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Wang R, Zhang D, Hu Y, Lyu Z, Ma T. High-sensitivity cardiac SPECT system design with collimator-less interspaced mosaic-patterned scintillators. Front Med (Lausanne) 2023; 10:1145351. [PMID: 37448793 PMCID: PMC10336213 DOI: 10.3389/fmed.2023.1145351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/02/2023] [Indexed: 07/15/2023] Open
Abstract
Purpose Single-photon emission computed tomography (SPECT) is an important tool for myocardial perfusion imaging (MPI). Mechanical collimators cause the resolution-sensitivity trade-off in the existing cardiac SPECT systems, which hinders fast cardiac scan capability. In this work, we propose a novel collimator-less cardiac SPECT system with interspaced mosaic-patterned scintillators, aiming to significantly improve sensitivity and reduce scan time without trading-off image resolution. Methods We propose to assemble a collimator-less cardiac SPECT with 7 mosaic-patterned detector modules forming a half-ring geometry. The detector module consists of 10 blocks, each of which is assembled with 768 sparsely distributed scintillators with a size of 1.68 mm × 1.68 mm × 20 mm, forming a mosaic pattern in the trans-axial direction. Each scintillator bar contains 5 GAGG(Ce) scintillators and 5 optical-guide elements, forming a mosaic pattern in the axial direction. In the Monte Carlo simulations, the in-plane resolution and axial resolution are evaluated using a hot-rod phantom and 5 disk phantoms, respectively. We simulate a cardiac phantom that is placed in a water-filled cylinder and evaluate the image performance with different data acquisition time. We perform image reconstruction with the expectation-maximization algorithm using system matrices derived from the simulation of a uniform cylindrical source filling the field-of-view (FOV). Besides, a 2-D prototype system is designed to demonstrate the feasibility of the collimator-less imaging concept. Results In the simulation system, the sensitivity is 16.31% ± 8.85% in a 180 mm (Φ) × 100 mm (L) FOV. The 6-mm rods in the hot rod phantom and the 5-mm disks in the disk phantom are clearly separable. Satisfactory MPI image quality is achieved in the cardiac phantom study with an acquisition time of 30 s. In prototype experiments, the point sources with an 8 mm center-to-center distance are clearly separable at different positions across the FOV. Conclusion The study reveals a promising approach to high-sensitivity SPECT imaging without a heavy-metal collimator. In cardiac imaging, this approach opens the way to a very fast cardiac scan with good resolution. Further works are ongoing to build a practical 3-D imaging system based on the existing design.
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Affiliation(s)
- Rui Wang
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
- Institute for Precision Medicine, Tsinghua University, Beijing, China
| | - Debin Zhang
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
- Institute for Precision Medicine, Tsinghua University, Beijing, China
| | - Yifan Hu
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
- Institute for Precision Medicine, Tsinghua University, Beijing, China
| | - Zhenlei Lyu
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
- Institute for Precision Medicine, Tsinghua University, Beijing, China
| | - Tianyu Ma
- Department of Engineering Physics, Tsinghua University, Beijing, China
- Key Laboratory of Particle and Radiation Imaging, Ministry of Education (Tsinghua University), Beijing, China
- Institute for Precision Medicine, Tsinghua University, Beijing, China
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Krizsan AK, Kukuts K, Al-Muhanna W, Szoboszlai Z, Balazs L, Szabo B, Kiss J, Nekolla S, Barna S, Garai I, Bukki T, Forgacs A. Performance evaluation of a novel multi-pinhole collimator on triple-NaI-detector SPECT/CT for dedicated myocardial imaging. EJNMMI Phys 2023; 10:24. [PMID: 36964406 PMCID: PMC10039219 DOI: 10.1186/s40658-023-00541-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/01/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND In this study we evaluated the imaging capabilities of a novel Multi-pinhole collimator (MPH-Cardiac) specially designed for nuclear cardiology imaging on a Triple-NaI-detector based SPECT/CT system. METHODS 99mTc point source measurements covering the field of view (FOV) were used to determine tomographic sensitivity (TSpointsource) and spatial resolution. Organ-size tomographic sensitivity (TSorgan) was measured with a left ventricle (LV) phantom filled with typical myocardial activity of a patient scan. Reconstructed image uniformity was measured with a 140 mm diameter uniform cylinder phantom. Using the LV phantom once filled with 99mTc and after with 123I, Contrast-to-noise ratio (CNR) was measured on the reconstructed images by ROI analysis on the myocardium activity and on the LV cavity. Furthermore, a polar map analysis was