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Vauchot F, Dubois J, Bourdon A. Improving multi-pinhole CZT myocardial perfusion imaging specificity without changing sensibility by using adapted filter parameters. EJNMMI Res 2024; 14:27. [PMID: 38453724 PMCID: PMC10920588 DOI: 10.1186/s13550-024-01083-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Meta-analysis show the diagnostic performance of cardiac dedicated multi-pinhole cadmium-zinc-telluride myocardial perfusion imaging (MPI) with a sensibility around 0.9 and a specificity around 0.7. The aim of the present study is to explore a simple method to generate less artefact on MPI using single photon emission computed tomography (SPECT) and to enhance specificity without changing sensibility. RESULTS From October 2018 to March 2019, 200 patients who underwent SPECT with [99mTc]Tc-tetrofosmin were prospectively recruited: 100 patients with ischemia or necrosis diagnosis (first arm), and 100 patients with myocardial reversible SPECT artefact (second arm). Each SPECT was explored using two image process based on a Butterworth prefilter and post-filter: the original image processing (reconstruction A) with a cut-off frequency equals to 37% of the Nyquist frequency and order equals to 7, and a second image processing (reconstruction B) with a cut-off frequency equals to 25% of the Nyquist frequency and order equals to 5. For each patient, sum stress or rest score with and without septum (SSRS and SSRSws) were calculated with the two reconstructions. No significant statistical difference between SSRSa and SSRSb was identified for the first arm (P = 0.54) and the relative difference ∆r was - 0.5 ± 11.1% (95% CI - 2.7 to 1.7). We found a significant statistical difference between SSRSa and SSRSb for the second arm (p < 0.0001) and the relative difference ∆r was 69.7 ± 16.2% (95% CI 66.6-72.9). CONCLUSION In conclusion, using a Butterworth prefilter and post-filter cut-off frequency equal to 25% of the Nyquist frequency before iterative reconstruction generates less artefact and improves myocardial SPECT specificity without affecting sensibility compared with the original reconstruction.
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Affiliation(s)
- Fabien Vauchot
- Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France.
| | - Julien Dubois
- Department of Radiopharmacy, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Aurélie Bourdon
- Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France
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2
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Van Tosh A, Cao JJ, Votaw JR, Cooke CD, Palestro CJ, Nichols KJ. Clinical implications of compromised 82Rb PET data acquisition. J Nucl Cardiol 2022; 29:2583-2594. [PMID: 34417670 DOI: 10.1007/s12350-021-02774-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We wished to document the prevalence and quantitative effects of compromised 82Rb PET data acquisitions on myocardial flow reserve (MFR). METHODS AND RESULTS Data were analyzed retrospectively for 246 rest and regadenoson-stress studies of 123 patients evaluated for known or suspected CAD. An automated injector delivered pre-determined activities of 82Rb. Automated quality assurance algorithms identified technical problems for 7% (9/123) of patients. Stress data exhibited 2 instances of scanner saturation, 1 blood peak detection, 1 blood peak width, 1 gradual patient motion, and 2 abrupt patient motion problems. Rest data showed 1 instance of blood peak width and 2 abrupt patient motion problems. MFR was lower for patients with technical problems flagged by the quality assurance algorithms than those without technical problems (1.5 ± 0.5 versus 2.1 ± 0.7, P = 0.01), even though rest and stress ejection fraction, asynchrony and relative myocardial perfusion measures were similar for these two groups (P > 0.05), suggesting that MFR accuracy was adversely affected by technical errors. CONCLUSION It is important to verify integrity of 82Rb data to ensure MFR computation quality.
