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Ruddy TD, Davies RA, Kiess MC. Development and evolution of nuclear cardiology and cardiac PET in Canada. J Med Imaging Radiat Sci 2024; 55:S3-S9. [PMID: 38637261 DOI: 10.1016/j.jmir.2024.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
Gated radionuclide angiography and myocardial perfusion imaging were developed in the United States and Europe in the 1970's and soon adopted in Canadian centers. Much of the early development of nuclear cardiology in Canada was in Toronto, Ontario and was quickly followed by new programs across the country. Clinical research in Canada contributed to the further development of nuclear cardiology and cardiac PET. The Canadian Nuclear Cardiology Society (CNCS) was formed in 1995 and became the Canadian Society of Cardiovascular Nuclear and CT Imaging (CNCT) in 2014. The CNCS had a major role in education and advocacy for cardiovascular nuclear medicine testing. The CNCS established the Dr Robert Burns Lecture and CNCT named the Canadian Society of Cardiovascular Nuclear and CT Imaging Annual Achievement Award for Dr Michael Freeman in memoriam of these two outstanding Canadian leaders in nuclear cardiology. The future of nuclear cardiology in Canada is exciting with the expanding use of SPECT imaging to include Tc-99m-pyrophosphate for diagnosis of transthyretin cardiac amyloidosis and the ongoing introduction of cardiac PET imaging.
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Affiliation(s)
- Terrence D Ruddy
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
| | - Ross A Davies
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Marla C Kiess
- Division of Cardiology, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Bishop A, King S, Stace S, Elliott J. Can retrospectively fusing SPECT to CT images reduce radiation doses in myocardial perfusion imaging? Radiography (Lond) 2023; 29:327-332. [PMID: 36706601 DOI: 10.1016/j.radi.2023.01.008] [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: 10/11/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION To establish if the CT dataset acquired during the stress element of myocardial perfusion imaging can be fused to the subsequent rest scan to reduce radiation doses from these procedures. METHODS 86 rest scans were processed and evaluated using a self-designed project specific tool. Recording processing time, the time between the two data sets selected for fusion and assessing radiographic reports to ensure produced images were of diagnostic quality. RESULTS 70% of fused scans were acquired 6-7 days apart; the mean (SD) processing time was calculated as 2.03 (0.36) minutes. The Pearson's correlation between these two variables was determined to be 0.22, showing a slight positive correlation although not statistically significant. 100% of the images produced were of diagnostic quality. CONCLUSION Rest scans can be fused to a previously acquired CT, careful consideration should be given when positioning the patient and to the time interval between acquiring the two data sets, departmental guidelines can assist with this. Staff training may also be beneficial to ensure staff can assess if data sets are fusible prior to completing a scan. IMPLICATIONS FOR PRACTICE This data provides evidence that retrospective fusion can reduce patient radiation doses in myocardial perfusion imaging without compromising diagnostic outcomes. Dose optimisation is an essential part of the ionising radiation (medical exposure) regulations therefore retrospective fusion should be considered in practice to ensure departmental compliance, although it is noteworthy this study is solely based in a single centred one camera department.
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Affiliation(s)
- A Bishop
- Hywel Dda University Health Board Pembrokeshire, UK: UWE, Bristol, UK: Cardiff University, Cardiff, UK.