performed determining Spill-Over-Ratio in water (SORwater) and image noise. The results were compared with that of a dual-head parallel-hole low energy high resolution (LEHR) collimator system. A patient with suspected coronary artery disease (CAD) was scanned on the LEHR system using local protocol of 16 min total acquisition time, followed by a 4-min MPH-Cardiac scan. RESULTS Peak TSpointsource was found to be 1013 cps/MBq in the axial center of the FOV while it was decreasing toward the radial edges. TSorgan in the CFOV was found to be 134 cps/MBq and 700 cps/MBq for the LEHR and MPH-Cardiac, respectively. Average spatial resolution throughout the FOV was 4.38 mm FWHM for the MPH-Cardiac collimator. Reconstructed image uniformity values were found to be 0.292% versus 0.214% for the LEHR and MPH-Cardiac measurements, respectively. CNR was found to be higher in case of MPH-Cardiac than for LEHR in case of 99mTc (15.5 vs. 11.7) as well as for 123I (13.5 vs. 8.3). SORwater values were found to be 28.83% and 21.1% for the 99mTc measurements, and 31.44% and 24.33% for the 123I measurements for LEHR and MPH-Cardiac, respectively. Pixel noise of the 99mTc polar maps resulted in values of 0.38% and 0.24% and of the 123I polar maps 0.62% and 0.21% for LEHR and MPH-Cardiac, respectively. Visually interpreting the patient scan images, MPH-Cardiac resulted in better image contrast compared to the LEHR technique with four times shorter scan duration. CONCLUSIONS The significant image quality improvement achieved with dedicated MPH-Cardiac collimator on triple head SPECT/CT system paves the way for short acquisition and low-dose cardiovascular SPECT applications.
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Affiliation(s)
- Aron K Krizsan
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary.
| | - Kornel Kukuts
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
| | - Walid Al-Muhanna
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
| | - Zoltan Szoboszlai
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
| | | | | | - Janos Kiss
- Medical Imaging Clinic - Radiology, Clinical Center, University of Debrecen, Debrecen, Hungary
| | - Stephan Nekolla
- Nuklearmedizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technische Universitӓt München, München, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Sandor Barna
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
- Mediso Ltd., Budapest, Hungary
- Department of Medical Imaging, Division of Nuclear Medicine and Translational Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildiko Garai
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
- Mediso Ltd., Budapest, Hungary
- Department of Medical Imaging, Division of Nuclear Medicine and Translational Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Attila Forgacs
- ScanoMed Nuclear Medicine Centers, Nagyerdei Krt. 98, Debrecen, 4032, Hungary
- Mediso Ltd., Budapest, Hungary
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Mendoza-Ibañez OI, Martínez-Lucio TS, Alexanderson-Rosas E, Slart RH. SPECT in Ischemic Heart Diseases. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Shibutani T, Nakajima K, Yoneyama H, Konishi T, Okuda K, Onoguchi M, Kinuya S. The utility of heart-to-mediastinum ratio using a planar image created from IQ-SPECT with Iodine-123 meta-iodobenzylguanidine. J Nucl Cardiol 2021; 28:2569-2577. [PMID: 32103408 DOI: 10.1007/s12350-020-02081-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/10/2020] [Indexed: 10/24/2022]
Abstract
AIMS 123I-labeled meta-iodobenzylguanidine (MIBG) has used a planar image to measure the heart-to-mediastinum ratio (HMR). However, planar images are not available from IQ-SPECT with SMARTZOOM collimator due to its multi-focal collimation. Since we created the planar-equivalent (IQ-planar) images by adding all slices of the IQ-SPECT coronal image. The aim of this study was to demonstrate the utility of the new method for calculating HMR. METHODS The planar image and transverse images of IQ-SPECT with attenuation and scatter corrections (ACSC) and without ACSC (NC) were obtained. Multi-planar reconstruction and ray-summation processing were applied to create IQ-planar images with NC and ACSC. Linear regression between the measured HMR from the planar image and the mathematically calculated HMR was used to calibrate HMR to standardized values. RESULTS Scatterplots and linear regression lines between planar and IQ-planar HMRs before and after cross-calibration showed systematic differences in both NC and ACSC conditions. The IQ-planar HMR with NC and ACSC was significantly higher compared with that of the conventional planar image. However, the IQ-planar HMR with NC and ACSC after cross-calibration was similar to the standardized HMR calculated by planar image. CONCLUSION The IQ-planar HMR using the new ray-summation processing method could be used along with the conventional planar HMR.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan.
