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Alqahtani MM. Whole-Body SPECT/CT: Protocol Variation and Technical Consideration-A Narrative Review. Diagnostics (Basel) 2024; 14:1827. [PMID: 39202315 PMCID: PMC11353707 DOI: 10.3390/diagnostics14161827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024] Open
Abstract
Introducing a hybrid imaging approach, such as single-photon emission computerized tomography with X-ray computed tomography (SPECT)/CT, improves diagnostic accuracy and patient management. The ongoing advancement of SPECT hardware and software has resulted in the clinical application of novel approaches. For example, whole-body SPECT/CT (WB-SPECT/CT) studies cover multiple consecutive bed positions, similar to positron emission tomography-computed tomography (PET/CT). WB-SPECT/CT proves to be a helpful tool for evaluating bone metastases (BM), reducing equivocal findings, and enhancing user confidence, displaying effective performance in contrast to planar bone scintigraphy (PBS). Consequently, it is increasingly utilized and might substitute PBS, which leads to new questions and issues concerning the acquisition protocol, patient imaging time, and workflow process. Therefore, this review highlights various aspects of WB-SPECT/CT acquisition protocols that need to be considered to help understand WB-SPECT/CT workflow processes and optimize imaging protocols.
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Affiliation(s)
- Mansour M. Alqahtani
- Department of Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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2
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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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3
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Boutaghane N, Hesse M, Bouzid B, Zaidi H, Jamar F, Walrand S. Dual-layer collimator for improved spatial resolution in SPECT with CZT camera: an analytical and Monte Carlo study. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac5671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/17/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Purpose. Current hole matching pixel detector (HMPD) collimators for SPECT imaging exist in two configurations: one hole per pixel (1HMPD) or four holes per pixel (4HMPD). The aim of this study was to assess the performance of a dual-layer collimator made by stacking up these two collimator types (1H/4HMDP) for low- and medium energy gamma emitters. Method. Analytical equations describing geometrical efficiency and full width at half maximum (FWHM) of the 1H/4HMDP collimator were derived. In addition, a fast dedicated Monte Carlo (MC) code neglecting scattering and designed for the collimator geometry was developed to assess the collimator’s point spread function and to simulate planar and SPECT acquisitions. Results. A relative agreement between analytical equations and MC simulations better than 3% was observed for the efficiency and for the FWHM. The length of the two layers was optimized to get the best spatial resolution while keeping the geometrical efficiency equal to that of the 45 mm length 1HMPD collimator. An optimized combination of the 1H/4HMPD configuration with respective hole lengths of 20 and 13 mm has been derived. For source-collimator distances above 5 cm and equal collimator geometrical efficiency, the spatial resolution of this optimal 1H/4HMDP collimator supersedes that of the 45 mm length 1HMPD collimator, and that of the 19.1 mm length 4HMPD collimator. This improvement was observed in simulations of bar phantom planar images and of hot rods phantom SPECT. Remarkably, the spatial resolution was preserved along the whole radial range within the Jaszczak phantom. Conclusion. The 1H/4HMDP collimator is a promising solution for CZT SPECT imaging of low- and medium energy emitters.
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Ahmad Saib DM, Noor Azman NZ, Said MA, Muhd Aseri MI, Almarri HM, Ramli RM. Evaluation of butterworth post-filtering effects on contrast and signal noise to ratio values for SPECT images reconstruction. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2021.109932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alqahtani MM, Willowson KP, Constable C, Fulton R, Kench PL. Optimization of
99m
Tc whole‐body SPECT/CT image quality: A phantom study. J Appl Clin Med Phys 2022; 23:e13528. [PMID: 35049129 PMCID: PMC8992937 DOI: 10.1002/acm2.13528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mansour M. Alqahtani
- Faculty of Medicine and Health University of Sydney Sydney Australia
- Department of Radiological sciences College of Applied Medical Science Najran University Najran Saudi Arabia
| | - Kathy P. Willowson
- Department of Nuclear Medicine Royal North Shore Hospital Sydney Australia
- Institute of Medical Physics Faculty of Science The University of Sydney Sydney Australia
| | - Chris Constable
- Faculty of Medicine and Health University of Sydney Sydney Australia
- HERMES Medical Solutions, Strandbergsgatan 16 Stockholm Sweden
| | - Roger Fulton
- Faculty of Medicine and Health University of Sydney Sydney Australia
- Department of Medical Physics Westmead Hospital Sydney Australia
| | - Peter L. Kench
- Faculty of Medicine and Health University of Sydney Sydney Australia
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Partington SL, Valente AM, Bruyere J, Rosica D, Shafer KM, Landzberg MJ, Taqueti VR, Blankstein R, Skali H, Kwatra N, DiCarli MF, Grant FD, Dorbala S. Reducing radiation dose from myocardial perfusion imaging in subjects with complex congenital heart disease. J Nucl Cardiol 2021; 28:1395-1408. [PMID: 31407235 PMCID: PMC7104915 DOI: 10.1007/s12350-019-01811-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/07/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The prevalence of defects and effective radiation dose from various myocardial perfusion imaging (MPI) strategies in congenital heart disease (CHD) is unknown. METHODS We studied 75 subjects with complex CHD (ages 5 to 80 years) referred for MPI between 2002 and 2015. A rest and exercise or pharmacologic stress MPI was performed using 99mTechnetium sestamibi, 82rubidium or 13N-ammonia, and Sodium iodide SPECT (single-photon emission computed tomography), SPECT/CT or Cadmium zinc telluride (CZT) SPECT or PET (positron emission tomography)/CT scanners. Deidentified images were interpreted semi-quantitatively in three batches: stress only MPI, stress/rest MPI, and stress/rest MPI with taking into account a history of ventricular septal defect repair. Effective radiation dose was estimated for stress/rest MPI and predicted for 1-day stress-first (normal stress scans), and for 2-day stress/rest MPI (abnormal stress scans). RESULTS The median age was 18.6 years. The most common type of CHD was transposition of the great arteries (63%). Rest/stress MPI was abnormal in 43% of subjects and 25% of the abnormal scans demonstrated reversible defects. Of the subjects with abnormal MPI, 33% had significant underlying anatomic coronary artery obstruction. Estimated mean effective radiation dose ranged from 2.1 ± 0.6 mSv for 13N-ammonia PET/CT to 12.5 ± 0.9 mSv for SPECT/CT. Predicted effective radiation dose was significantly lower for stress-first MPI and for 2-day stress/rest protocols. CONCLUSIONS Due to the relatively high prevalence of abnormal stress MPI, tailored protocols with a stress-first MPI as well as the use of 2-day protocols and advanced imaging technologies including CZT SPECT, novel image reconstruction software, and PET MPI could substantially reduce radiation dose in complex CHD.
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Affiliation(s)
- Sara L Partington
- Division of Cardiology, Department of Medicine, Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, USA
| | - Anne Marie Valente
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Division of Medicine, Department of Cardiology, Brigham and Women's Hospital, Boston, USA
| | - John Bruyere
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Dillenia Rosica
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Keri M Shafer
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Division of Medicine, Department of Cardiology, Brigham and Women's Hospital, Boston, USA
| | - Michael J Landzberg
- Department of Cardiology, Boston Children's Hospital, Boston, USA
- Division of Medicine, Department of Cardiology, Brigham and Women's Hospital, Boston, USA
| | - Viviany R Taqueti
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Ron Blankstein
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Hicham Skali
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
| | - Neha Kwatra
- Division of Nuclear Medicine, Department of Radiology, Boston Children's Hospital, Boston, USA
| | - Marcelo F DiCarli
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Frederick D Grant
- Division of Nuclear Medicine, Department of Radiology, Boston Children's Hospital, Boston, USA
| | - Sharmila Dorbala
- Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, USA.