| | | | - S Stace
- Hywel Dda University Health Board Pembrokeshire, UK
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Al-Mallah MH, Bateman TM, Branch KR, Crean A, Gingold EL, Thompson RC, McKenney SE, Miller EJ, Murthy VL, Nieman K, Villines TC, Yester MV, Einstein AJ, Mahmarian JJ. 2022 ASNC/AAPM/SCCT/SNMMI guideline for the use of CT in hybrid nuclear/CT cardiac imaging. J Nucl Cardiol 2022; 29:3491-3535. [PMID: 36056224 DOI: 10.1007/s12350-022-03089-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 01/29/2023]
Affiliation(s)
- Mouaz H Al-Mallah
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
| | - Timothy M Bateman
- Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Kelley R Branch
- Division of Cardiovascular, University of Washington, Seattle, WA, USA
| | - Andrew Crean
- Division of Cardiovascular Medicine, Ottawa Heart Institute, Ottawa, ON, Canada
| | - Eric L Gingold
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Randall C Thompson
- Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sarah E McKenney
- Department of Radiology, University of California, Davis Medical Center, Sacramento, CA, USA
| | - Edward J Miller
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Venkatesh L Murthy
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Koen Nieman
- Departments of Cardiovascular Medicine and Radiology, Stanford University Medical Center, Stanford, CA, USA
| | - Todd C Villines
- Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Michael V Yester
- Department of Radiology, School of Medicine, University of Alabama Medical Center, Birmingham, AL, USA
| | - Andrew J Einstein
- Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, NY, USA
| | - John J Mahmarian
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
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Karahan Şen NP, Bekis R, Şentürk B, Akdeniz B. The Comparison of Quantitative Evaluation Results of the MPS SPECT/CT and Coronary Angiography: Determining the Most Valuable Quantitative Evaluation Score. Mol Imaging Radionucl Ther 2021; 30:169-176. [PMID: 34658498 PMCID: PMC8522523 DOI: 10.4274/mirt.galenos.2021.26056] [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
Objectives: This study aimed to determine the most important perfusion score in patient selection for coronary angiography (CA) by quantitatively evaluating myocardial perfusion scintigraphy (MPS). Methods: Patients who underwent MPS single-photon emission computerized tomography/computed tomograph imaging in our clinic between December 2017 and January 2019, without coronary artery disease (CAD) history, followed by CA were included in the study. CA was considered positive when there is a stenosis of 70% or more in at least one coronary vessel. The summed stress score, rest score, and differential score; total perfusion deficit (TPD); and the defect’s extent obtained from non-attenuation-corrected (NC) and attenuation-corrected (AC) images of 80 patients were evaluated using the Mann-Whitney U test. A p value of <0.05 was considered significant. Receiver operating characteristic (ROC) analysis was performed. Results: The scores obtained from NC and AC images showed a significant difference between the two groups for all scores except for the extent and TPD scores at rest from AC images. The applied ROC curves’ highest diagnostic value was determined as the TPD score at stress (TPDS) obtained from NC images (area under the curve: 0.880, 95% confidence interval, 0.807-0.952, p<0.001). The cut-off value obtained for the TPDS from the ROC curve was found to be 5.5. Conclusion: The scores obtained from NC images have more power to detect CAD than those obtained from AC images. Patients with no prior CAD history with TPDS score higher than 5 in MPS should be referred for CA with priority.