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Affiliation(s)
- Andrew Van Tosh
- St. Francis Hospital, Roslyn, NY, USA
- Research Department, St. Francis Hospital, 100 Port Washington Blvd., Roslyn, NY, 11576-1348, USA
| | | | | | | | | | - Kenneth J Nichols
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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3
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Cichocki P, Błaszczyk M, Cygulska K, Filipczak K, Adamczewski Z, Kuśmierek J, Lipiec P, Kasprzak JD, Płachcińska A. Inter- and Intraobserver Repeatability of Myocardial Flow Reserve Values Determined with SPECT Study Using a Discovery NM530c Camera and Corridor 4DM Software. J Pers Med 2021; 11:jpm11111164. [PMID: 34834516 PMCID: PMC8624690 DOI: 10.3390/jpm11111164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/31/2021] [Accepted: 11/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Myocardial blood flow (MBF) and flow reserve (MFR) examination, especially useful in the diagnosis of multivessel coronary artery disease (CAD), can be assessed with a cadmium-zinc-telluride (CZT) SPECT gamma camera, as an alternative to the expensive and less available PET. However, study processing is not free from subjective factors. Therefore, this paper aims to evaluate intra- and interobserver repeatability of MBF and MFR values obtained by the same operator and two independent operators. METHODS This study included 57 adult patients. MBF and MFR were assessed using a Discovery NM530c camera in a two-day, rest/dipyridamople protocol, using 99mTc-MIBI. Data were processed using Corridor4DM software, twice by one operator and once by another operator. RESULTS The repeatability of the assessed values was quite good in the whole myocardium, LAD and LCX vascular territories, but was poor in the RCA territory. CONCLUSIONS The poor repeatability of MBF and MFR in RCA vascular territory can be explained by poor automatic orientation of the heart axis during post-processing and a so-called "cardiac creep" phenomenon. Better automatic heart orientation and introduction of automatic motion correction is likely to drastically improve this repeatability. In the present state of the software, PET is better for patients requiring assessment of MFR in the RCA territory.
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Affiliation(s)
- Paweł Cichocki
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
| | - Michał Błaszczyk
- Department of Quality Control and Radiological Protection, Medical University of Lodz, 92-216 Lodz, Poland; (M.B.); (K.F.); (A.P.)
| | - Kamila Cygulska
- Chair and Department of Cardiology, Bieganski Hospital, Medical University of Lodz, 91-347 Lodz, Poland; (K.C.); (P.L.); (J.D.K.)
| | - Krzysztof Filipczak
- Department of Quality Control and Radiological Protection, Medical University of Lodz, 92-216 Lodz, Poland; (M.B.); (K.F.); (A.P.)
| | - Zbigniew Adamczewski
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
- Correspondence:
| | - Jacek Kuśmierek
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
| | - Piotr Lipiec
- Chair and Department of Cardiology, Bieganski Hospital, Medical University of Lodz, 91-347 Lodz, Poland; (K.C.); (P.L.); (J.D.K.)
| | - Jarosław Damian Kasprzak
- Chair and Department of Cardiology, Bieganski Hospital, Medical University of Lodz, 91-347 Lodz, Poland; (K.C.); (P.L.); (J.D.K.)
| | - Anna Płachcińska
- Department of Quality Control and Radiological Protection, Medical University of Lodz, 92-216 Lodz, Poland; (M.B.); (K.F.); (A.P.)
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4
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Cichocki P, Adamczewski Z, Kuśmierek J, Płachcińska A. Mask-Related Motion Artifact on 99mTc-MIBI SPECT: Unexpected Pitfalls of SARS-CoV-2 Countermeasures. Diagnostics (Basel) 2021; 11:diagnostics11081426. [PMID: 34441360 PMCID: PMC8391267 DOI: 10.3390/diagnostics11081426] [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: 07/15/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/04/2022] Open
Abstract
A 61-year-old man was referred for myocardial perfusion scintigraphy (MPS) by an occupational physician to exclude coronary artery disease (CAD). The patient had a complete left bundle branch block (LBBB) that rendered the routine exercise stress test non-diagnostic, but otherwise had no history of heart diseases, good stress tolerance with no symptoms of angina, and no abnormalities in transthoracic echocardiogram, apart from contraction patterns typical for LBBB. Initial MPS, performed using technetium-labeled Sestamibi on a Discovery NM 530c camera equipped with solid-state semiconductor detectors, revealed a significant stress-induced ischemia that did not match the good overall condition of the patient. A motion detection procedure revealed significant heart motion in Z-axis during the stress study. Upon inquiry, the patient reported breathing difficulties caused by the mandatory mask, which slipped into an uncomfortable position during the study. Repeated acquisition, without motion artifacts, revealed no features of ischemia.