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
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Slomka P. Do we need dedicated cardiac SPECT systems? J Nucl Cardiol 2021; 28:1331-1333. [PMID: 31650495 DOI: 10.1007/s12350-019-01921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA.
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Wetzl M, Sanders JC, Kuwert T, Ritt P. Effect of reduced photon count levels and choice of normal data on semi-automated image assessment in cardiac SPECT. J Nucl Cardiol 2020; 27:1469-1482. [PMID: 29654444 DOI: 10.1007/s12350-018-1272-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/19/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND The SMARTZOOM multifocal collimator from Siemens Healthcare was developed to improve the γ-photon sensitivity in myocardial perfusion imaging without truncating the field of view. As part of the IQ-SPECT package, it may be used to reduce radiopharmaceutical dose to patients, as well as acquisition time. The aim of this study was twofold: (1) to evaluate the influence of dose reduction in semi-automated MPI scoring, with focus on different strategies for the choice of normal data (count-matched, full-count), and (2) to evaluate the effect of dose reduction afforded by Siemens' IQ-SPECT package. METHODS 50 patients underwent Tc-99m-sestamibi one-day stress/rest SPECT/CT. Multiple levels of count reduction were generated using binomial thinning. Using Corridor 4DM, summed stress score (SSS) was calculated using either count-matched or full-count normal data. Studies were classified as low-risk (SSS < 4) or intermediate/high-risk (SSS ≥ 4). RESULTS Count reduction using count-matched normal data increases false-normal rate and decreases sensitivity. With full-count normal data, count reduction increases false-hypoperfusion rate, leading to decreased specificity. Altogether, rate of reclassification was significant at roughly 67% dose and below. CONCLUSION Significant bias results from count level of normal data relative to actual patient data. Compared to standard LEHR, IQ-SPECT should allow for significant dose reduction.
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Affiliation(s)
- Matthias Wetzl
- Clinic of Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany
| | - James C Sanders
- Clinic of Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Torsten Kuwert
- Clinic of Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany
| | - Philipp Ritt
- Clinic of Nuclear Medicine, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany.
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9
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Okuda K, Nakajima K, Yoneyama H, Shibutani T, Onoguchi M, Matsuo S, Hashimoto M, Kinuya S. Impact of iterative reconstruction with resolution recovery in myocardial perfusion SPECT: phantom and clinical studies. Sci Rep 2019; 9:19618. [PMID: 31873141 PMCID: PMC6928019 DOI: 10.1038/s41598-019-56097-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/05/2019] [Indexed: 11/11/2022] Open
Abstract
The corrections of photon attenuation, scatter, and depth-dependent blurring improve image quality in myocardial perfusion single-photon emission computed tomography (SPECT) imaging; however, the combined corrections induce artifacts. Here, we present the single correction method of depth-dependent blurring and its impact for myocardial perfusion distribution in phantom and clinical studies. The phantom and clinical patient images were acquired with two conditions: circular and noncircular orbits of gamma cameras yielded constant and variable depth-dependent blurring, respectively. An iterative reconstruction with the correction method of depth-dependent was used to reconstruct the phantom and clinical patient images. We found that the single correction method improved the robustness of phantom images whether the images contained constant or variable depth-dependent blurring. The myocardial perfusion databases generated from 72 normal patients exhibited uniform perfusion distribution of whole myocardium. In summary, the single correction method of depth-dependent blurring with iterative reconstruction is helpful for myocardial perfusion SPECT.
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Affiliation(s)
- Koichi Okuda
- Department of Physics, Kanazawa Medical University, Uchinada, Japan.
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
| | - Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Shinro Matsuo
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | | | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
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10
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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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van Dijk JD. Dose-optimization in nuclear cardiac imaging, time for the next step? J Nucl Cardiol 2019; 26:1981-1983. [PMID: 30218218 DOI: 10.1007/s12350-018-1441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Joris D van Dijk
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands.
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12
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Abbott BG, Case JA, Dorbala S, Einstein AJ, Galt JR, Pagnanelli R, Bullock-Palmer RP, Soman P, Wells RG. Contemporary Cardiac SPECT Imaging-Innovations and Best Practices: An Information Statement from the American Society of Nuclear Cardiology. Circ Cardiovasc Imaging 2019; 11:e000020. [PMID: 30354679 DOI: 10.1161/hci.0000000000000020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Brian G Abbott
- Warren Alpert Medical School, Brown University, Providence, RI (B.G.A.)
| | - James A Case
- Cardiovascular Imaging Technologies, Kansas City, MO (J.A.C.)
| | - Sharmila Dorbala
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA (S.D.)
| | - Andrew J Einstein
- Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY (A.J.E.)
| | - James R Galt
- Emory University School of Medicine, Atlanta, GA (J.R.G.)
| | | | | | - Prem Soman
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA (P.S.)
| | - R Glenn Wells
- University of Ottawa Heart Institute, Ottawa, Canada (R.G.W.)
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Salvadori J, Petegnief Y, Sabbah R, Morel O, Boulahdour H, Karcher G, Marie PY, Imbert L. Compared vulnerabilities to small cardiac motions between different cameras used for myocardial perfusion imaging. J Nucl Cardiol 2019; 26:1313-1322. [PMID: 29327252 DOI: 10.1007/s12350-017-1175-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/08/2017] [Indexed: 10/18/2022]
Abstract
This phantom-based study was aimed to determine whether cardiac CZT-cameras, which provide an enhanced spatial resolution and image contrast compared to Anger cameras, are similarly affected by small cardiac motions. Translations of a left ventricular (LV) insert at half-SPECT acquisitions through six possible orthogonal directions and with 5- or 10-mm amplitude were simulated on the Discovery NM-530c and DSPECT CZT-cameras and on an Anger Symbia T2 camera equipped with an astigmatic (IQ.SPECT) or conventional parallel-hole collimator (Conv.SPECT). SPECT images were initially reconstructed as currently recommended for clinical routine. The heterogeneity in recorded activity from the 17 LV segments gradually increased between baseline and motions simulated at 5- and 10-mm amplitudes with all cameras, although being higher for Anger- than CZT-cameras at each step and resulting in a higher mean number of artifactual abnormal segments (at 10-mm amplitude, Conv.SPECT: 3.7; IQ.SPECT: 1.8, Discovery: 0.7, DSPECT: 0). However, this vulnerability to motion was markedly (1) decreased for Conv.SPECT reconstructed without the recommended Resolution Recovery algorithm and (2) increased for DSPECT reconstructed without the recommended cardiac model. CZT-cameras and especially the DSPECT appear less vulnerable to small cardiac motions than Anger-cameras although these differences are strongly dependent on reconstruction parameters.
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Affiliation(s)
- Julien Salvadori
- Institut de Cancérologie de Lorraine, Université de Lorraine, 54000, Nancy, France
| | - Yolande Petegnief
- CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France
| | - Remi Sabbah
- CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France
| | - Olivier Morel
- CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France
| | - Hatem Boulahdour
- CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France
| | - Gilles Karcher
- CHRU-Nancy, Université de Lorraine, Plateforme Nancyclotep, 54000, Nancy, France
- Médecine Nucléaire, Hôpital de Brabois, CHRU-Nancy, Université de Lorraine, Service de Médecine Nucléaire, 54000, Nancy, France
| | - Pierre-Yves Marie
- CHRU-Nancy, Université de Lorraine, Plateforme Nancyclotep, 54000, Nancy, France
- Médecine Nucléaire, Hôpital de Brabois, CHRU-Nancy, Université de Lorraine, Service de Médecine Nucléaire, 54000, Nancy, France
- Université de Lorraine, INSERM, UMR-1116 DCAC, 54000, Nancy, France
| | - Laetitia Imbert
- Institut de Cancérologie de Lorraine, Université de Lorraine, 54000, Nancy, France.
