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Hansen MN, Haarmark C, Kristensen B, Zerahn B. An Algorithm for Individual Dosage in Cadmium-Zinc-Telluride SPECT-Gated Radionuclide Angiography. Diagnostics (Basel) 2021; 11:diagnostics11122268. [PMID: 34943505 PMCID: PMC8700612 DOI: 10.3390/diagnostics11122268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 11/27/2022] Open
Abstract
The aim of the present study was to test an individualised dose without compromising the ease of analysing data when performing equilibrium radionuclide angiography (ERNA) using cadmium–zinc–telluride (CZT) SPECT. From March 2018 to January 2019, 1650 patients referred for ERNA received either an individualised dose of 99mTc-labeled human serum albumin (HSA) according to their age, sex, height, and weight (n = 1567), or a standard dose of 550 MBq (n = 83). The target count rate (CRT) was reduced every two months from 2.7 to 1.0 kcps. A final test with a CRT of 1.7 kcps was run for three months to test whether an agreement within 2% points for the determination of LVEF, on the basis of only two analyses, was obtainable in at least 95% of acquisitions. All the included ERNAs were performed on a dedicated cardiac CZT SPECT camera. When using the algorithm for an individualised dose, we found that agreement between the measured and predicted count rate was 80%. With a CRT of 1.7 kcps, the need for more than two analyses to obtain sufficient agreement for LVEF was 4.9%. Furthermore, this resulted in a mean dose reduction from 550 to 258 MBq. Patients’ weight, height, sex, and age can, therefore, be used for individualising a tracer dose while reducing the mean dose.
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Affiliation(s)
- Maria Normand Hansen
- Department of Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark; (C.H.); (B.K.); (B.Z.)
- Correspondence:
| | - Christian Haarmark
- Department of Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark; (C.H.); (B.K.); (B.Z.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Bent Kristensen
- Department of Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark; (C.H.); (B.K.); (B.Z.)
| | - Bo Zerahn
- Department of Nuclear Medicine, Copenhagen University Hospital Herlev and Gentofte, 2730 Herlev, Denmark; (C.H.); (B.K.); (B.Z.)
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2
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van Dijk JD, Dotinga M, Jager PL, Slump CH, Ottervanger JP, Mouden M, van Dalen JA. Body weight-dependent Rubidium-82 activity results in constant image quality in myocardial perfusion imaging with PET. J Nucl Cardiol 2021; 28:1536-1544. [PMID: 31485963 DOI: 10.1007/s12350-019-01875-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical practice shows degrading image quality in heavier patients who undergo myocardial perfusion imaging (MPI) with Rubidium-82 (Rb-82) PET when using a fixed tracer activity. Our aim was to derive and validate a patient-specific activity protocol resulting in a constant image quality in PET MPI. METHODS We included 251 patients who underwent rest MPI with Rb-82 PET (Discovery 670, GE Healthcare). 132 patients were included retrospectively and were scanned using a fixed activity of 740 MBq. The total number of measured prompts was normalized to activity and correlated to body weight, mass per body length and body mass index to find the best predicting parameter. Next, a patient-specific activity was derived and subsequently validated in 119 additional patients. Image quality was scored by three experts on a four-point scale. RESULTS Both image quality and prompts decreased in heavier patients when using a fixed activity (p < .005). Body weight was used to derive a new activity formula: Activity = 8.3 MBq/kg. When applying this formula, both measured prompts and scored image quality became independent of body weight (p > .60). CONCLUSION Administrating a Rb-82 activity that linearly depends on body weight resulted in a constant image quality across all patients and is recommended.
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Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
| | - M Dotinga
- Department of Nuclear Medicine, Isala, PO Box 10400, 8000 GK, Zwolle, The Netherlands
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - P L Jager
- Department of Nuclear Medicine, Isala, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - C H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | | | - M Mouden
- Department of Cardiology, Isala, Zwolle, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala, Zwolle, The Netherlands
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3
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van Dijk JD, Jager PL, van Dalen JA. The next step in standardizing SPECT myocardial perfusion imaging. J Nucl Cardiol 2021; 28:234-235. [PMID: 30972720 DOI: 10.1007/s12350-019-01716-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
Affiliation(s)
- J D van Dijk
- Isala hospital, Department of Nuclear Medicine, Zwolle, The Netherlands.