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takahiro Konishi
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Ishikawa, 920-8641, Japan
| | - Koichi Okuda
- Department of Physics, Kanazawa Medical University, Uchinada, Kahoku, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
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Karády J, Mayrhofer T, Ivanov A, Foldyna B, Lu MT, Ferencik M, Pursnani A, Salerno M, Udelson JE, Mark DB, Douglas PS, Hoffmann U. Cost-effectiveness Analysis of Anatomic vs Functional Index Testing in Patients With Low-Risk Stable Chest Pain. JAMA Netw Open 2020; 3:e2028312. [PMID: 33315111 PMCID: PMC7737090 DOI: 10.1001/jamanetworkopen.2020.28312] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Both noninvasive anatomic and functional testing strategies are now routinely used as initial workup in patients with low-risk stable chest pain (SCP). OBJECTIVE To determine whether anatomic approaches (ie, coronary computed tomography angiography [CTA] and coronary CTA supplemented with noninvasive fractional flow reserve [FFRCT], performed in patients with 30% to 69% stenosis) are cost-effective compared with functional testing for the assessment of low-risk SCP. DESIGN, SETTING, AND PARTICIPANTS This cost-effectiveness analysis used an individual-based Markov microsimulation model for low-risk SCP. The model was developed using patient data from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial. The model was validated by comparing model outcomes with outcomes observed in the PROMISE trial for anatomic (coronary CTA) and functional (stress testing) strategies, including diagnostic test results, referral to invasive coronary angiography (ICA), coronary revascularization, incident major adverse cardiovascular event (MACE), and costs during 60 days and 2 years. The validated model was used to determine whether anatomic approaches are cost-effective over a lifetime compared with functional testing. EXPOSURE Choice of index test for evaluation of low-risk SCP. MAIN OUTCOMES AND MEASURES Downstream ICA and coronary revascularization, MACE (death, nonfatal myocardial infarction), cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) of competing strategies. RESULTS The model cohort included 10 003 individual patients (median [interquartile range] age, 60.0 [54.4-65.9] years; 5270 [52.7%] women; 7693 [77.4%] White individuals), who entered the model 100 times. The Markov model accurately estimated the test assignment, results of anatomic and functional index testing, referral to ICA, revascularization, MACE, and costs at 60 days and 2 years compared with observed data in PROMISE (eg, coronary CTA: ICA, 12.2% [95% CI, 10.9%-13.5%] vs 12.3% [95% CI, 12.2%-12.4%]; revascularization, 6.2% [95% CI, 5.5%-6.9%] vs 6.4% [95% CI, 6.3%-6.5%]; functional strategy: ICA, 8.1% [95% CI, 7.4%-8.9%] vs 8.2% [95% CI, 8.1%-8.3%]; revascularization, 3.2% [95% CI, 2.7%-3.7%] vs 3.3% [95% CI, 3.2%-3.4%]; 2-year MACE rates: coronary CTA, 2.1% [95% CI, 1.7%-2.5%] vs 2.3% [95% CI, 2.2%-2.4%]; functional strategy, 2.2% [95% CI, 1.8%-2.6%] vs 2.4% [95% CI, 2.3%-2.4%]). Anatomic approaches led to higher ICA and revascularization rates at 60 days, 2 years, and 5 years compared with functional testing but were more effective in patient selection for ICA (eg, 60-day revascularization-to-ICA ratio, CTA: 53.7% [95% CI, 53.3%-54.0%]; CTA with FFRCT: 59.5% [95% CI, 59.2%-59.8%]; functional testing: 40.7% [95% CI, 40.4%-50.0%]). Over a lifetime, anatomic approaches gained an additional 6 months in perfect health compared with functional testing (CTA, 25.16 [95% CI, 25.14-25.19] QALYs; CTA with FFRCT, 25.14 [95% CI, 25.12-25.17] QALYs; functional testing, 24.68 [95% CI, 24.66-24.70] QALYs). Anatomic strategies were less costly and more effective; thus, CTA with FFRCT dominated and CTA alone was cost-effective (ICERs ranged from $1912/QALY for women and $3,559/QALY for men) compared with functional testing. In probabilistic sensitivity analyses, anatomic approaches were cost-effective in more than 65% of scenarios, assuming a willingness-to-pay threshold of $100 000/QALY. CONCLUSIONS AND RELEVANCE The results of this study suggest that anatomic strategies may present a more favorable initial diagnostic option in the evaluation of low-risk SCP compared with functional testing.