- CHRU-Nancy, Université de Lorraine, Plateforme Nancyclotep, 54000, Nancy, France.
- Université de Lorraine, INSERM, UMR-947 IADI, 54000, Nancy, France.
- Médecine Nucléaire, Hôpital de Brabois, CHRU-Nancy, Allée du Morvan, 54500, Nancy, Vandœuvre-lès-Nancy, France.
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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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15
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Massalha S, Almufleh A, Small G, Marvin B, Keidar Z, Israel O, Kennedy JA. Strategies for Minimizing Occupational Radiation Exposure in Cardiac Imaging. Curr Cardiol Rep 2019; 21:71. [PMID: 31227929 DOI: 10.1007/s11886-019-1157-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Radiation safety has been at the center of interest of both researchers and healthcare institutions. This review will summarize and shed light on the various techniques adapted to reduce staff exposure to ionizing radiation (IR) in the field of cardiac imaging. RECENT FINDINGS In the last years, with the advance of awareness and the development of new technologies, there have been several tools and techniques adapted. The breakthrough of several technologies to lower radiation dose and shorten the duration of diagnostic tests associated with IR, the use of protection devices by staff members, and mostly the awareness of exposure to IR are the hallmark of these advances. Using all these measures has led to a significant decrease in staff exposure to IR. Reducing staff exposure to meet the "As Low As Reasonably Achievable" principle is feasible. This review introduces the most important strategies applied in cardiac imaging.
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Affiliation(s)
- Samia Massalha
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada. .,Department of Cardiology, Rambam Health Care Campus, Haifa, Israel. .,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.
| | - Aws Almufleh
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Garry Small
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Brian Marvin
- Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, K1Y 4W7, Canada
| | - Zohar Keidar
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Ora Israel
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - John A Kennedy
- Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel.,Faculty of Biomedical Engineering, Technion - Israel Institute of Technology, Haifa, Israel
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16
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Liga R, Gimelli A. Automatic evaluation of myocardial perfusion on SPECT: Need for "Normality". J Nucl Cardiol 2019; 26:786-789. [PMID: 29071669 DOI: 10.1007/s12350-017-1097-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 11/30/2022]
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17
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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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18
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Abbott BG, Case JA, Dorbala S, Einstein AJ, Galt JR, Pagnanelli R, Bullock-Palmer RP, Soman P, Wells RG. Contemporary Cardiac SPECT Imaging-Innovations and Best Practices: An Information Statement from the American Society of Nuclear Cardiology. J Nucl Cardiol 2018; 25:1847-1860. [PMID: 30143954 DOI: 10.1007/s12350-018-1348-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This information statement from the American Society of Nuclear Cardiology highlights advances in cardiac SPECT imaging and supports the incorporation of new technology and techniques in laboratories performing nuclear cardiology procedures. The document focuses on the application of the latest imaging protocols and the utilization of newer hardware and software options to perform high quality, state-of-the-art SPECT nuclear cardiology procedures. Recommendations for best practices of cardiac SPECT imaging are discussed, highlighting what imaging laboratories should be doing as the standard of care in 2018 to achieve optimal results (based on the ASNC 2018 SPECT guideline [Dorbala et al., J Nucl Cardiol. 2018. https://doi.org/10.1007/s12350-018-1283-y ]).
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Affiliation(s)
- Brian G Abbott
- Warren Alpert Medical School, Brown University, Providence, RI, USA.
| | - James A Case
- Cardiovascular Imaging Technologies, Kansas City, MO, USA
| | - Sharmila Dorbala
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew J Einstein
- Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - James R Galt
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Prem Soman
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - R Glenn Wells
- University of Ottawa Heart Institute, Ottawa, Canada
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Dorbala S, Ananthasubramaniam K, Armstrong IS, Chareonthaitawee P, DePuey EG, Einstein AJ, Gropler RJ, Holly TA, Mahmarian JJ, Park MA, Polk DM, Russell R, Slomka PJ, Thompson RC, Wells RG. Single Photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging Guidelines: Instrumentation, Acquisition, Processing, and Interpretation. J Nucl Cardiol 2018; 25:1784-1846. [PMID: 29802599 DOI: 10.1007/s12350-018-1283-y] [Citation(s) in RCA: 212] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Sharmila Dorbala
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | - Andrew J Einstein
- Columbia University Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | | | - Thomas A Holly
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - John J Mahmarian
- Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA
| | | | - Donna M Polk
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | | | - R Glenn Wells
- University of Ottawa Heart Institute, Ottawa, Canada
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20
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Tanaka H, Takahashi T, Ohashi N, Tanaka K, Okada T, Kihara Y. Diagnostic value of thallium-201 myocardial perfusion IQ-SPECT without and with computed tomography-based attenuation correction to predict clinically significant and insignificant fractional flow reserve: A single-center prospective study. Medicine (Baltimore) 2017; 96:e9275. [PMID: 29390486 PMCID: PMC5758188 DOI: 10.1097/md.0000000000009275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to clarify the predictive value of fractional flow reserve (FFR) determined by myocardial perfusion imaging (MPI) using thallium (Tl)-201 IQ-SPECT without and with computed tomography-based attenuation correction (CT-AC) for patients with stable coronary artery disease (CAD).We assessed 212 angiographically identified diseased vessels using adenosine-stress Tl-201 MPI-IQ-SPECT/CT in 84 consecutive, prospectively identified patients with stable CAD. We compared the FFR in 136 of the 212 diseased vessels using visual semiquantitative interpretations of corresponding territories on MPI-IQ-SPECT images without and with CT-AC.FFR inversely correlated most accurately with regional summed difference scores (rSDS) in images without and with CT-AC (r = -0.584 and r = -0.568, respectively, both P < .001). Receiver-operating characteristics analyses using rSDS revealed an optimal FFR cut-off of <0.80 without and with CT-AC. Although the diagnostic accuracy of FFR <0.80 did not significantly differ, FFR ≥0.82 was significantly more accurate with, than without CT-AC. Regions with rSDS ≥2 without or with CT-AC predicted FFR <0.80, and those with rSDS ≤1 without and with CT-AC predicted FFR ≥0.81, with 73% and 83% sensitivity, 84% and 67% specificity, and 79% and 75% accuracy, respectively.Although limited by the sample size and the single-center design, these findings showed that the IQ-SPECT system can predict FFR at an optimal cut-off of <0.80, and we propose a novel application of CT-AC to MPI-IQ-SPECT for predicting clinically significant and insignificant FFR even in nonobese patients.