| | - P L Jager
- Isala hospital, Department of Nuclear Medicine, Zwolle, The Netherlands
| | - J A van Dalen
- Isala hospital, Department of Medical Physics, Zwolle, The Netherlands
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4
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Cuddy-Walsh SG, Clackdoyle DC, Renaud JM, Wells RG. Patient-specific SPECT imaging protocols to standardize image noise. J Nucl Cardiol 2021; 28:225-233. [PMID: 30834500 DOI: 10.1007/s12350-019-01664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND In addition to acquired photon counts, image noise depends on the image reconstruction algorithm. This work develops patient-specific activity or acquisition time protocols to standardize the average noise in a reconstructed image for different patients, cameras, and reconstruction algorithms. METHODS Image noise was calculated for images from 43 patients acquired on both a conventional and a multiple-pinhole cardiac SPECT camera. Functions were found to relate image noise to radiotracer activity, scan time, and body mass and were validated by normalizing the image noise in a test set of 58 patients. RESULTS There was a 3.6-fold difference in photon sensitivity between the two cameras but a 16-fold difference in activity-scan time was necessary to match the noise levels. Image noise doubled from 45 to 128 kg for the conventional camera (12.8 minutes) and tripled for the multiple-pinhole camera (5 minutes) for 350 MBq (9.5 mCi) 99mTc-tetrofosmin. It was 16.3% and 6.1% respectively for an average sized patient. CONCLUSIONS A linear scaling of activity with respect to the patient weight normalizes image noise but the scaling factors depend on the choice of camera and image reconstruction parameters. Therefore, equivalent numbers of acquired photon counts are not sufficient to guarantee equivalent image noise.
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Affiliation(s)
- Sarah G Cuddy-Walsh
- Department of Physics, Carleton University, Ottawa, ON, Canada.
- Division of Cardiology, Cardiac Imaging, University of Ottawa Heart Institute, H2258 - 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
| | - Duncan C Clackdoyle
- Division of Cardiology, Cardiac Imaging, University of Ottawa Heart Institute, H2258 - 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
| | - Jennifer M Renaud
- Division of Cardiology, Cardiac Imaging, University of Ottawa Heart Institute, H2258 - 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
| | - R Glenn Wells
- Department of Physics, Carleton University, Ottawa, ON, Canada
- Division of Cardiology, Cardiac Imaging, University of Ottawa Heart Institute, H2258 - 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
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5
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Rydberg J, Andersen J, Haarmark C, Zerahn B. The influence of anthropometric and basic circulatory variables on count rate in cadmium-zinc-telluride SPECT gated radionuclide angiography. J Nucl Cardiol 2019; 26:1974-1980. [PMID: 30120749 DOI: 10.1007/s12350-018-1402-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
AIM To determine the influence of weight, height, gender, age, heart rate, and blood pressure on count rate in cadmium-zinc-telluride single-photon emission computed tomography (CZT SPECT) gated radionuclide angiography. METHOD A total of 1,065 eligible patients referred for routine assessment of left ventricular ejection fraction were registered from August 2015 to November 2016. Data were recorded on heart rate, systolic and diastolic blood pressure, age, gender, height, weight, and count rate. All radionuclide angiographies were performed on a dedicated cardiac CZT SPECT camera, GE Discovery 530c. A dose of 550 MBq 99mTc-labeled human serum albumin was administered intravenously to each patient. RESULTS Count rate varied from 1.2 to 8.9 counts per second. All test variables were significantly associated with count rate. From the preliminary analysis, weight appeared as the main contributing factor for explaining the variations in count rate with and R2 of 0.68. A model consisting of weight, height, gender, and age explains 75% of the variance in count rate. CONCLUSION Patient height, weight, gender, and age have significant impact on count rate when performing CZT radionuclide angiography and may subsequently be used for individualized planning of tracer dosage.