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Affiliation(s)
- Júlia Karády
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Thomas Mayrhofer
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
- School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany
| | - Alexander Ivanov
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Borek Foldyna
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Michael T. Lu
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Maros Ferencik
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland
| | - Amit Pursnani
- Cardiology Division, Evanston Hospital, Evanston, Illinois
| | - Michael Salerno
- Departments of Medicine and Radiology, University of Virginia Health System, Charlottesville
| | - James E. Udelson
- Division of Cardiology, Tufts Medical Center, Boston, Massachusetts
| | - Daniel B. Mark
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Pamela S. Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Udo Hoffmann
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
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Ronkainen AP, Eneh CTM, Linder PH, Hippeläinen E, Heikkinen JO. Assessment of ejection fraction and heart perfusion using myocardial perfusion single-photon emission computed tomography in Finland and Estonia: a multicenter phantom study. Nucl Med Commun 2020; 41:888-895. [PMID: 32796477 DOI: 10.1097/mnm.0000000000001234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Myocardial SPECT/CT imaging is frequently performed to assess myocardial perfusion and dynamic parameters of heart function, such as ejection fraction (EF). However, potential pitfalls exist in the imaging chain that can unfavorably affect diagnosis and treatment. We performed a national cardiac quality control study to investigate how much SPECT/CT protocols vary between different nuclear medicine units in Finland, and how this may affect the heart perfusion and EF values. METHODS Altogether, 21 nuclear medicine units participated with 27 traditional SPECT/CT systems and two cardiac-centered IQ-SPECT systems. The reproducibility of EF and the uniformity of perfusion were studied using a commercial dynamic heart phantom. SPECT/CT acquisitions were performed and processed at each participating unit using their own clinical protocol and with a standardized protocol. The effects of acquisition protocols and analysis routines on EF estimates and uniformity of perfusion were studied. RESULTS Considerable variation in EF estimates and in the uniformity of perfusion were observed between the units. Uniformity of perfusion was improved in some units after applying the higher count-statistic standard acquisition protocol. EF estimates varied more due to differences in analysis routines than as a result of different acquisition protocols. The results obtained with the two IQ-SPECT systems differed substantially from the traditional multipurpose cameras. CONCLUSION On average, the EF and heart perfusion were accurately estimated by SPECT/CT, but high errors could be produced if the acquisition and analysis routines were poorly optimized. Eight of the 21 participants altered their imaging protocol after this quality control tour.
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Affiliation(s)
- Ari-Petteri Ronkainen
- Department of Medical Physics, The Social and Health Care Authority of South Savo, Mikkeli Central Hospital, Mikkeli
- Department of Nuclear Medicine and Clinical Physiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio
| | - Chibuzor T M Eneh
- Department of Medical Physics, The Social and Health Care Authority of South Savo, Mikkeli Central Hospital, Mikkeli
- Department of Medical Physics, Division of Medical Imaging, Turku University Hospital, Turku
| | - Pia H Linder
- Department of Medical Physics, The Social and Health Care Authority of South Savo, Mikkeli Central Hospital, Mikkeli
- Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio
| | - Eero Hippeläinen
- HUS, Medical Imaging Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Jari O Heikkinen
- Department of Medical Physics, The Social and Health Care Authority of South Savo, Mikkeli Central Hospital, Mikkeli
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Karády J, Taron J, Kammerlander AA, Hoffmann U. Outcomes of anatomical vs. functional testing for coronary artery disease : Lessons from the major trials. Herz 2020; 45:421-430. [PMID: 32504209 DOI: 10.1007/s00059-020-04950-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] [Indexed: 11/29/2022]
Abstract
Management of patients presenting with suspected stable coronary artery disease (CAD) are challenging because estimation of pretest probability for obstructive CAD remains difficult. In addition, identification of those who benefit from coronary revascularization remains ineffective regardless of the wide array of noninvasive testing alternatives available. Functional testing, which has long been considered to be the test of choice to risk stratify these patients, shows modest agreement with CAD severity detected by invasive coronary angiography and has been reported to be ineffective in settings of low prevalence of obstructive CAD. A growing body of evidence demonstrates the excellent diagnostic accuracy as well as prognostic value of coronary computed tomography (CT) angiography especially in conjunction with noninvasive fractional flow reserve (FFR) testing, challenging the primary role of functional testing especially in patients without prior or known CAD. Landmark trials, including the Prospective Multicenter Imaging Study for Evaluation of chest pain (PROMISE) and Scottish Computed Tomography of the Heart (SCOT-HEART), have contributed to a better understanding of how coronary CT angiography may play a role in more efficient management and even improved health outcomes. The emerging role of coronary CT has been acknowledged by the 2019 Guidelines of the European Society of Cardiology recommending the use of CT as a first-line tool for the evaluation of patients with stable chest pain with a class I, level of evidence B recommendation. The purpose of this article is to provide an overview on existing evidence, clinical implication, limitations of available data, and remaining questions to be answered by future research.