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Affiliation(s)
- Haruki Tanaka
- Department of Cardiology, Miyoshi Central Hospital, Miyoshi City, Hiroshima, Japan
| | | | - Norihiko Ohashi
- Department of Cardiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital
| | - Koichi Tanaka
- Department of Cardiology, Miyoshi Central Hospital, Miyoshi City, Hiroshima, Japan
| | - Takenori Okada
- Department of Cardiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
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21
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Gimelli A, Achenbach S, Buechel RR, Edvardsen T, Francone M, Gaemperli O, Hacker M, Hyafil F, Kaufmann PA, Lancellotti P, Nieman K, Pontone G, Pugliese F, Verberne HJ, Gutberlet M, Bax JJ, Neglia D, Gerber B, Donal E, Flachskampf F, Haugaa K, Delgado V, Knuuti J, Knaapen P, Maurovich-Horvat P, Schroeder S. Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR). Eur Heart J 2017; 39:286-296. [DOI: 10.1093/eurheartj/ehx582] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/26/2017] [Indexed: 12/23/2022] Open
Affiliation(s)
- Alessia Gimelli
- Fondazione Toscana/CNR Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
| | - Stephan Achenbach
- Department of Internal Medicine 2 (Cardiology), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Thor Edvardsen
- Oslo University Hospital, Department of Cardiology, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Oliver Gaemperli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Fabien Hyafil
- Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique—Hôpitaux de Paris, Inserm 1148, DHU FIRE, University Paris 7 Diderot, Paris, France
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Patrizio Lancellotti
- Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Koen Nieman
- Departments of Cardiovascular Medicine and Radiology, Stanford University, School of Medicine, Stanford, CA, USA
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
- Yonsei University Health System, Seoul, South Korea
| | - Francesca Pugliese
- NIHR Barts BRC, Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Hein J Verberne
- Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias Gutberlet
- Department of Diagnostic and Interventional Radiology, University of Leipzig-Heart Center, Leipzig, Germany
| | - Jeroen J Bax
- Heart Lung Center Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana/CNR Gabriele Monasterio, Via Moruzzi 1, 56124 Pisa, Italy
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22
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Kuşlu D, Öztürk E. A Comparison of Iterative Reconstruction and Prone Imaging in Reducing the Inferior Wall Attenuation in Tc-99m Sestamibi Myocardial Perfusion SPECT. Mol Imaging Radionucl Ther 2017; 26:110-115. [PMID: 28976333 PMCID: PMC5643938 DOI: 10.4274/mirt.83007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Prone positioning, iterative reconstruction (IR-OSEM) and electrocardiography (ECG) gating have been demonstrated to improve the specificity of myocardial perfusion SPECT (MPS) in the diagnosis of coronary artery disease. Methods: The gated supine and prone MPS images of 45 patients were reconstructed with both IR-OSEM [supine (SIR) and prone (PIR)] FBPs [supine (SFBP), prone (PFBP)] for comparison. Perfusion, wall motion (WM) and wall thickening were also interpreted semi-quantitatively. Two groups were generated as those with normal or abnormal findings. Segmental myocardial tracer uptake values were noted from four of the reconstructed images from 17 segment model of bullseye. Results: The difference between mean values and the standard deviations of the % tracer uptakes of inferior wall segments were statistically significant in all images. The normalcy rates were highest in PIR images, followed by PFBP and SIR images. The number of patients with any perfusion abnormality were 42, 12, 32, and 6, in SFBP, PFBP, SIR and PIR images, respectively. The six patients with perfusion abnormality in PIR images were re-evaluated with rest images and were diagnosed with a fixed perfusion defect. There was positive correlation between WM and either PFBP or PIR images. Sixteen patients’ WM were evaluated as abnormal while only 6 patients’ perfusions were abnormal in PIR. Conclusion: Prone imaging in addition to a supine perfusion SPECT improves imaging quality of the inferior wall, especially when reconstructed with iterative methods. If prone imaging can not be performed, ECG-gating can also be used as a beneficial method.
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Affiliation(s)
- Duygu Kuşlu
- Antalya Training and Research Hospital, Clinic of Nuclear Medicine, Antalya, Turkey
| | - Emel Öztürk
- Memorial Hospital, Clinic of Nuclear Medicine, Ankara, Turkey
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23
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Quantification of Myocardial Blood Flow with CZT SPECT Imaging: Is It Ready for Clinical Use? CURRENT CARDIOVASCULAR IMAGING REPORTS 2017. [DOI: 10.1007/s12410-017-9432-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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24
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Taillefer R. Myocardial perfusion imaging with 99mTc-labeled radiopharmaceuticals: How fast can a stress-rest same-day imaging protocol be completed? J Nucl Cardiol 2017; 24:1328-1331. [PMID: 27044387 DOI: 10.1007/s12350-016-0461-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Raymond Taillefer
- Département de médecine nucléaire, Hôpital du Haut-Richelieu, 920 Boulevard du Séminaire Nord, Saint-Jean-sur-Richelieu, QC, J3A 1B7, Canada.
- Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montréal, QC, Canada.
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25
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Yoneyama H, Shibutani T, Konishi T, Mizutani A, Hashimoto R, Onoguchi M, Okuda K, Matsuo S, Nakajima K, Kinuya S. Validation of Left Ventricular Ejection Fraction with the IQ•SPECT System in Small-Heart Patients. J Nucl Med Technol 2017; 45:201-207. [DOI: 10.2967/jnmt.116.188680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/09/2017] [Indexed: 11/16/2022] Open
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26
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Patchett ND, Pawar S, Miller EJ. Visual identification of coronary calcifications on attenuation correction CT improves diagnostic accuracy of SPECT/CT myocardial perfusion imaging. J Nucl Cardiol 2017; 24:711-720. [PMID: 26850031 DOI: 10.1007/s12350-016-0395-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Coronary artery calcium (CAC) is a powerful CAD risk marker when assessed by dedicated calcium scoring CT scan. We assessed diagnostic implications of CAC visible on attenuation correction CT scans (CTAC) from SPECT/CT myocardial perfusion imaging (MPI). METHODS Visual presence or absence of CAC was assessed on CTAC in 1047 consecutive patients undergoing SPECT/CT MPI. Accuracy of MPI was assessed in patients undergoing invasive coronary angiography (ICA) within 1 year (n = 109). Outcomes were identified by retrospective chart review. RESULTS Prevalence of true positive SPECT/CT MPI studies was greater among patients with CAC on CTAC (70% vs 16%; p < .001); prevalence of false positive studies was greater among those without (68% vs 15%; p < .001). PPV of MPI was 0.82 in patients with CAC, but only 0.19 in those without. Within median follow-up of 27.7 months, patients with CAC had higher all-cause mortality (6% vs 0.4%; p < .001), more late revascularizations (8% vs 0.4%; p < .001), and more MI (5% vs 0.2%; p < .001). Hazard ratio for all-cause mortality, MI, or late revascularization was 22.7 (p < .001) for patients with CAC vs those without. CONCLUSIONS Visual assessment of CAC on CTAC should be performed during SPECT/CT MPI because it affects diagnostic certainty and may improve risk stratification.
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Affiliation(s)
- Nicholas D Patchett
- Department of Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Sumeet Pawar
- Department of Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | - Edward J Miller
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
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27
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Dendy JM, Tilkemeier P. Successful innovation: A time for change? J Nucl Cardiol 2017; 24:134-137. [PMID: 27220878 DOI: 10.1007/s12350-016-0533-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 12/20/2022]
Abstract
Innovation plays an important role in the advancement of nuclear cardiology, meeting the need for reduced exposure to radiation, and maintaining and improving image quality. As we innovate, it is important to understand the impact of these improvements on the clinical and research knowledge base that has made nuclear cardiology such a powerful clinical tool. The need for comparative studies insuring stability in the clinical applicability of our current guidelines and use of the prognostic power of radionuclide myocardial perfusion imaging in clinical practice is essential for new and innovative techniques. The existing data demonstrating the significant differences that can occur with the innovative techniques is explored. The need for tools to insure comparable data is available as we begin to utilize registries to inform our clinical practice and research will be an important part of the future of nuclear cardiology.
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Affiliation(s)
- Jeffrey M Dendy
- Department of Medicine, Greenville Health System, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, SC, 29605, USA
| | - Peter Tilkemeier
- Department of Medicine, Greenville Health System, University of South Carolina School of Medicine Greenville, 701 Grove Road, Greenville, SC, 29605, USA.