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Affiliation(s)
- Julie Rydberg
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
| | - Jannick Andersen
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Christian Haarmark
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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6
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Papanastasiou E, Theodoridou E, Doumas A, Gerasimou G, Siountas A. A study on the optimization of the administered activity in myocardial perfusion SPECT imaging with Tc-99m according to body measurements. Phys Med 2019; 68:69-74. [PMID: 31759267 DOI: 10.1016/j.ejmp.2019.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Nuclear medicine myocardial perfusion imaging (MPI) in obese patients requires the administration of higher amounts of radioactivity, to compensate for the loss of photons due to the increased attenuation and scatter. The aim of the present study was to investigate whether an administered activity escalation protocol, proposed to yield the same effective dose irrespective of patient's weight, can also lead to images of comparable count density for all patients. MATERIALS AND METHODS 184 pharmacologically induced stress 99m-Tc MIBI and 99m-Tc tetrofosmin SPECT MPI examinations (123 males, 61 females) were included in this study. Body weight, BMI and chest circumference were collected for each patient. The administered activity was adjusted to body weight according to the IAEA protocol. Detector count rate (DCR) from the projection images and normal myocardial count rate (MCR) from the appropriately segmented reconstructed images, with and without attenuation correction, were recorded. RESULTS No statistically significant correlation was found between DCR and any anthropometric parameter. A weak correlation was observed between MCR and BMI and between MCR and chest circumference for male patients only, but even these correlations were eliminated after the application of attenuation correction. The anthropometric parameter that generally correlates more strongly with DCR/MBq and MCR/MBq was body weight for men and chest circumference for women. CONCLUSION The IAEA activity escalation protocol used in this study leads to comparable image count densities, irrespective of body weight, for both men and women.
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Affiliation(s)
- Emmanouil Papanastasiou
- Medical Physics Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24, Greece.
| | - Eleni Theodoridou
- Medical Physics Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24, Greece
| | - Argyrios Doumas
- 2nd Nuclear Medicine Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24, Greece
| | - Georgios Gerasimou
- 2nd Nuclear Medicine Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24, Greece
| | - Anastasios Siountas
- Medical Physics Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24, Greece
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7
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Fang W, Liu S. New 99mTc Radiotracers for Myocardial Perfusion Imaging by SPECT. Curr Radiopharm 2019; 12:171-186. [PMID: 30727939 DOI: 10.2174/1874471012666190206102214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Myocardial Perfusion Imaging (MPI) with radiotracers is an integral component in evaluation of the patients with known or suspected coronary artery diseases (CAD). 99mTc-Sestamibi and 99mTc-Tetrofosmin are commercial radiopharmaceuticals for MPI by single photon-emission computed tomography (SPECT). Despite their widespread clinical applications, they do not meet the requirements of an ideal perfusion imaging agent due to their inability to linearly track the regional myocardial blood flow rate at >2.5 mL/min/g. With tremendous development of CZT-based SPECT cameras over the past several years, the nuclear cardiology community has been calling for better perfusion radiotracers with improved extraction and biodistribution properties. METHODS This review will summarize recent research efforts on new cationic and neutral 99mTc radiotracers for SPECT MPI. The goal of these efforts is to develop a 99mTc radiotracer that can be used to detect perfusion defects at rest or under stress, determine the regional myocardial blood flow, and measure the perfusion and left ventricular function. RESULTS The advantage of cationic radiotracers (e.g. 99mTc-Sestamibi) is their long myocardial retention because of the positive molecular charge and fast liver clearance kinetics. 99mTc-Teboroxime derivatives have a high initial heart uptake (high first-pass extraction fraction) due to their neutrality. 99mTc- 3SPboroxime is the most promising radiotracer for future clinical translation considering its initial heart uptake, myocardial retention time, liver clearance kinetics, heart/liver ratios and SPECT image quality. CONCLUSION 99mTc-3SPboroximine is an excellent example of perfusion radiotracers, the heart uptake of which is largely relies on the regional blood flow. It is possible to use 99mTc-3SPboroximine for detection of perfusion defect(s), accurate quantification and determination of regional blood flow rate. Development of such a 99mTc radiotracer is of great clinical benefit for accurate diagnosis of CAD and assessing the risk of future hard events (e.g. heart attack and sudden death) in cardiac patients.