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Affiliation(s)
- Júlia Karády
- Cardiovascular Imaging Research Center, Massachusetts General Hospital-Harvard Medical School, 165 Cambridge St Suite 400, 02114, Boston, MA, USA.
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Jana Taron
- Cardiovascular Imaging Research Center, Massachusetts General Hospital-Harvard Medical School, 165 Cambridge St Suite 400, 02114, Boston, MA, USA
- Department of Radiology, Freiburg University Hospital, Freiburg, Germany
| | - Andreas Anselm Kammerlander
- Cardiovascular Imaging Research Center, Massachusetts General Hospital-Harvard Medical School, 165 Cambridge St Suite 400, 02114, Boston, MA, USA
- Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Udo Hoffmann
- Cardiovascular Imaging Research Center, Massachusetts General Hospital-Harvard Medical School, 165 Cambridge St Suite 400, 02114, Boston, MA, USA
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Shibutani T, Okuda K, Ichikawa H, Kato T, Miwa K, Tsushima H, Onoguchi M, Nagaki A. Imaging technology for myocardial perfusion single-photon emission computed tomography 2018 in Japan. Jpn J Radiol 2020; 38:274-282. [PMID: 31919636 DOI: 10.1007/s11604-019-00915-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022]
Abstract
AIM Recently, nuclear cardiology has dramatically advanced by a new technology development such as the device, short-term acquisition system, image reconstruction algorithm and image analysis. Although these innovations have been gradually employed in routine examinations, we did not investigate the current use of image acquisition, image reconstruction, and image analysis with myocardial perfusion single-photon emission computed tomography (MPS). We investigated the current status of MPS imaging technology in Japan. METHODS We carried out a survey using a Web-based questionnaire system, the opening of which was announced via e-mail, and it was available on a website for 3 months. We collected data on the current use of MPS with 201Tl and/or 99mTc agents with respect to routine protocols, image acquisition, image reconstruction, and image analysis. RESULTS We received responses to the Web-based questionnaire from 178 and 174 people for 99mTc and 201Tl MPS, respectively. The routine protocols of MPS of stress-rest and rest-stress MPS on 1-day protocols with 99mTc were 41.2% and 14.5%, respectively, and the rest-only scan response rate was 23.7%, whereas that of 201Tl MPS was 65.9% with stress-rest MPS, 19.0% with rest-only MPS, and 10.9% with stress-rest MPS adding a rest scan 24 h after injection. The filtered back projection (FBP) method is most commonly used image reconstruction method, yielding 70.5% for 99mTc MPS and 76.8% for 201Tl MPS, including combined FBP and ordered subset expectation maximization method. The results for no-correction (NC) images were 49.2% with 99mTc MPS and 55.2% with 201Tl MPS including the response of NC and combined attenuation correction (AC) and scatter correction (SC) (i.e., ACSC) images. The AC or ACSC images of 99mTc and 201Tl were provided by 30-40% of the institutions surveyed. CONCLUSIONS We investigated the current status of MPS imaging technology in Japan, and found that although the use of various technical developments has been reported, some of these technologies have not been utilized effectively. Hence, we expect that nuclear medicine technology will be used more effectively to improve diagnosis.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan.