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28
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Lima R, Peclat T, Soares T, Ferreira C, Souza AC, Camargo G. Comparison of the prognostic value of myocardial perfusion imaging using a CZT-SPECT camera with a conventional anger camera. J Nucl Cardiol 2017; 24:245-251. [PMID: 27510176 DOI: 10.1007/s12350-016-0618-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 07/15/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent studies have shown that myocardial perfusion imaging (MPI) in cadmium-zinc-telluride (CZT) cameras allow faster exams with less radiation dose but there are little data comparing its prognosis information with that of dedicated cardiac Na-I SPECT cameras OBJECTIVE: The objective of this study is to compare the prognostic value of MPI using an ultrafast protocol with low radiation dose in a CZT-SPECT and a traditional one. METHODS Group 1 was submitted to a two-day MIBI protocol in a conventional camera, and group 2 was submitted to a 1-day MIBI protocol in CZT camera. MPI were classified as normal or abnormal, and perfusion scores were calculated. Propensity score matching methods were performed RESULTS: 3554 patients were followed during 33±8 months. Groups 1 and 2 had similar distribution of age, gender, body mass index, risk factors, previous revascularization, and use of pharmacological stress. Group 1 had more abnormal scans, higher scores than group 2. Annualized hard events rate was higher in group 1 with normal scans but frequency of revascularization was similar to normal group 2. Patients with abnormal scans had similar event rates in both groups CONCLUSION: New protocol of MPI in CZT-SPECT showed similar prognostic results to those obtained in dedicated cardiac Na-I SPECT camera, with lower prevalence of hard events in patients with normal scan.
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Affiliation(s)
- Ronaldo Lima
- Department of Cardiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
- Nuclear Medicine, Clínica de Diagnóstico por Imagem, Rio de Janeiro, Brazil.
| | - Thais Peclat
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thalita Soares
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caio Ferreira
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gabriel Camargo
- Department of Cardiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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29
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Qualitative and quantitative comparison of gated blood pool single photon emission computed tomography using low-energy high-resolution and SMARTZOOM collimation. Nucl Med Commun 2017; 38:35-43. [DOI: 10.1097/mnm.0000000000000609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Denisova NV, Terekhov IN. A study of myocardial perfusion SPECT imaging with reduced radiation dose using maximum likelihood and entropy-based maximum
a posteriori
approaches. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/5/055015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bourque JM, Beller GA. Value of Exercise ECG for Risk Stratification in Suspected or Known CAD in the Era of Advanced Imaging Technologies. JACC Cardiovasc Imaging 2016; 8:1309-21. [PMID: 26563861 DOI: 10.1016/j.jcmg.2015.09.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/15/2015] [Accepted: 09/23/2015] [Indexed: 02/07/2023]
Abstract
Exercise stress electrocardiography (ExECG) is underutilized as the initial test modality in patients with interpretable electrocardiograms who are able to exercise. Although stress myocardial imaging techniques provide valuable diagnostic and prognostic information, variables derived from ExECG can yield substantial data for risk stratification, either supplementary to imaging variables or without concurrent imaging. In addition to exercise-induced ischemic ST-segment depression, such markers as ST-segment elevation in lead aVR, abnormal heart rate recovery post-exercise, failure to achieve target heart rate, and poor exercise capacity improve risk stratification of ExECG. For example, patients achieving ≥10 metabolic equivalents on ExECG have a very low prevalence of inducible ischemia and an excellent prognosis. In contrast, cardiac imaging techniques add diagnostic and prognostic value in higher-risk populations (e.g., poor functional capacity, diabetes, or chronic kidney disease). Optimal test selection for symptomatic patients with suspected coronary artery disease requires a patient-centered approach factoring in the risk/benefit ratio and cost-effectiveness.
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Affiliation(s)
- Jamieson M Bourque
- Cardiovascular Division and the Cardiovascular Imaging Center, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia; Department of Radiology, University of Virginia Health System, Charlottesville, Virginia.
| | - George A Beller
- Cardiovascular Division and the Cardiovascular Imaging Center, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
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Lee WW. Recent Advances in Nuclear Cardiology. Nucl Med Mol Imaging 2016; 50:196-206. [PMID: 27540423 DOI: 10.1007/s13139-016-0433-x] [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: 05/12/2016] [Accepted: 06/24/2016] [Indexed: 11/24/2022] Open
Abstract
Nuclear cardiology is one of the major fields of nuclear medicine practice. Myocardial perfusion studies using single-photon emission computed tomography (SPECT) have played a crucial role in the management of coronary artery diseases. Positron emission tomography (PET) has also been considered an important tool for the assessment of myocardial viability and perfusion. However, the recent development of computed tomography (CT)/magnetic resonance imaging (MRI) technologies and growing concerns about the radiation exposure of patients remain serious challenges for nuclear cardiology. In response to these challenges, remarkable achievements and improvements are currently in progress in the field of myocardial perfusion imaging regarding the applicable software and hardware. Additionally, myocardial perfusion positron emission tomography (PET) is receiving increasing attention owing to its unique capability of absolute myocardial blood flow estimation. An F-18-labeled perfusion agent for PET is under clinical trial with promising interim results. The applications of F-18 fluorodeoxyglucose (FDG) and F-18 sodium fluoride (NaF) to cardiovascular diseases have revealed details on the basic pathophysiology of ischemic heart diseases. PET/MRI seems to be particularly promising for nuclear cardiology in the future. Restrictive diseases, such as cardiac sarcoidosis and amyloidosis, are effectively evaluated using a variety of nuclear imaging tools. Considering these advances, the current challenges of nuclear cardiology will become opportunities if more collaborative efforts are devoted to this exciting field of nuclear medicine.
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Affiliation(s)
- Won Woo Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea ; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
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Difference in appearance between prone and supine myocardial perfusion images obtained on a high-efficiency cadmium zinc telluride SPECT camera. Nucl Med Commun 2016; 37:487-92. [DOI: 10.1097/mnm.0000000000000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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Acampa W, Buechel RR, Gimelli A. Low dose in nuclear cardiology: state of the art in the era of new cadmium–zinc–telluride cameras. Eur Heart J Cardiovasc Imaging 2016; 17:591-5. [DOI: 10.1093/ehjci/jew036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/13/2016] [Indexed: 01/22/2023] Open
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Performance of 3DOSEM and MAP algorithms for reconstructing low count SPECT acquisitions. Z Med Phys 2015; 26:311-322. [PMID: 26725165 DOI: 10.1016/j.zemedi.2015.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE Low count single photon emission computed tomography (SPECT) is becoming more important in view of whole body SPECT and reduction of radiation dose. In this study, we investigated the performance of several 3D ordered subset expectation maximization (3DOSEM) and maximum a posteriori (MAP) algorithms for reconstructing low count SPECT images. MATERIALS AND METHODS Phantom experiments were conducted using the National Electrical Manufacturers Association (NEMA) NU2 image quality (IQ) phantom. The background compartment of the phantom was filled with varying concentrations of pertechnetate and indiumchloride, simulating various clinical imaging conditions. Images were acquired using a hybrid SPECT/CT scanner and reconstructed with 3DOSEM and MAP reconstruction algorithms implemented in Siemens Syngo MI.SPECT (Flash3D) and Hermes Hybrid Recon Oncology (Hyrid Recon 3DOSEM and MAP). Image analysis was performed by calculating the contrast recovery coefficient (CRC),percentage background variability (N%), and contrast-to-noise ratio (CNR), defined as the ratio between CRC and N%. Furthermore, image distortion is characterized by calculating the aspect ratio (AR) of ellipses fitted to the hot spheres. Additionally, the performance of these algorithms to reconstruct clinical images was investigated. RESULTS Images reconstructed with 3DOSEM algorithms demonstrated superior image quality in terms of contrast and resolution recovery when compared to images reconstructed with filtered-back-projection (FBP), OSEM and 2DOSEM. However, occurrence of correlated noise patterns and image distortions significantly deteriorated the quality of 3DOSEM reconstructed images. The mean AR for the 37, 28, 22, and 17mm spheres was 1.3, 1.3, 1.6, and 1.7 respectively. The mean N% increase in high and low count Flash3D and Hybrid Recon 3DOSEM from 5.9% and 4.0% to 11.1% and 9.0%, respectively. Similarly, the mean CNR decreased in high and low count Flash3D and Hybrid Recon 3DOSEM from 8.7 and 8.8 to 3.6 and 4.2, respectively. Regularization with smoothing priors could suppress these noise patterns at the cost of reduced image contrast. The mean N% was 6.4% and 6.8% for low count QSP and MRP MAP reconstructed images. Alternatively, regularization with an anatomical Bowhser prior resulted in sharp images with high contrast, limited image distortion, and low N% of 8.3% in low count images, although some image artifacts did occur. Analysis of clinical images suggested that the same effects occur in clinical imaging. CONCLUSION Image quality of low count SPECT acquisitions reconstructed with modern 3DOSEM algorithms is deteriorated by the occurrence of correlated noise patterns and image distortions. The artifacts observed in the phantom experiments can also occur in clinical imaging.