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Affiliation(s)
- Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing, China
| | - Shuang Liu
- School of Health Sciences, Purdue University, Beijing, IN 47907, United States
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8
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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: 214] [Impact Index Per Article: 35.7] [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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9
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van Dijk JD, van Dalen JA, Mouden M, Ottervanger JP, Knollema S, Slump CH, Jager PL. Value of automatic patient motion detection and correction in myocardial perfusion imaging using a CZT-based SPECT camera. J Nucl Cardiol 2018; 25:419-428. [PMID: 27406376 PMCID: PMC5869883 DOI: 10.1007/s12350-016-0571-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/01/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Correction of motion has become feasible on cadmium-zinc-telluride (CZT)-based SPECT cameras during myocardial perfusion imaging (MPI). Our aim was to quantify the motion and to determine the value of automatic correction using commercially available software. METHODS AND RESULTS We retrospectively included 83 consecutive patients who underwent stress-rest MPI CZT-SPECT and invasive fractional flow reserve (FFR) measurement. Eight-minute stress acquisitions were reformatted into 1.0- and 20-second bins to detect respiratory motion (RM) and patient motion (PM), respectively. RM and PM were quantified and scans were automatically corrected. Total perfusion deficit (TPD) and SPECT interpretation-normal, equivocal, or abnormal-were compared between the noncorrected and corrected scans. Scans with a changed SPECT interpretation were compared with FFR, the reference standard. Average RM was 2.5 ± 0.4 mm and maximal PM was 4.5 ± 1.3 mm. RM correction influenced the diagnostic outcomes in two patients based on TPD changes ≥7% and in nine patients based on changed visual interpretation. In only four of these patients, the changed SPECT interpretation corresponded with FFR measurements. Correction for PM did not influence the diagnostic outcomes. CONCLUSION Respiratory motion and patient motion were small. Motion correction did not appear to improve the diagnostic outcome and, hence, the added value seems limited in MPI using CZT-based SPECT cameras.
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Affiliation(s)
- Joris D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands.
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - Jorn A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
| | - Mohamed Mouden
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | | | - Siert Knollema
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands
| | - Cornelis H Slump
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Pieter L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000, Zwolle, GK, The Netherlands
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10
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Verberne HJ, Scholtens AM. The very hungry caterpillar and the ongoing effort to reduce radiation in myocardial perfusion scintigraphy: Have we become the beautiful butterfly? J Nucl Cardiol 2018; 25:36-38. [PMID: 28822086 DOI: 10.1007/s12350-017-1024-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 10/24/2022]
Affiliation(s)
- Hein J Verberne
- Department of Radiology and Nuclear Medicine, F2-238, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Asbjørn M Scholtens
- Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands
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11
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van Dijk JD, Borren NM, Mouden M, van Dalen JA, Ottervanger JP, Jager PL. Effect of a patient-specific minimum activity in stress myocardial perfusion imaging using CZT-SPECT: Prognostic value, radiation dose, and scan outcome. J Nucl Cardiol 2018; 25:26-35. [PMID: 28822102 DOI: 10.1007/s12350-017-1011-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND SPECT Myocardial perfusion imaging (MPI) is associated with a relatively high radiation burden and decreasing image quality in heavy patients. Patient-specific low-activity protocols (PLAPs) are suggested but follow-up data is lacking. Our aim was to compare the use of a standard fixed-activity protocol (FAP) with a PLAP in cadmium zinc telluride (CZT)-SPECT MPI. METHODS We retrospectively included 1255 consecutive patients who underwent CZT-SPECT stress-optional rest MPI. 668 Patients were scanned using FAP (370 MBq) and 587 patients using PLAP (2.25 MBq·kg-1). Percentage of scans interpreted as normal, radiation dose, and 1-year follow-up including hard event rates (all-cause death or non-fatal myocardial infarction) were collected and compared. RESULTS The percentage of scans interpreted as normal was 67% in FAP and 70% in PLAP groups (P = .29). The annualized hard event rates in these patients were 1.0% in the FAP and 0.9% in the PLAP group (P = .86). However, the mean radiation dose decreased by 23% for stress-only and by 15% to 2.6 mSv for stress-optional rest MPI after introduction of the PLAP (p<0.001). CONCLUSIONS Introduction of a patient-specific low-activity protocol does not affect the percentage of scans interpreted as normal or prognosis but significantly lowers the radiation dose for CZT-SPECT MPI.