| | - Koichi Okuda
- Department of Physics, Kanazawa Medical University, Kahoku, Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Toyohiro Kato
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, International University of Health and Welfare, Ohtawara, Japan
| | - Hiroyuki Tsushima
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Akio Nagaki
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan
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Pelletier-Galarneau M, Finnerty V, Tan S, Authier S, Gregoire J, Harel F. Assessment of left ventricular ejection fraction with cardiofocal collimators: Comparison between IQ-SPECT, planar equilibrium radionuclide angiography, and cardiac magnetic resonance. J Nucl Cardiol 2019; 26:1857-1864. [PMID: 29520572 DOI: 10.1007/s12350-018-1251-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/26/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND IQ-SPECT has been shown to significantly reduce acquisition time and administered dose while preserving image quality in myocardial perfusion imaging. Whether IQ-SPECT provides accurate left ventricular ejection fractions (LVEF) with gated blood pool SPECT (GBPS) remains unknown. METHODS Sixty patients underwent IQ-SPECT GBPS and planar imaging. Among those patients, 11 underwent both cMRI and GBPS. GBPS LVEF, LVEDV, and LVESV were calculated using 2 validated software; QBS (Cedars-Sinai Medical Center, Los Angeles, USA) and MHI (Montreal Heart Institute, Montreal, Canada). LVEF, LVEDV, and LVESV obtained with the different modalities were compared. RESULTS Average planar LVEF was 48 ± 11% (mean ± SD), average LVEDV was 177 ± 59 mL (range 63 to 342 mL), and average LVESV was 96 ± 46 mL (range 16 to 234 mL). GBPS LVEF and their correlation coefficient with planar LVEF were 40 ± 12% (r = 0.70) and 44 ± 12% (r = 0.83) with QBS and MHI, respectively. Correlation coefficient between cMRI and planar LVEF was 0.65 and were 0.69 and 0.52 between cMRI and GBPS using QBS and MHI, respectively. CONCLUSIONS LVEF calculated with GBPS using IQ-SPECT correlates with planar measurements. Correlation is best using the MHI method and variation is independent of LVEDV.
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Affiliation(s)
- Matthieu Pelletier-Galarneau
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada.
| | - Vincent Finnerty
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada
| | - Stephanie Tan
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada
| | - Sebastien Authier
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada
| | - Jean Gregoire
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada
| | - Francois Harel
- Department of Radiology and Nuclear Medicine, Montreal Heart Institute, 5000 Belanger, Montreal, QC, H1T1C8, Canada
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10
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Rosenberg RD, Patil PV. Multimodality imaging of the left ventricle: Choosing soundly. J Nucl Cardiol 2019; 26:1865-1868. [PMID: 29752640 DOI: 10.1007/s12350-018-1294-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 04/23/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Russell D Rosenberg
- Section of Cardiology, Department of Medicine, Lewis Katz School of Medicine at Temple University, 9th Floor Parkinson Pavilion, 3401 N. Broad Street, Philadelphia, PA, 19140, USA
| | - Pravin V Patil
- Section of Cardiology, Department of Medicine, Lewis Katz School of Medicine at Temple University, 9th Floor Parkinson Pavilion, 3401 N. Broad Street, Philadelphia, PA, 19140, USA.
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11
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Thibault F, Bailly M, Le Rouzic G, Metrard G. Clinical evaluation of General Electric new Swiftscan solution in bone scintigraphy on NaI-camera: A head to head comparison with Siemens Symbia. PLoS One 2019; 14:e0222490. [PMID: 31536519 PMCID: PMC6752842 DOI: 10.1371/journal.pone.0222490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/30/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The General Electric (GE) Swiftscan solution combines a new Low Energy High Resolution and Sensitivity collimator (LEHRS) with image processing (Clarity 2D) and tomographic step and shoot continuous mode. The aim of this study was to compare clinical and physical performances of this new technology in bone scintigraphy. METHODS Physical phantom measurements were performed using GE LEHRS, GE Low Energy High Resolution (LEHR) and Siemens LEHR collimators. These measurements were associated with a prospective clinical study. Sixty-seven patients referred for bone scintigraphy were enrolled from February to July 2018. Each patient underwent two acquisitions consecutively on GE and Siemens gamma camera, using respectively Swiftscan solution and LEHR collimator. RESULTS On planar acquisitions, maximum sensitivity was 100 cts/MBq for Siemens LEHR. GE SwiftScan LEHRS and GE LEHR maximum sensitivity were respectively 9% and 22% lower. Using Clarity 2D, GE Swiftscan LEHRS spatial resolution was the best with 9.2 mm versus 10.1 mm and 10.6 mm for GE LEHR and Siemens LEHR collimators. In tomographic mode, the sensitivity of GE Swiftscan solution was superior to both LEHR systems (16% and 25% respectively for Siemens and GE). There was no significant difference in spatial resolution. In clinical use, signal was higher on Siemens system and noise was lower on GE Swiftscan solution. Contrast-to-noise ratios were not significantly different between the two systems. There was a significant image quality improvement with GE SwiftScan in planar images and in whole body scan. No significant difference in image quality was observed on SPECT images. CONCLUSION New GE SwiftScan collimator design improved sensitivity compared to "classical" GE LEHR collimator without compromising resolution. GE SwiftScan solution enhances planar image quality with a better Clarity 2D resolution recovery and noise treatment. In SPECT mode, GE SwiftScan solution improves volumetric sensitivity without significant impact on image quality, and could lead to time or dose reduction.