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Abstract
![]()
Development
of novel imaging probes for cancer diagnostics remains
critical for early detection of disease, yet most imaging agents are
hindered by suboptimal tumor accumulation. To overcome these limitations,
researchers have adapted antibodies for imaging purposes. As cancerous
malignancies express atypical patterns of cell surface proteins in
comparison to noncancerous tissues, novel antibody-based imaging agents
can be constructed to target individual cancer cells or surrounding
vasculature. Using molecular imaging techniques, these agents may
be utilized for detection of malignancies and monitoring of therapeutic
response. Currently, there are several imaging modalities commonly
employed for molecular imaging. These imaging modalities include positron
emission tomography (PET), single-photon emission computed tomography
(SPECT), magnetic resonance (MR) imaging, optical imaging (fluorescence
and bioluminescence), and photoacoustic (PA) imaging. While antibody-based
imaging agents may be employed for a broad range of diseases, this
review focuses on the molecular imaging of pancreatic cancer, as there
are limited resources for imaging and treatment of pancreatic malignancies.
Additionally, pancreatic cancer remains the most lethal cancer with
an overall 5-year survival rate of approximately 7%, despite significant
advances in the imaging and treatment of many other cancers. In this
review, we discuss recent advances in molecular imaging of pancreatic
cancer using antibody-based imaging agents. This task is accomplished
by summarizing the current progress in each type of molecular imaging
modality described above. Also, several considerations for designing
and synthesizing novel antibody-based imaging agents are discussed.
Lastly, the future directions of antibody-based imaging agents are
discussed, emphasizing the potential applications for personalized
medicine.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States
| | - Reinier Hernandez
- Department of Medical Physics, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States
| | - Savo Bou Zein Eddine
- Department of Medical Physics, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin-Madison , Madison, Wisconsin 53705, United States.,Department of Radiology, University of Wisconsin-Madison , Madison, Wisconsin 53792, United States.,University of Wisconsin Carbone Cancer Center , Madison, Wisconsin 53792, United States
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Caobelli F, Akin M, Thackeray JT, Brunkhorst T, Widder J, Berding G, Burchert I, Bauersachs J, Bengel FM. Diagnostic accuracy of cadmium-zinc-telluride-based myocardial perfusion SPECT: impact of attenuation correction using a co-registered external computed tomography. Eur Heart J Cardiovasc Imaging 2015; 17:1036-43. [PMID: 26628617 DOI: 10.1093/ehjci/jev312] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/29/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Computed tomography (CT)-based attenuation correction (AC) improves the accuracy of standard myocardial perfusion SPECT. Most dedicated cadmium-zinc-telluride (CZT) SPECT cameras are not equipped with an integrated CT component. We aimed to determine the impact of AC on diagnostic performance of CZT SPECT using co-registration with an external low-dose CT. METHODS Sixty patients underwent CZT SPECT (GE Discovery 530c) with (99m)Tc-sestamibi at rest and following regadenoson stress. Using commercial software, SPECT images were co-registered with a low-dose CT acquired on a separate system (GE Discovery 670NMCT). Attenuation corrected and non-corrected (NC) images were reconstructed using an iterative algorithm. Accuracy was measured in 44 patients who had undergone invasive angiography within 6 months. Normalcy was compared in the remaining 16 patients who had a low pre-test likelihood (<5%) of coronary artery disease (CAD). RESULTS Summed stress and rest scores were significantly lower in AC images (9 ± 8 vs. 13 ± 9 and 6 ± 7 vs. 10 ± 9, P = 0.01), while summed difference score did not differ. According to angiography, 38 patients had significant CAD in 71 vascular territories. Attenuation correction improved accuracy globally (P = 0.03) and in RCA territory (P = 0.008). Specificity improved both globally (100 vs. 40%, P < 0.05) and in each individual territory (LAD: 63 vs. 36%, LCX: 70 vs. 33%, RCA: 81 vs. 19%, P < 0.01). Normalcy was 100% for AC and 62.5% for NC images (P < 0.05). CONCLUSION Attenuation correction with a co-registered external CT is feasible using CZT cameras and improves diagnostic accuracy mostly by improving specificity over uncorrected images.
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Affiliation(s)
- Federico Caobelli
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
| | - Muharrem Akin
- Department of Clinical Cardiology, Hannover Medical School, Hannover, Germany
| | - James T Thackeray
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
| | - Thomas Brunkhorst
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
| | - Julian Widder
- Department of Clinical Cardiology, Hannover Medical School, Hannover, Germany
| | - Georg Berding
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
| | - Ina Burchert
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- Department of Clinical Cardiology, Hannover Medical School, Hannover, Germany
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Carl Neuberg Strasse, 1, 30625 Hannover, Germany
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Shrestha UM, Seo Y, Botvinick EH, Gullberg GT. Image reconstruction in higher dimensions: myocardial perfusion imaging of tracer dynamics with cardiac motion due to deformation and respiration. Phys Med Biol 2015; 60:8275-301. [PMID: 26450115 DOI: 10.1088/0031-9155/60/21/8275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Myocardial perfusion imaging (MPI) using slow rotating large field of view cameras requires spatiotemporal reconstruction of dynamically acquired data to capture the time variation of the radiotracer concentration. In vivo, MPI contains additional degrees of freedom involving unavoidable motion of the heart due to quasiperiodic beating and the effects of respiration, which can severely degrade the quality of the images. This work develops a technique for a single photon emission computed tomography (SPECT) that reconstructs the distribution of the radiotracer concentration in the myocardium using a tensor product of different sets of basis functions that approximately describe the spatiotemporal variation of the radiotracer concentration and the motion of the heart. In this study the temporal B-spline basis functions are chosen to reflect the dynamics of the radiotracer, while the intrinsic deformation and the extrinsic motion of the heart are described by a product of a discrete set of Gaussian basis functions. Reconstruction results are presented showing the dynamics of the tracer in the myocardium as it deforms due to cardiac beating, and is displaced due to respiratory motion. These results are compared with the conventional 4D-spatiotemporal reconstruction method that models only the temporal changes of the tracer activity. The higher dimensional reconstruction method proposed here improves bias, yet the signal-to-noise ratio (SNR) decreases slightly due to redistribution of the counts over the cardiac-respiratory gates. Additionally, there is a trade-off between the number of gates and the number of projections per gate to achieve high contrast images.
