I-β-methyl-p-iodophenyl pentadecanoic acid dual-tracer imaging with cadmium-zinc-telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction. Nucl Med Commun 2020; 40:1130-1137. [PMID: 31524763 DOI: 10.1097/mnm.0000000000001084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The use of cadmium-zinc-telluride-based scanners may increase the clinical feasibility of simultaneous dual-isotope imaging. In the current study, we sought to investigate a potential acquisition time in simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging using a Discovery NM/CT 670 cadmium-zinc-telluride. METHODS Simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-isotope imaging was performed in 29 patients who had undergone primary percutaneous coronary intervention for acute myocardial infarction. Referenced images with an acquisition time of 65 s/view (16.25 min) were reframed to produce images with acquisition times of 33, 16, and 8 s/view. The values for the quantitative-gated single-photon emission computed tomography (SPECT) and the quantitative perfusion SPECT were compared. RESULTS The quantitative-gated SPECT values for images with 33, 16, and 8 s/views showed good consistency with those for 65 s/view (the lower 95% confidence intervals for the intraclass correlation were ≥0.80). The quantitative perfusion SPECT values for Tc-tetrofosmin images with 33, 16, and 8 s/views also showed good consistency with those for 65 s/view; however, the quantitative perfusion SPECT values for I-β-methyl-p-iodophenyl pentadecanoic acid images with an acquisition time of 8 s/view were not consistent with the reference acquisition time of 65 s/view. CONCLUSIONS The quantitative-gated SPECT and quantitative perfusion SPECT values obtained from images with shorter acquisition times correlated with the values obtained from images with a reference acquisition time of 65 s/view; however, tracer-specific predisposition should be considered. These findings suggest that it is possible to reduce acquisition time when performing simultaneous Tc-tetrofosmin/I-β-methyl-p-iodophenyl pentadecanoic acid dual-tracer imaging with the novel cadmium-zinc-telluride scanner.
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Abstract
Molecular imaging enables both spatial and temporal understanding of the complex biologic systems underlying carcinogenesis and malignant spread. Single-photon emission tomography (SPECT) is a versatile nuclear imaging-based technique with ideal properties to study these processes in vivo in small animal models, as well as to identify potential drug candidates and characterize their antitumor action and potential adverse effects. Small animal SPECT and SPECT-CT (single-photon emission tomography combined with computer tomography) systems continue to evolve, as do the numerous SPECT radiopharmaceutical agents, allowing unprecedented sensitivity and quantitative molecular imaging capabilities. Several of these advances, their specific applications in oncology as well as new areas of exploration are highlighted in this chapter.
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Affiliation(s)
- Benjamin L Franc
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H2232, MC 5281, Stanford, CA, 94305-5105, USA.
| | - Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Robert Flavell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Carina Mari Aparici
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H2232, MC 5281, Stanford, CA, 94305-5105, USA
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Comparative Cardiac Phantom Study Using Tc-99m/I-123 and Tl-201/I-123 Tracers with Cadmium-Zinc-Telluride Detector-Based Single-Photon Emission Computed Tomography. Nucl Med Mol Imaging 2019; 53:57-63. [PMID: 30828402 DOI: 10.1007/s13139-018-0559-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 11/08/2018] [Accepted: 12/04/2018] [Indexed: 12/25/2022] Open
Abstract
Objective A recently introduced single-photon emission computed tomography (SPECT), based on cadmium-zinc-telluride (CZT) detectors (D-SPECT), supports high energy resolution for cardiac imaging. Importantly, the high energy resolution may allow simultaneous dual-isotope (SDI) imaging (e.g., using Tc-99m and I-123). We quantitatively evaluated Tc-99m/I-123 SDI imaging by D-SPECT in comparison with conventional T1-201/I-123. Materials and Methods Energy resolution was measured as a percentage of the full width at half maximum (FWHM) for Tc-99m, I-123, and Tl-201. The impact of cross-talk and reconstructed image contrast were quantified by measuring the contrast-to-noise ratio (CNR), and the transmural defect contrast in the left ventricle wall (C TD) induced by a difference in energy, for combinations of Tc-99m/I-123 or Tl-201/I-123, using an RH-2 cardiac phantom. Corresponding measurement was also carried out in Anger SPECT (A-SPECT). Results The energy resolution of the D-SPECT system was 5.4%/5.1% for Tc-99m/I-123 and 5.4%/5.3% for Tl-201/I-123, which was approximately two times higher than the A-SPECT. No notable difference was confirmed in the CNRs of the two systems, but T1-201/I-123 showed overall higher value than Tc-99m/I-123. Compared to A-SPECT, C TD of D-SPECT significantly increased with both Tc-99m/I-123 and T1-201/I-123 (p < 0.05). In DSPECT, the combination of Tc-99m/I-123 had a slightly better C TD than T1-201/I-123. In addition, C TD of Tc-99m/I-123 was improved with scatter correction at both nuclides (p < 0.05), but in Tl-201/I-123, no significant improvement was confirmed in I-123 (p > 0.05). Conclusion D-SPECT was considered to be capable of performing high-quality SDI imaging using Tc-99m/I-123.
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Miyazaki Y, Kato Y, Imoto A, Fukuchi K. Imaging of the thyroid and parathyroid using a cardiac cadmium zinc telluride camera: Phantom studies. J Nucl Med Technol 2017; 46:jnmt.117.199042. [PMID: 29127244 DOI: 10.2967/jnmt.117.199042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 09/23/2017] [Indexed: 11/16/2022] Open
Abstract
Purpose: Cadmium zinc telluride (CZT) detectors have recently been introduced to the field of clinical nuclear cardiology. However, the feasibility of using them for organs other than the heart remains unclear. The aim of this study was to evaluate the potential of a cardiac CZT camera to acquire thyroid and parathyroid images. We used custom-made phantoms and the currently available standard protocols for CZT, instead of a sodium-iodine scintillation (NaI) camera. Materials and Methods: Thyroid phantoms with or without parathyroid adenomas were made from agar using radiopharmaceuticals (99mTc or 123I) and imaged using CZT and NaI cameras. Using the CZT camera data, we prepared maximum intensity projection (MIP) images and planar equivalent (PE) images. Image counts were compared to those from the NaI camera, and the radioactivity of the phantoms was measured. For parathyroid imaging, three different protocols with the NaI camera were tested using MIP images. Results: For thyroid imaging, MIP could provide images as clear as those obtained from the NaI camera. The radioactivity and image counts correlated better for the PE images than the MIP images, especially for 123I images. We succeeded in obtaining clear parathyroid adenoma images from MIP images using all three protocols. Conclusion: A cardiac CZT camera can effectively perform qualitative and quantitative assessments of the thyroid and parathyroid organs.
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11
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Henzlova MJ, Duvall WL. What do we know? What do we need to know? J Nucl Cardiol 2017; 24:252-254. [PMID: 27535415 DOI: 10.1007/s12350-016-0640-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Milena J Henzlova
- Division of Cardiology, Mount Sinai Medical Center, New York, NY, USA
| | - W Lane Duvall
- Division of Cardiology, Hartford Hospital, Hartford, CT, USA.
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