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Affiliation(s)
- F. Thibault
- Nuclear Medicine Department, CHR Orléans, ORLEANS, FRANCE
| | - M. Bailly
- Nuclear Medicine Department, CHR Orléans, ORLEANS, FRANCE
| | - G. Le Rouzic
- Nuclear Medicine Department, CHR Orléans, ORLEANS, FRANCE
| | - G. Metrard
- Nuclear Medicine Department, CHR Orléans, ORLEANS, FRANCE
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12
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Hyafil F, Gimelli A, Slart RHJA, Georgoulias P, Rischpler C, Lubberink M, Sciagra R, Bucerius J, Agostini D, Verberne HJ. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. Eur J Hybrid Imaging 2019; 3:11. [PMID: 34191169 PMCID: PMC8218102 DOI: 10.1186/s41824-019-0058-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/10/2019] [Indexed: 01/28/2023] Open
Abstract
An increasing number of Nuclear Medicine sites in Europe are using cardiac-centered gamma cameras for myocardial perfusion scintigraphy (MPS). Three cardiac-centered gamma cameras are currently the most frequently used in Europe: the D-SPECT (Spectrum Dynamics), the Alcyone (Discovery NM 530c and Discovery NM/CT 570c; General Electric Medical Systems), and the IQ-SPECT (Siemens Healthcare). The increased myocardial count sensitivity of these three cardiac-centered systems has allowed for a decrease in the activities of radiopharmaceuticals injected to patients for myocardial perfusion imaging and, consequently, radiation exposure of patients. When setting up protocols for MPS, the overall objective should be to maintain high diagnostic accuracy of MPS, while injecting the lowest activities reasonably achievable to reduce the level of radiation exposure of patient and staff. These guidelines aim at providing recommendations for acquisition protocols and image interpretation using cardiac-centered cameras. As each imaging system has specific design and features for image acquisition and analysis, these guidelines have been separated into three sections for each gamma camera system. These recommendations have been written by the members of the Cardiovascular Committee of EANM and were based on their own experience with each of these systems and on the existing literature.
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Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine; Bichat University Hospital, Assistance Publique - Hôpitaux de Paris; Inserm UMR 1148, Paris Diderot-Paris 7 University, 46 rue Henri Huchard, 75018, Paris, France.
| | | | - Riemer H J A Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.,TechMed Centre, Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mark Lubberink
- Department of Medical Physics and PET Centre, Uppsala University Hospital, Uppsala, Sweden
| | - Roberto Sciagra
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Jan Bucerius
- Department of Nuclear Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Denis Agostini
- Department of Nuclear Medicine, CHU Caen Normandy University, Caen, France
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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13
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Abstract
Cardiac SPECT continues to play a critical role in detecting and managing cardiovascular disease, in particularly coronary artery disease (CAD) (Jaarsma et al 2012 J. Am. Coll. Cardiol. 59 1719-28), (Agostini et al 2016 Eur. J. Nucl. Med. Mol. Imaging 43 2423-32). While conventional dual-head SPECT scanners using parallel-hole collimators and scintillation crystals with photomultiplier tubes are still the workhorse of cardiac SPECT, they have the limitations of low photon sensitivity (~130 count s-1 MBq-1), poor image resolution (~15 mm) (Imbert et al 2012 J. Nucl. Med. 53 1897-903), relatively long acquisition time, inefficient use of the detector, high radiation dose, etc. Recently our field observed an exciting growth of new developments of dedicated cardiac scanners and collimators, as well as novel imaging algorithms for quantitative cardiac SPECT. These developments have opened doors to new applications with potential clinical impact, including ultra-low-dose imaging, absolute quantification of myocardial blood flow (MBF) and coronary flow reserve (CFR), multi-radionuclide imaging, and improved image quality as a result of attenuation, scatter, motion, and partial volume corrections (PVCs). In this article, we review the recent advances in cardiac SPECT instrumentation and imaging methods. This review mainly focuses on the most recent developments published since 2012 and points to the future of cardiac SPECT from an imaging physics perspective.