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Affiliation(s)
- Uttam M Shrestha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA. Structural Biology and Imaging Department, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P, Buechel RR, Cuocolo A, van Eck-Smit BLF, Flotats A, Hacker M, Hindorf C, Kaufmann PA, Lindner O, Ljungberg M, Lonsdale M, Manrique A, Minarik D, Scholte AJHA, Slart RHJA, Trägårdh E, de Wit TC, Hesse B. EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. Eur J Nucl Med Mol Imaging 2015; 42:1929-40. [PMID: 26290421 PMCID: PMC4589547 DOI: 10.1007/s00259-015-3139-x] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 01/18/2023]
Abstract
Since the publication of the European Association of Nuclear Medicine (EANM) procedural guidelines for radionuclide myocardial perfusion imaging (MPI) in 2005, many small and some larger steps of progress have been made, improving MPI procedures. In this paper, the major changes from the updated 2015 procedural guidelines are highlighted, focusing on the important changes related to new instrumentation with improved image information and the possibility to reduce radiation exposure, which is further discussed in relation to the recent developments of new International Commission on Radiological Protection (ICRP) models. Introduction of the selective coronary vasodilator regadenoson and the use of coronary CT-contrast agents for hybrid imaging with SPECT/CT angiography are other important areas for nuclear cardiology that were not included in the previous guidelines. A large number of minor changes have been described in more detail in the fully revised version available at the EANM home page: http://eanm.org/publications/guidelines/2015_07_EANM_FINAL_myocardial_perfusion_guideline.pdf.
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Affiliation(s)
- Hein J Verberne
- Department of Nuclear Medicine, F2-238, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Wanda Acampa
- Institute of Biostructures and Bioimaging, National Council of Research, Naples, Italy
| | - Constantinos Anagnostopoulos
- Center for Experimental Surgery, Clinical and Translational Research, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Jim Ballinger
- Department of Nuclear Medicine, Guy's Hospital - Guy's & St Thomas' Trust Foundation, London, UK
| | - Frank Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Pieter De Bondt
- Department of Nuclear Medicine, OLV Hospital, Aalst, Belgium
| | - Ronny R Buechel
- Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Berthe L F van Eck-Smit
- Department of Nuclear Medicine, F2-238, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Albert Flotats
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Cecilia Hindorf
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | | | - Oliver Lindner
- Heart and Diabetes Center North Rhine-Westphalia, Institute for Radiology, Nuclear Medicine and Molecular Imaging, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Michael Ljungberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Markus Lonsdale
- Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Alain Manrique
- Department of Nuclear Medicine, Service Commun Investigations chez l'Homme, GIP Cyceron, Caen University Hospital, Caen, France
| | - David Minarik
- Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elin Trägårdh
- Clinical Physiology and Nuclear Medicine, Skåne University Hospital and Lund University, Malmö, Sweden
| | - Tim C de Wit
- Department of Nuclear Medicine, F2-238, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Birger Hesse
- Department of Clinical Physiology and Nuclear Medicine & PET, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
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Liu S. Radiolabeled Cyclic RGD Peptide Bioconjugates as Radiotracers Targeting Multiple Integrins. Bioconjug Chem 2015; 26:1413-38. [PMID: 26193072 DOI: 10.1021/acs.bioconjchem.5b00327] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Angiogenesis is a requirement for tumor growth and metastasis. The angiogenic process depends on vascular endothelial cell migration and invasion, and is regulated by various cell adhesion receptors. Integrins are such a family of receptors that facilitate the cellular adhesion to and migration on extracellular matrix proteins in the intercellular spaces and basement membranes. Among 24 members of the integrin family, αvβ3 is studied most extensively for its role in tumor angiogenesis and metastasis. The αvβ3 is expressed at relatively low levels on epithelial cells and mature endothelial cells, but it is highly expressed on the activated endothelial cells of tumor neovasculature and some tumor cells. This restricted expression makes αvβ3 an excellent target to develop antiangiogenic drugs and diagnostic molecular imaging probes. Since αvβ3 is a receptor for extracellular matrix proteins with one or more RGD tripeptide sequence, many radiolabeled cyclic RGD peptides have been evaluated as "αvβ3-targeted" radiotracers for tumor imaging over the past decade. This article will use the dimeric and tetrameric cyclic RGD peptides developed in our laboratories as examples to illustrate basic principles for development of αvβ3-targeted radiotracers. It will focus on different approaches to maximize the radiotracer tumor uptake and tumor/background ratios. This article will also discuss some important assays for preclinical evaluations of integrin-targeted radiotracers. In general, multimerization of cyclic RGD peptides increases their integrin binding affinity and the tumor uptake and retention times of their radiotracers. Regardless of their multiplicity, the capability of cyclic RGD peptides to bind other integrins (namely, αvβ5, α5β1, α6β4, α4β1, and αvβ6) is expected to enhance the radiotracer tumor uptake due to the increased integrin population. The results from preclinical and clinical studies clearly show that radiolabeled cyclic RGD peptides (such as (99m)Tc-3P-RGD2, (18)F-Alfatide-I, and (18)F-Alfatide-II) are useful as the molecular imaging probes for early cancer detection and noninvasive monitoring of the tumor response to antiangiogenic therapy.
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Affiliation(s)
- Shuang Liu
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
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Feasibility of one-eighth time gated myocardial perfusion SPECT functional imaging using IQ-SPECT. Eur J Nucl Med Mol Imaging 2015; 42:1920-8. [PMID: 26227534 DOI: 10.1007/s00259-015-3142-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE IQ-SPECT, an add-on to general purpose cameras based on multifocal collimation, can reduce myocardial perfusion imaging (MPI) acquisition times to one-fourth that of standard procedures (to 12 s/view). In a phantom study, a reduction of the acquisition time to one-eighth of the standard time (to 6 s/view) was demonstrated as feasible. It remains unclear whether such a reduction could be extended to clinical practice. METHODS Fifty patients with suspected or diagnosed CAD underwent a 2-day stress-rest (99m)Tc-sestamibi MPI protocol. Two consecutive SPECT acquisitions (6 and 12 s/view) were performed. Electrocardiogram-gated images were reconstructed with and without attenuation correction (AC). Polar maps were generated and visually scored by two blinded observers for image quality and perfusion in 17 segments. Global and regional summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) were determined. Left ventricular volumes and ejection fraction were calculated based on automated contour detection. RESULTS Image quality was scored higher with the 12 s/view acquisition, both with and without AC. Summed scores were statistically comparable between the 6 s/view and the 12 s/view acquisition, both globally and in individual coronary territories (e.g. in images with AC, SSS were 6.6 ± 8.3 and 6.2 ± 8.2 with 6 s and 12 s/view, respectively, p = 0.10; SRS were 3.9 ± 5.6 and 3.5 ± 5.3, respectively, p = 0.19; and SDS were 2.8 ± 5.7 and 2.6 ± 5.7, respectively, p = 0.59). Both acquisitions allowed MPI-based diagnosis of CAD in 25 of the 50 patients (with AC). Calculated end-diastolic volume (EDV) and end-systolic volume (ESV) were modestly higher with the 6 s/view acquisition than with the 12 s/view acquisition (EDV +4.8 ml at rest and +3.7 ml after stress, p = 0.003; ESV +4.1 ml at rest and +2.6 ml after stress, p = 0.01), whereas the ejection fraction did not differ (-1.2 % at rest, p = 0.20, and -0.9 % after stress, p = 0.27). CONCLUSION Image quality and LV functional parameters obtained with a one-eighth acquisition time were statistically comparable to the previously validated one-fourth time protocol using IQ-SPECT. Shorter acquisition times without loss of diagnostic accuracy provide improved patient comfort and streamlined departmental efficiency.