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Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
- MIRA: Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - N M Borren
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - M Mouden
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
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12
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Zhao ZQ, Liu M, Fang W, Liu S. Sulfonyl-Containing Boronate Caps for Optimization of Biological Properties of 99mTc(III) Radiotracers [99mTcCl(CDO)(CDOH)2B-R] (CDOH2 = Cyclohexanedione Dioxime). J Med Chem 2017; 61:319-328. [PMID: 29186661 DOI: 10.1021/acs.jmedchem.7b01412] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Zuo-Quan Zhao
- Department of
Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical
College, No.167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Min Liu
- School
of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
| | - Wei Fang
- Department of
Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical
College, No.167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Shuang Liu
- School
of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, Indiana 47907, United States
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13
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Liu M, Zhao ZQ, Fang W, Liu S. Novel Approach for 99mTc-Labeling of Red Blood Cells: Evaluation of 99mTc-4SAboroxime as a Blood Pool Imaging Agent. Bioconjug Chem 2017; 28:2998-3006. [PMID: 29148726 DOI: 10.1021/acs.bioconjchem.7b00601] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Angiography with radiolabeled red blood cells (RBCs) plays an important role in diagnosis and prognosis in vascular diseases. Both in vitro and in vivo methods have been developed for 99mTc-labeling of RBCs. However, these methods are complicated and lack reproducibility. Therefore, it is highly desirable to develop an alternative method for routine 99mTc-labeling of RBCs. In this report, we present a novel approach for 99mTc-labeling of RBCs. We prepared a new 99mTc(III) radiotracer [99mTcCl(CDO)(CDOH)2B-4AS] (99mTc-4ASboroxime: 4AS-B(OH)2 = 4-aminosulfonylphenyl)boronic acid, and CDOH2 = cyclohexanedione dioxime) in >95% radiochemical purity. Imaging and biodistribution studies were performed in Sprague-Dawley (SD) rats. It was found that the blood radioactivity was ∼6.0%ID/g (∼90% injected dose for 200-225 g SD rats) for 99mTc-4ASboroxime with low uptake in the myocardium, kidneys, liver, lungs, and muscle, most likely due to lack of leakage of 99mTc-labeled RBCs from the intravascular space. The blood radioactivity was almost unchanged over the 2 h period, suggesting that the binding of 99mTc-4ASboroxime to blood components (cells, proteins, and plasma) is stable. The results from γ-counting of the isolated blood components showed that 99mTc-4ASboroxime had >95% of blood radioactivity binding to RBCs, ∼1% to albumin, and ∼3% remaining free in blood plasma, demonstrating its RBC-specificity. The results from imaging studies in SD rats indicated that 99mTc-4ASboroxime is predominantly distributed in the blood pool. Main blood vessels were well delineated in the head/neck and abdominal regions. This statement was further substantiated by the results from imaging studies in pigs. 99mTc-4ASboroxime is an excellent blood pool agent with the potential for diagnosis and prognosis of vascular diseases.
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Affiliation(s)
- Min Liu
- School of Health Sciences, Purdue University , West Lafayette, Indiana 47907, United States
| | - Zuo-Quan Zhao
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 167 North Lishi Road, Xicheng District, Beijing 100037, China
| | - Shuang Liu
- School of Health Sciences, Purdue University , West Lafayette, Indiana 47907, United States
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14
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van Dijk JD, Jager PL, van Dalen JA. Patient-specific activity or scan-time in SPECT myocardial perfusion imaging: A hands-on approach. J Nucl Cardiol 2017; 24:2129-2132. [PMID: 28879533 DOI: 10.1007/s12350-017-1056-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands.
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, 8000 GK, Zwolle, The Netherlands
| | - J A van Dalen
- Departments of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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Liu M, Liu S. 99mTc-3Cboroxime: a novel 99mTc(iii) complex [99mTcCl(CDO)(CDOH)2B-3C] (CDOH2 = cyclohexanedione dioxime; 3C-B(OH)2 = 3-(carbamoylphenyl)boronic acid) with high heart uptake and long myocardial retention. Dalton Trans 2017; 46:14509-14518. [DOI: 10.1039/c7dt01292f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this study, we found that 99mTc-3Cboroxime has the myocardial retention longer than that of 99mTc-Teboroxime, and its heart washout kinetics follows a regressive linear relationship over the 60 min period.