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Affiliation(s)
- Paweł Cichocki
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
| | - Zbigniew Adamczewski
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
- Correspondence:
| | - Jacek Kuśmierek
- Department of Nuclear Medicine, Medical University of Lodz, 92-216 Lodz, Poland; (P.C.); (J.K.)
| | - Anna Płachcińska
- Department of Quality Control and Radiation Protection, Medical University of Lodz, 92-216 Lodz, Poland;
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Kyme AZ, Fulton RR. Motion estimation and correction in SPECT, PET and CT. Phys Med Biol 2021; 66. [PMID: 34102630 DOI: 10.1088/1361-6560/ac093b] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/08/2021] [Indexed: 11/11/2022]
Abstract
Patient motion impacts single photon emission computed tomography (SPECT), positron emission tomography (PET) and X-ray computed tomography (CT) by giving rise to projection data inconsistencies that can manifest as reconstruction artifacts, thereby degrading image quality and compromising accurate image interpretation and quantification. Methods to estimate and correct for patient motion in SPECT, PET and CT have attracted considerable research effort over several decades. The aims of this effort have been two-fold: to estimate relevant motion fields characterizing the various forms of voluntary and involuntary motion; and to apply these motion fields within a modified reconstruction framework to obtain motion-corrected images. The aims of this review are to outline the motion problem in medical imaging and to critically review published methods for estimating and correcting for the relevant motion fields in clinical and preclinical SPECT, PET and CT. Despite many similarities in how motion is handled between these modalities, utility and applications vary based on differences in temporal and spatial resolution. Technical feasibility has been demonstrated in each modality for both rigid and non-rigid motion, but clinical feasibility remains an important target. There is considerable scope for further developments in motion estimation and correction, and particularly in data-driven methods that will aid clinical utility. State-of-the-art machine learning methods may have a unique role to play in this context.
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Affiliation(s)
- Andre Z Kyme
- School of Biomedical Engineering, The University of Sydney, Sydney, New South Wales, AUSTRALIA
| | - Roger R Fulton
- Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, AUSTRALIA
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6
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Benz DC, Buechel RR. The winding road towards respiratory motion correction: is this just another dead-end or do we finally get breathing under control? J Nucl Cardiol 2020; 27:2231-2233. [PMID: 30843146 DOI: 10.1007/s12350-019-01679-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
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7
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Grossmann M, Giannopoulos AA, Bechtiger FA, Messerli M, Schwyzer M, Benz DC, Kudura K, Gebhard C, Gräni C, Pazhenkottil AP, Kaufmann PA, Buechel RR. Ultra-low-dose computed tomography for attenuation correction of cadmium-zinc-telluride single photon emission computed tomography myocardial perfusion imaging. J Nucl Cardiol 2020; 27:228-237. [PMID: 29923103 DOI: 10.1007/s12350-018-1303-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/30/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The applicability of ultra-low-dose computed tomography (CT) for attenuation correction (AC) of single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) remains elusive. METHODS AND RESULTS One-hundred patients underwent one-day 99mTc-tetrofosmin stress-rest MPI and non-contrast enhanced cardiac CT with 120, 80, and 70 kilovolt peak (kVp) tube voltage and tube current of 200 milliamperes for creation of AC maps. Normalized percent myocardial uptake from SPECT-MPI using 80 kVp scans for AC showed excellent correlation vs AC from 120 kVp scans for stress [intraclass correlation (ICC) = 0.988, 95% CI = 0.986-0.989, P < .001] and rest (ICC = 0.985, 95% CI = 0.983-0.987, P < .001) with narrow Bland-Altman limits of agreement (BA-LA) (- 5.3% to 4.5% and - 5.4% to 4.4%, respectively) and minimal bias (- 0.4% and - 0.5%, respectively). Correlation of AC SPECT-MPI based on 70 vs 120 kVp scans was excellent for stress (ICC = 0.988, 95% CI = 0.986-0.989, P < .001) and rest (ICC = 0.986, 95% CI = 0.984-0.987, P < .001) with narrow BA-LA (- 5.3% to 4.4% and - 5.2% to 4.5%, respectively) and small bias (- 0.4% and - 0.3%, respectively). Mean effective radiation dose for the 120, 80 and 70 kVp scans were 0.58 ± 0.07, 0.19 ± 0.02, and 0.12 ± 0.01 mSv, respectively. CONCLUSIONS Attenuation maps for MPI obtained from ultra-low radiation dose CT scans are interchangeable with attenuation maps from standard-dose CT while offering a substantial reduction in radiation dose exposure.
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Affiliation(s)
- Marvin Grossmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Fabiola A Bechtiger
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Moritz Schwyzer
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Dominik C Benz
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Ken Kudura
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Catherine Gebhard
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Christoph Gräni
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.