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Joergensen T, Hansson SH. Evaluation of the Left Ventricular Ejection Fraction with Gated IQ-SPECT Myocardial Perfusion Imaging. J Nucl Med Technol 2015; 43:193-200. [DOI: 10.2967/jnmt.115.155382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/05/2015] [Indexed: 11/16/2022] Open
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Cardiac CT vs. Stress Testing in Patients with Suspected Coronary Artery Disease: Review and Expert Recommendations. CURRENT CARDIOVASCULAR IMAGING REPORTS 2015; 8. [PMID: 26500716 DOI: 10.1007/s12410-015-9344-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Diagnosis and management of coronary artery disease represent a major challenge to our health care systems affecting millions of patients each year. Until recently, the diagnosis of coronary artery disease could be conclusively determined only by invasive coronary angiography. To avoid risks from cardiac catheterization, many healthcare systems relied on stress testing as gatekeeper for coronary angiography. Advancements in cardiac computed tomography angiography technology now allows to noninvasively visualize coronary artery disease, challenging the role of stress testing as the default noninvasive imaging tool for evaluating patients with chest pain. In this review, we summarize current data on the clinical utility of cardiac computed tomography and stress testing in stable patients with suspected coronary artery disease.
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Hannequin PP. Dual adaptive statistical approach for quantitative noise reduction in photon-counting medical imaging: application to nuclear medicine images. Phys Med Biol 2015; 60:4581-99. [PMID: 26009552 DOI: 10.1088/0031-9155/60/11/4581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Noise reduction in photon-counting images remains challenging, especially at low count levels. We have developed an original procedure which associates two complementary filters using a Wiener-derived approach. This approach combines two statistically adaptive filters into a dual-weighted (DW) filter. The first one, a statistically weighted adaptive (SWA) filter, replaces the central pixel of a sliding window with a statistically weighted sum of its neighbors. The second one, a statistical and heuristic noise extraction (extended) (SHINE-Ext) filter, performs a discrete cosine transformation (DCT) using sliding blocks. Each block is reconstructed using its significant components which are selected using tests derived from multiple linear regression (MLR). The two filters are weighted according to Wiener theory. This approach has been validated using a numerical phantom and a real planar Jaszczak phantom. It has also been illustrated using planar bone scintigraphy and myocardial single-photon emission computed tomography (SPECT) data. Performances of filters have been tested using mean normalized absolute error (MNAE) between the filtered images and the reference noiseless or high-count images.Results show that the proposed filters quantitatively decrease the MNAE in the images and then increase the signal-to-noise Ratio (SNR). This allows one to work with lower count images. The SHINE-Ext filter is well suited to high-size images and low-variance areas. DW filtering is efficient for low-size images and in high-variance areas. The relative proportion of eliminated noise generally decreases when count level increases. In practice, SHINE filtering alone is recommended when pixel spacing is less than one-quarter of the effective resolution of the system and/or the size of the objects of interest. It can also be used when the practical interest of high frequencies is low. In any case, DW filtering will be preferable.The proposed filters have been applied to nuclear medicine images but can also be used for any other kind of photon-counting images, such as x-ray and fluorescence images.
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Affiliation(s)
- Pascal Paul Hannequin
- Centre d'Imagerie Nucléaire d'Annecy, Immeuble Le Péricles, Entrée B, Allée de la Mandallaz, 74370 Metz-Tessy, France
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Van Kriekinge SD, Berman DS, Germano G. Assessment of RV function using gated blood pool SPECT. J Nucl Cardiol 2015; 22:493-5. [PMID: 25795395 DOI: 10.1007/s12350-015-0091-x] [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: 01/27/2015] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Serge D Van Kriekinge
- AIM Program, Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Ste A047N, Los Angeles, CA, 90048, USA,
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White D, Lawson RS. A Poisson resampling method for simulating reduced counts in nuclear medicine images. Phys Med Biol 2015; 60:N167-76. [PMID: 25880881 DOI: 10.1088/0031-9155/60/9/n167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nuclear medicine computers now commonly offer resolution recovery and other software techniques which have been developed to improve image quality for images with low counts. These techniques potentially mean that these images can give equivalent clinical information to a full-count image. Reducing the number of counts in nuclear medicine images has the benefits of either allowing reduced activity to be administered or reducing acquisition times. However, because acquisition and processing parameters vary, each user should ideally evaluate the use of images with reduced counts within their own department, and this is best done by simulating reduced-count images from the original data. Reducing the counts in an image by division and rounding off to the nearest integer value, even if additional Poisson noise is added, is inadequate because it gives incorrect counting statistics. This technical note describes how, by applying Poisson resampling to the original raw data, simulated reduced-count images can be obtained while maintaining appropriate counting statistics. The authors have developed manufacturer independent software that can retrospectively generate simulated data with reduced counts from any acquired nuclear medicine image.
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Affiliation(s)
- Duncan White
- Barnsley Hospital NHS Foundation Trust, Barnsley, UK. The Institute of Physics and Engineering in Medicine, Nuclear Medicine Software Quality Group
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Hill KD, Einstein AJ. New approaches to reduce radiation exposure. Trends Cardiovasc Med 2015; 26:55-65. [PMID: 25962784 DOI: 10.1016/j.tcm.2015.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/04/2015] [Accepted: 04/07/2015] [Indexed: 12/20/2022]
Abstract
Exposure to ionizing radiation is associated with a long-term risk of health effects, including cancer. Radiation exposure to the U.S. population from cardiac imaging has increased markedly over the past three decades. Initiatives to reduce radiation exposure have focused on the tenets of appropriate study "justification" and "optimization" of imaging protocols. This article reviews ways to optimally reduce radiation dose across the spectrum of cardiac imaging.
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Affiliation(s)
- Kevin D Hill
- Division of Pediatric Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC.
| | - Andrew J Einstein
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY; Department of Radiology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY
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Dorbala S, Blankstein R, Skali H, Park MA, Fantony J, Mauceri C, Semer J, Moore SC, Di Carli MF. Approaches to reducing radiation dose from radionuclide myocardial perfusion imaging. J Nucl Med 2015; 56:592-9. [PMID: 25766891 DOI: 10.2967/jnumed.112.115097] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/27/2015] [Indexed: 11/16/2022] Open
Abstract
Radionuclide myocardial perfusion imaging (MPI) plays a vital role in the evaluation and management of patients with coronary artery disease. However, because of a steep growth in MPI in the mid 2000s, concerns about inappropriate use of MPI and imaging-related radiation exposure increased. In response, the professional societies developed appropriate-use criteria for MPI. Simultaneously, novel technology, image-reconstruction software for traditional scanners, and dedicated cardiac scanners emerged and facilitated the performance of MPI with low-dose and ultra-low-dose radiotracers. This paper provides a practical approach to performing low-radiation-dose MPI using traditional and novel technologies.
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Affiliation(s)
- Sharmila Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ron Blankstein
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Hicham Skali
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mi-Ae Park
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jolene Fantony
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Charles Mauceri
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - James Semer
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Stephen C Moore
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Marcelo F Di Carli
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, the Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology) and Radiology, Brigham and Women's Hospital, Boston, Massachusetts
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