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Affiliation(s)
- Min Liu
- Department of Radiation Medicine and Protection
- Medical College
- Soochow University
- China
- School of Health Sciences
| | - Shuang Liu
- School of Health Sciences
- Purdue University
- USA
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16
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Liu M, Zheng Y, Avcibasi U, Liu S. Novel 99mTc(III)-azide complexes [ 99mTc(N 3)(CDO)(CDOH) 2B-R] (CDOH 2=cyclohexanedione dioxime) as potential radiotracers for heart imaging. Nucl Med Biol 2016; 43:732-741. [PMID: 27632344 DOI: 10.1016/j.nucmedbio.2016.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In this study, novel 99mTc(III)-azide complexes [99mTc(N3)(CDO)(CDOH)2B-R] (99mTc-ISboroxime-N3: R=IS; 99mTc-MPboroxime-N3: R=MP; 99mTc-PAboroxime-N3: R=PA; 99mTc-PYboroxime-N3: R=PY; and 99mTc-Uboroxime-N3: R=5U) were evaluated as heart imaging agents. METHODS Complexes [99mTc(N3)(CDO)(CDOH)2B-R] (R=IS, MP, PA, PY and 5U) were prepared by ligand exchange between NaN3 and [99mTcCl(CDO)(CDOH)2B-R]. Biodistribution and imaging studies were carried out in Sprague-Dawley rats. Image quantification was performed to compare their initial heart uptake and myocardial retention. RESULTS 99mTc-ISboroxime-N3, 99mTc-PYboroxime-N3 and 99mTc-Uboroxime-N3 were prepared with high RCP (93-98%) while the RCP of 99mTc-MPboroxime-N3 and 99mTc-PAboroxime-N3 was 80-85%. The myocardial retention curves of 99mTc-ISboroxime-N3, 99mTc-PYboroxime-N3 and 99mTc-Uboroxime-N3 were best fitted to the bi-exponential decay function. The half-time of the fast component was 1.6±0.4min for 99mTc-ISboroxime-N3, 0.7±0.1min for 99mTc-PYboroxime-N3 and 0.9±0.4min for 99mTc-Uboroxime-N3. The 2-min heart uptake from biodistribution studies followed the ranking order of 99mTc-ISboroxime-N3 (3.60±0.68%ID/g)>99mTc-PYboroxime-N3 (2.35±0.37%ID/g)≫99mTc-Uboroxime-N3 (1.29±0.06%ID/g). 99mTc-ISboroxime-N3 had the highest 2-min heart uptake among 99mTc radiotracers revaluated in SD rats. High quality SPECT images were obtained with the right and left ventricular walls being clearly delineated. The best image acquisition window was 0-5min for 99mTc-ISboroxime-N3. CONCLUSION Both azide coligand and boronate caps had significant impact on the heart uptake and myocardial retention of complexes [99mTc(N3)(CDO)(CDOH)2B-R]. Among the radiotracers evaluated in SD rats, 99mTc-ISboroxime-N3 has the highest initial heart uptake with the heart retention comparable to that of 99mTc-Teboroxime. 99mTc-ISboroxime-N3 is a promising alternative to 99mTc-Teboroxime for SPECT MPI.
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Affiliation(s)
- Min Liu
- Department of Radiation Medicine and Protection, Medical College, Soochow University, China; School of Health Sciences, Purdue University, IN, 47907, USA
| | - Yumin Zheng
- Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing, 100037, China
| | - Ugur Avcibasi
- School of Health Sciences, Purdue University, IN, 47907, USA; Department of Chemistry, Faculty of Arts and Science, Celal Bayar University, 45040, Yunusemre/Manisa, Turkey
| | - Shuang Liu
- School of Health Sciences, Purdue University, IN, 47907, USA.
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17
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Liu M, Fang W, Liu S. Novel 99mTc(III) Complexes [99mTcCl(CDO)(CDOH)2B–R] (CDOH2 = Cyclohexanedione Dioxime) Useful as Radiotracers for Heart Imaging. Bioconjug Chem 2016; 27:2770-2779. [DOI: 10.1021/acs.bioconjchem.6b00552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Min Liu
- Department
of Radiation Medicine and Protection, Medical College, Soochow University, China
- School
of Health Sciences, Purdue University, Indiana 47907, United States
| | - Wei Fang
- Department
of Nuclear Medicine, Fuwai Hospital, the National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Liu
- School
of Health Sciences, Purdue University, Indiana 47907, United States
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18
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Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2016; 43:2423-2432. [PMID: 27542010 DOI: 10.1007/s00259-016-3467-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
Abstract
The trade-off between resolution and count sensitivity dominates the performance of standard gamma cameras and dictates the need for relatively high doses of radioactivity of the used radiopharmaceuticals in order to limit image acquisition duration. The introduction of cadmium-zinc-telluride (CZT)-based cameras may overcome some of the limitations against conventional gamma cameras. CZT cameras used for the evaluation of myocardial perfusion have been shown to have a higher count sensitivity compared to conventional single photon emission computed tomography (SPECT) techniques. CZT image quality is further improved by the development of a dedicated three-dimensional iterative reconstruction algorithm, based on maximum likelihood expectation maximization (MLEM), which corrects for the loss in spatial resolution due to line response function of the collimator. All these innovations significantly reduce imaging time and result in a lower patient's radiation exposure compared with standard SPECT. To guide current and possible future users of the CZT technique for myocardial perfusion imaging, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, has decided to examine the current literature regarding procedures and clinical data on CZT cameras. The committee hereby aims 1) to identify the main acquisitions protocols; 2) to evaluate the diagnostic and prognostic value of CZT derived myocardial perfusion, and finally 3) to determine the impact of CZT on radiation exposure.
