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Wei H, Wu J, Han K, Hu G, Wang H, Guo X, Liu H, Wu Z, Li S. CMR validation of left ventricular volumes and ejection fraction measured by the IQ-SPECT system in patients with small heart size. EJNMMI Res 2023; 13:33. [PMID: 37093329 PMCID: PMC10126186 DOI: 10.1186/s13550-023-00987-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The IQ-SPECT system is equipped with multifocal collimators and uses ordered-subset conjugate gradient minimization (OSCGM) as its reconstruction algorithm, achieving a shorter acquisition time than conventional SPECT. Left ventricular ejection fraction (LVEF) is overestimated by conventional SPECT in patients with small heart size. In this study, we compared IQ-SPECT with conventional SPECT and cardiovascular magnetic resonance (CMR) for the estimation of LVEF in patients with small hearts (males: EDV ≤ 60 ml, ESV ≤ 25 ml; females: EDV ≤ 45 ml, ESV ≤ 20 ml). METHODS The study consisted of 49 consecutive patients (20 normal and 29 with small heart size) undergoing gated myocardial perfusion imaging (GMPI) with a 99mTc-labelled agent during stress or rest to assess the risk of coronary artery disease (CAD). The data were reconstructed using filtered back-projection (FBP) for conventional SPECT and OSCGM for IQ-SPECT. ESV, EDV, and LVEF were calculated using quantitative gated SPECT (QGS). To determine the optimal ordered-subset reconstruction parameters, we compared the LVEF from SPECT to the corresponding measurement from CMR. RESULTS EDV, ESV, and LVEF values obtained from IQ-SPECT and conventional SPECT showed that the results of these two forms of SPECT were significantly correlated, although the EDV and ESV obtained by IQ-SPECT were higher than those obtained by conventional SPECT. IQ-SPECT yielded lower LVEF measurements than conventional SPECT (normal heart size: 50.6 ± 4.3% vs. 73.4 ± 8.4%, P = 0.002; small heart size: 62.1 ± 7.8% vs. 75.0 ± 11.4%, P < 0.001). There were no significant differences in LVEF measurements made by IQ-SPECT and CMR (normal heart size: 50.6 ± 4.3% vs. 53.2 ± 5.8%, P > 0.05; small heart size: 62.1 ± 7.8% vs. 64.6 ± 8.8%, P > 0.05). Five subsets (S) and 12 iterations (I) did not differ significantly in LVEF between CMR and IQ-SPECT for patients with small hearts (64.6 ± 8.8% vs. 62.1 ± 7.8%, P = 0.120), while 3 S and 10 I were the best parameters for patients with normal heart size (50.6 ± 4.3% vs. 53.1 ± 5.8%, P = 0.117). CONCLUSION With CMR as the standard, IQ-SPECT yields more reliable LVEF values than conventional SPECT for populations with small heart size. The best reconstruction parameters from IQ-SPECT were 5 S and 12 I for patients with small hearts.
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Affiliation(s)
- Hua Wei
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Center for Post-Doctoral Studies, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Jiaojiao Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Ke Han
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Guang Hu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Hongliang Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Xiaoshan Guo
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Haiyan Liu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Verrecchia-Ramos E, Morel O, Beauchat V, Denet S, Djibo Sidikou A, Ginet M, Pfletschinger E, Teodor L, Trombowsky M, Verdier J, Vère C, Retif P, Mahmoud SB. Personalization of 99mTc-sestamibi activity in SPECT/CT myocardial perfusion imaging with the cardiofocal SmartZoom® collimator. EJNMMI Phys 2023; 10:23. [PMID: 36959483 PMCID: PMC10036680 DOI: 10.1186/s40658-023-00545-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Patient radioprotection in myocardial perfusion imaging (MPI)-SPECT is important but difficult to optimize. The aim of this study was to adjust injected activity according to patient size-weight or BMI-by using a cardiofocal collimator camera. METHODS The correlation equation between size and observed counts in image was determined in patients who underwent stress Tc-99m-sestamibi MPI-SPECT/CT with a cardiofocal collimator-equipped conventional Anger SPECT/CT system. Image quality analyses by seven nuclear physicians were conducted to determine the minimum patient size-independent observed count threshold that yielded sufficient image quality for perfusion-defect diagnosis. These data generated an equation that can be used to calculate personalized activity for patients according to their size. RESULTS Analysis of consecutive patients (n = 294) showed that weight correlated with observed counts better than body mass index. The correlation equation was used to generate the equation that expressed the relationship between observed counts, patient weight, and injected activity. Image quality analysis with 50 images yielded an observed count threshold of 22,000 counts. Using this threshold means that the injected activity in patients with < 100 kg would be reduced (e.g., by 67% in 45-kg patients). Patients who are heavier than 100 kg would also benefit from the use of the threshold because although the injected activity would be higher (up to 78% for 150-kg patients), good image quality would be obtained. CONCLUSIONS This study provided a method for determining the optimal injected activity according to patient weight without compromising the image quality of conventional Anger SPECT/CT systems equipped with a cardiofocal collimator. Personalized injected activities for each patient weight ranging from 45 to 150 kg were generated, to standardize the resulting image quality independently of patient attenuation. This approach improves patient/staff radioprotection because it reduces the injected activity for < 100-kg patients (the majority of patients).