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Affiliation(s)
| | - Recep Bekis
- Dokuz Eylül University Faculty of Medicine, Department of Nuclear Medicine, İzmir, Turkey
| | - Bihter Şentürk
- Dokuz Eylül University Faculty of Medicine, Department of Cardiology, İzmir, Turkey
| | - Bahri Akdeniz
- Dokuz Eylül University Faculty of Medicine, Department of Cardiology, İzmir, Turkey
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Fukami M, Tamura K, Nakamura Y, Nakatsukasa S, Sasaki M. Evaluating the effectiveness of a single CT method for attenuation correction in stress-rest myocardial perfusion imaging with thallium-201 chloride SPECT. Radiol Phys Technol 2019; 13:20-26. [PMID: 31768935 DOI: 10.1007/s12194-019-00540-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/17/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
This study aimed to evaluate the effectiveness of a single computed tomography (CT) based attenuation correction method using thallium-201 chloride (201TlCl) in stress-rest myocardial perfusion imaging (MPI). The data of 106 patients who underwent MPI with single photon emission computed tomography (SPECT) using 201TlCl were retrospectively reviewed. MPI SPECT images were reconstructed using stress SPECT and stress CT (SIO), rest SPECT and rest CT (RIO), and rest SPECT and stress CT (RIA). The accuracy of alignment between the SPECT and CT images was evaluated with normalized cross-correlation (NCC) and visual examination. The summed rest score (SRS) was used to evaluate hypoperfusion at rest; washout rate (WO) was used to assess ischemia; and left ventricular ejection fraction (LVEF) was used to evaluate the left ventricle (LV) function. There was no significant difference in NCC and visual evaluation in all three dimensions. The SRS of both RIO and RIA (7.5 ± 7.7 and 7.7 ± 7.6, respectively) did not differ significantly. However, SRSs of RIO and RIA showed a strong correlation (r = 0.98). The WO was 39.0 ± 0.98% for both RIO and RIA, with a strong correlation between the two values (r = 1.00). LVEF was 61.1 ± 17.4% for RIO and 61.3 ± 17.4% for RIA, and a strong correlation was observed between the two values (r = 1.00). In conclusion, the single CT-based attenuation correction method with 201TlCl SPECT has an accuracy equivalent to that of the conventional two CT-based attenuation correction method.
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Affiliation(s)
- Mitsuha Fukami
- Department of Radiology, JCHO Tokuyama Central Hospital, 1-1 Koda-cho, Shunan, 745-8522, Yamaguchi, Japan.
| | - Kiyoshi Tamura
- Department of Radiology, JCHO Tokuyama Central Hospital, 1-1 Koda-cho, Shunan, 745-8522, Yamaguchi, Japan
| | - Yuya Nakamura
- Department of Radiology, JCHO Tokuyama Central Hospital, 1-1 Koda-cho, Shunan, 745-8522, Yamaguchi, Japan
| | - Syoichi Nakatsukasa
- Department of Radiology, JCHO Tokuyama Central Hospital, 1-1 Koda-cho, Shunan, 745-8522, Yamaguchi, Japan
| | - Masayuki Sasaki
- Department of Medical Quantum Science, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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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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Wells RG, Soueidan K, Timmins R, Ruddy TD. Comparison of attenuation, dual-energy-window, and model-based scatter correction of low-count SPECT to 82Rb PET/CT quantified myocardial perfusion scores. J Nucl Cardiol 2013; 20:785-96. [PMID: 23737161 DOI: 10.1007/s12350-013-9738-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 05/23/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND New reconstruction algorithms allow reduction in acquisition times or the amount of injected radioactivity. We examined the impact of different corrections on low-count clinical SPECT myocardial perfusion images (MPI) and compared to (82)Rb PET/CT. We compared no corrections (NC) to attenuation correction (AC) with and without scatter correction by either a dual-energy-window (AC-DEW) or model-based (AC-ESSE) approach. All reconstructions included resolution recovery. METHODS 56 patients were imaged using a standard rest/stress Tc-99m-tetrofosmin MPI SPECT/CT protocol with an additional half-time acquisition. A (82)Rb-rest/stress PET/CT MPI was acquired within 4 weeks. Reconstruction methods were compared using summed rest/stress/difference scores from an objective algorithm (SRS/SSS/SDS). RESULTS The SRS and SSS for NC were significantly (P < .01) higher than for AC, but well correlated (r ≥ 0.87). The correlation in SRS/SSS among AC, AC-DEW, and AC-ESSE was excellent (r ≥ 0.98). AC-ESSE and AC-DEW had higher SRS (P ≤ .05) than AC, but the SDS values were not significantly different. Concordance with PET normal/abnormal classification was 76% for NC and ≥85% for the AC methods. CONCLUSION AC significantly improves the accuracy of low-count myocardial perfusion SPECT half-time imaging for the detection of disease compared to NC. Compared to PET, there was no significant difference among AC, AC-DEW, and AC-ESSE.
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Affiliation(s)
- R Glenn Wells
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada,
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