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van Dijk JD, Jager PL, Ottervanger JP, Slump CH, Knollema S, van Dalen JA. Patient-specific tracer activity in MPI SPECT: A hands-on approach. J Nucl Cardiol 2016; 23:145-8. [PMID: 26453569 PMCID: PMC4720695 DOI: 10.1007/s12350-015-0286-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands.
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - C H Slump
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - S Knollema
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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20
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van Dijk JD, Jager PL, Ottervanger JP, de Boer J, Oostdijk AHJ, Engbers EM, Slump CH, Knollema S, van Dalen JA. Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using conventional SPECT. J Nucl Cardiol 2016; 23:134-42. [PMID: 26353751 PMCID: PMC4720700 DOI: 10.1007/s12350-015-0246-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/01/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND The decreasing image quality in heavier patients can be compensated by administration of a patient-specific dose in myocardial perfusion imaging (MPI) using a cadmium zinc telluride-based SPECT camera. Our aim was to determine if the same can be achieved when using a conventional SPECT camera. METHODS 148 patients underwent SPECT stress MPI using a fixed Tc-99m tetrofosmin tracer dose. Measured photon counts were normalized to administered tracer dose and scan time and were correlated with body weight, body mass index, and mass per length to find the best predicting parameter. From these data, a protocol to provide constant image quality was derived, and subsequently validated in 125 new patients. RESULTS Body weight was found to be the best predicting parameter for image quality and was used to derive a new dose formula; A admin (MBq) = 223·body weight (kg)(0.65)/T scan (min). The measured photon counts decreased in heavier patients when using a fixed dose (P < .01) but this was no longer observed after applying a body-weight-dependent protocol (P = .20). CONCLUSIONS Application of a patient-specific protocol resulted in an image quality less depending on patient's weight. The results are most likely independent of the type of SPECT camera used, and, hence, adoption of patient-specific dose and scan time protocols is recommended.
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Affiliation(s)
- J D van Dijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, Zwolle, 8000 GK, The Netherlands.
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, Zwolle, 8000 GK, The Netherlands.
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands.
| | - J de Boer
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, Zwolle, 8000 GK, The Netherlands.
| | - A H J Oostdijk
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, Zwolle, 8000 GK, The Netherlands.
| | - E M Engbers
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands.
| | - C H Slump
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
| | - S Knollema
- Department of Nuclear Medicine, Isala Hospital, PO Box 10400, Zwolle, 8000 GK, The Netherlands.
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands.
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21
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Thompson RC, Burgett EV. Patient centered imaging and the dose of radiopharmaceuticals. J Nucl Cardiol 2016; 23:143-4. [PMID: 26353750 DOI: 10.1007/s12350-015-0263-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 08/05/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Randall C Thompson
- St. Luke's Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO, 64111, USA.
| | - Eric V Burgett
- St. Luke's Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO, 64111, USA
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22
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Yokota S, Mouden M, Ottervanger JP, Engbers E, Knollema S, Timmer JR, Jager PL. Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT. Eur J Nucl Med Mol Imaging 2015; 43:296-301. [DOI: 10.1007/s00259-015-3192-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
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23
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Blankstein R. Can advances in nuclear cardiology hardware overcome the challenges of imaging obese patients? J Nucl Cardiol 2015; 22:276-8. [PMID: 25294434 DOI: 10.1007/s12350-014-0005-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ron Blankstein
- Non-Invasive Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA,
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