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Affiliation(s)
- Emilie Verrecchia-Ramos
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France.
| | - Olivier Morel
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Valérie Beauchat
- CHR Metz-Thionville, Department of Nuclear Medicine, Bel-Air Hospital, 1, Rue du Friscaty, 57100, Thionville, France
| | - Sylvie Denet
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Abdourahamane Djibo Sidikou
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Merwan Ginet
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Estelle Pfletschinger
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Luminita Teodor
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Maud Trombowsky
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Jeany Verdier
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
| | - Christelle Vère
- CHR Metz-Thionville, Department of Nuclear Medicine, Bel-Air Hospital, 1, Rue du Friscaty, 57100, Thionville, France
| | - Paul Retif
- CHR Metz-Thionville, Department of Medical Physics, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
- Université de Lorraine, CNRS, CRAN, 54000, Nancy, France
| | - Sinan Ben Mahmoud
- CHR Metz-Thionville, Department of Nuclear Medicine, Mercy Hospital, 1, Allée du Château, 57530, Ars-Laquenexy, France
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Garcia EV, Slomka P, Moody JB, Germano G, Ficaro EP. Quantitative Clinical Nuclear Cardiology, Part 1: Established Applications. J Nucl Cardiol 2020; 27:189-201. [PMID: 31654215 DOI: 10.1007/s12350-019-01906-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/11/2019] [Indexed: 11/30/2022]
Abstract
Single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has attained widespread clinical acceptance as a standard of care for patients with known or suspected coronary artery disease (CAD). A significant contribution to this success has been the use of computer techniques to provide objective quantitative assessment in the standardization of the interpretation of these studies. Software platforms have been developed as a pipeline to provide the quantitative algorithms researched, developed and validated to be clinically useful so diagnosticians everywhere can benefit from these tools. The goal of this CME article (PART 1) is to describe the many quantitative tools that are clinically established and more importantly how clinicians should use them routinely in the interpretation, clinical management and therapy guidance of patients with CAD.
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Affiliation(s)
- Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University, 101 Woodruff Circle, Room 1203, Atlanta, GA, 30322, USA.
| | - Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Guido Germano
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Edward P Ficaro
- INVIA Medical Imaging Solutions, Ann Arbor, MI, USA
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Garcia EV, Slomka P, Moody JB, Germano G, Ficaro EP. Quantitative Clinical Nuclear Cardiology, Part 1: Established Applications. J Nucl Med 2019; 60:1507-1516. [PMID: 31375569 DOI: 10.2967/jnumed.119.229799] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/11/2019] [Indexed: 01/10/2023] Open
Abstract
SPECT myocardial perfusion imaging has attained widespread clinical acceptance as a standard of care for patients with known or suspected coronary artery disease. A significant contribution to this success has been the use of computer techniques to provide objective quantitative assessment in the standardization of the interpretation of these studies. Software platforms have been developed as a pipeline to provide the quantitative algorithms researched, developed and validated to be clinically useful so diagnosticians everywhere can benefit from these tools. The goal of this continuing medical education article (part 1) is to describe the many quantitative tools that are clinically established and, more importantly, how clinicians should use them routinely in interpretation, clinical management, and therapy guidance for patients with coronary artery disease.
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Affiliation(s)
- Ernest V Garcia
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Piotr Slomka
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Guido Germano
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Edward P Ficaro
- INVIA Medical Imaging Solutions, Ann Arbor, Michigan; and.,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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