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8
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Koenders SS, van Dijk JD, Jager PL, Ottervanger JP, Slump CH, van Dalen JA. Impact of regadenoson-induced myocardial creep on dynamic Rubidium-82 PET myocardial blood flow quantification. J Nucl Cardiol 2019; 26:719-728. [PMID: 30788758 PMCID: PMC6517358 DOI: 10.1007/s12350-019-01649-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/24/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Repositioning of the heart during myocardial perfusion imaging (MPI) using Rubidium-82 (Rb-82) PET may occur when using regadenoson. Our aim was to determine the prevalence and the effect of correcting for this myocardial creep on myocardial blood flow (MBF) quantification. METHODS We retrospectively included 119 consecutive patients who underwent dynamic rest- and regadenoson-induced stress MPI using Rb-82 PET. The presence of myocardial creep was visually assessed in the dynamic stress PET series by identifying differences between the automatically drawn myocardium contour and the activity. Uncorrected and corrected stress MBFs were compared for the three vascular territories (LAD, LCX, and RCA) and for the whole myocardium. RESULTS Myocardial creep was observed in 52% of the patients during stress. Mean MBF values decreased after correction in the RCA from 4.0 to 2.7 mL/min/g (P < 0.001), in the whole myocardium from 2.7 to 2.6 mL/min/g (P = 0.01), and increased in the LAD from 2.5 to 2.6 mL/min/g (P = 0.03) and remained comparable in the LCX (P = 0.3). CONCLUSIONS Myocardial creep is a frequent phenomenon when performing regadenoson-induced stress Rb-82 PET and has a significant impact on MBF values, especially in the RCA territory. As this may hamper diagnostic accuracy, myocardial creep correction seems necessary for reliable quantification.
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Affiliation(s)
- S S Koenders
- 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.
| | - 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 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
| | - J A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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9
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Daou D. Dedicated cardiac CZT SPECT is steadily moving to achieve its destiny. J Nucl Cardiol 2019; 26:453-455. [PMID: 28744820 DOI: 10.1007/s12350-017-1006-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 01/26/2023]
Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
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10
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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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11
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Giannopoulos AA, Buechel RR. A further step towards getting cardiac respiratory motion under control. J Nucl Cardiol 2018; 25:1310-1312. [PMID: 28247262 DOI: 10.1007/s12350-017-0835-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
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12
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Daou D, Sabbah R, Coaguila C, Boulahdour H. Impact of data-driven cardiac respiratory motion correction on the extent and severity of myocardial perfusion defects with free-breathing CZT SPECT. J Nucl Cardiol 2018; 25:1299-1309. [PMID: 28160264 DOI: 10.1007/s12350-017-0806-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/24/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND We previously reported the clinical feasibility and positive impact on image characteristics of a data-driven cardiac respiratory motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). Here, we evaluate its impact on the extent and severity of myocardial perfusion defects (MPD). METHODS We included 25 patients having a 1-day 99mTc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT. Acquisitions were processed with REGAT to generate mean RM gated SPECT. These were summed either after (R-SPECT) or without realignment (NR-SPECT). We noted the maximal cardiac RM shift in the 3 axes of the left ventricle (LV). Both visual and semi-quantitative analyses of myocardial tracer uptake were realized. Studies were classified as having an impact on the extent/severity of MPD with REGAT if ≥1 segment presented a severity score changing by ≥1 level between NR-SPECT and R-SPECT. An impact on the extent of MPD was considered present if at least 1 segment shifted from normal (score = 0) to abnormal (score different from 0) or inversely. RESULTS Cardiac RM was >10 mm in 55% of studies. With visual and semi-quantitative analyses, an impact on the extent/severity MPD was observed in 14% of all studies (7/49) and 60% of studies with cardiac RM >15 mm. An impact on the extent of MPD was observed in 5 of the 7 upper listed studies. All studies presenting an impact on MPD had RM in the anterior to inferior LV axis >10 mm. CONCLUSIONS A substantial number of MPI studies presented significant cardiac RM. Cardiac RM compensation showed a frequent impact on the extent/severity of MPD.
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Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
| | - Rémy Sabbah
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
| | - Carlos Coaguila
- Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France
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13
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Benz DC, Fuchs TA. Breathless or breathtaking: Respiratory motion correction. J Nucl Cardiol 2018; 25:429-432. [PMID: 27435279 DOI: 10.1007/s12350-016-0590-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Dominik C Benz
- Department of Nuclear Medicine, University Hospital Zurich, Ramistr 100, 8091, Zurich, Switzerland
| | - Tobias A Fuchs
- Department of Nuclear Medicine, University Hospital Zurich, Ramistr 100, 8091, Zurich, Switzerland.
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14
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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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15
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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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