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Affiliation(s)
- Jing Wu
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, United States of America
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14
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Denisova NV, Ansheles AA. A study of false apical defects in myocardial perfusion imaging with SPECT/CT. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aae414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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15
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Characteristics of iodine-123 IQ-SPECT/CT imaging compared with conventional SPECT/CT. Ann Nucl Med 2018; 33:103-111. [PMID: 30324427 DOI: 10.1007/s12149-018-1310-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/08/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Although the utility of IQ-SPECT imaging using 99mTc and 201Tl myocardial perfusion SPECT has been reported, 123I-labeled myocardial SPECT has not been fully evaluated. We determined the characteristics and utility of 123I IQ-SPECT imaging compared with conventional SPECT (C-SPECT). METHODS Two myocardial phantom patterns were used to simulate normal myocardium and myocardial infarction. SPECT acquisition was performed using a hybrid dual-head SPECT/CT system equipped with a SMARTZOOM collimator for IQ-SPECT or a low-medium energy general purpose collimator for C-SPECT. Projection data were reconstructed using ordered subset expectation maximization with depth-dependent 3-dimensional resolution recovery for C-SPECT and ordered subset conjugate gradient minimizer method for IQ-SPECT. Three types of myocardial image were created; namely, no correction (NC), with attenuation correction (AC), and with both attenuation and scatter corrections (ACSC). Five observers visually scored the homogeneity of normal myocardium and defect severity of the myocardium with inferior defects by a five-point scale: homogeneity scores (5 = homogeneous to 1 = inhomogeneous) and defect scores (5 = excellent to 1 = poor). We also created a 17-segment polar map and quantitatively assessed segmental %uptake using a myocardial phantom with normal findings and defects. RESULTS The average visual homogeneity scores of the IQ-SPECT with NC and ACSC were significantly higher than that of C-SPECT, whereas the average visual defect scores of IQ-SPECT with AC and ACSC were significantly lower. The %uptake of all segments for IQ-SPECT with NC was significantly higher than that of C-SPECT. Furthermore, the subtraction of %uptake for C-SPECT and IQ-SPECT was the largest in inferior wall, which was approximately 10.1%, 14.7% and 14.4% for NC, AC and ACSC, respectively. The median % uptake values of the inferior wall with defect areas for C-SPECT and IQ-SPECT were 46.9% and 50.7% with NC, 59.8% and 69.2% with AC, and 54.7% and 66.5% with ACSC, respectively. CONCLUSION 123I IQ-SPECT imaging significantly improved the attenuation artifact compared with C-SPECT imaging. Although the defect detectability of IQ-SPECT was inferior to that of C-SPECT, 123I IQ-SPECT images with NC and ACSC met the criteria for defect detectability. Use of 123I IQ-SPECT is suitable for routine examinations.
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Otsuka R, Miyazaki Y, Kubo N, Kawahara M, Takaesu J, Fukuchi K. The Status of Stress Myocardial Perfusion Imaging Using 99mTc Pharmaceuticals in Japan: Results from a Nationwide Survey. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2018; 6:90-96. [PMID: 29998141 PMCID: PMC6038977 DOI: 10.22038/aojnmb.2018.10477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective(s): To appropriately use one-day myocardial perfusion imaging (MPI) with 99mTc radiopharmaceuticals (i.e. to avoid shine-through artifacts), injection doses need to be optimized and dose ratios between the 1st and 2nd scans should be maintained at ≥ 3. However, the current state of practice in Japan is unclear. Thus, the aim of this study was to clarify the details of MPI protocols using 99mTc radiopharmaceuticals in Japan. Methods: A nationwide survey was conducted in June and July 2016. Questionnaires about stress MPI protocols using 99mTc radiopharmaceuticals were sent to 641 nuclear medicine facilities. Results: Responses were received from 246 facilities. One-day protocols were used in 97.1% of the facilities. The most common injection dose ratio was 2.5. Only 18.2% of facilities achieved the recommended injection dose ratio. Stress-only protocols were performed in only 1.7% of facilities; the primary reasons for not performing stress-only protocols were as follows: 1) “The reading-physician cannot interpret the image just after the first scan,” and 2) “Preparation of radiopharmaceuticals and scan arrangements turn out to be complicated.” Conclusion: Approximately 80% of nuclear medicine facilities do not follow the recommended injection dose ratio. Stress-only protocols are ideal, but are performed at very few facilities. Both optimization and standardization of stress MPI protocols using 99mTc radiopharmaceuticals are needed in Japan.
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Affiliation(s)
- Ryuto Otsuka
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yosuke Miyazaki
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Narumi Kubo
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mio Kawahara
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Takaesu
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Fukuchi
- Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
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