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Huang Y, Zhang H, Hu X, Qin S, Hu F, Li Y, Cai H, Shi K, Yu F. The D-SPECT SH reconstruction protocol: improved quantification of small left ventricle volumes. EJNMMI Phys 2024; 11:5. [PMID: 38190088 PMCID: PMC10774323 DOI: 10.1186/s40658-023-00606-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Due to spatial resolution limitations, conventional NaI-SPECT typically overestimates the left ventricular (LV) ejection fraction (EF) in patients with small LV volumes. The purpose of this study was to explore the clinical application value of the small heart (SH) reconstruction protocol embedded in the postprocessing procedure of D-SPECT. METHODS We retrospectively analyzed patients who undergo both D-SPECT and echocardiography (Echo) within one week. Patients with small LV volume were defined as those with a rest end-systolic volume (rESV) ≤ 25 mL and underwent reconstruction using the standard (SD) reconstruction protocol. The SH protocol was deemed successful in correcting the LVEF value if it decreased by 5% or more compared to the SD protocol. The ROC curve was used to calculate the optimal cutoff value of the SH protocol. LVEF, ESV and EDV were computed with SD and SH, respectively. Echo was performed as a reference, and Echo-LVEF, ESV, and EDV were calculated using the Teichholz formula. One-way ANOVA was used to compare these parameters among the three groups. RESULTS The final study included 209 patients (73.21% female, age 67.34 ± 7.85 years). Compared with the SD protocol, the SH protocol significantly decreased LVEF (67.43 ± 7.38% vs. 71.30 ± 7.61%, p < 0.001). The optimal cutoff value for using the SH protocol was rESV > 17 mL (AUC = 0.651, sensitivity = 78.43%, specificity = 45.57%, p = 0.001). In the subgroup of rESV > 17 mL, there was no significant difference in LVEF (61.84 ± 4.67% vs. 62.83 ± 2.85%, p = 0.481) between the SH protocol and Echo, and no significant difference was observed in rESV (26.92 ± 3.25 mL vs. 27.94 ± 7.96 mL, p = 0.60) between the SH protocol and Echo. CONCLUSION This pilot study demonstrated that the SH reconstruction protocol was able to effectively correct the overestimation of LVEF in patients with small LV volumes. Particularly, in the rESV > 17 mL subgroup, the time and computing power waste could be reduced while still ensuring the accuracy of the LVEF value and image quality.
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Affiliation(s)
- Yan Huang
- Medical College, Anhui University of Science and Technology, Huainan, China
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Han Zhang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Xueping Hu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Shanshan Qin
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Fan Hu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Yuchen Li
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Haidong Cai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kuangyu Shi
- Department of Informatics, Technical University of Munich, Munich, Germany
- Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China.
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Błaszczyk M, Adamczewski Z, Płachcińska A. Capabilities of Modern Semiconductor Gamma Cameras in Radionuclide Diagnosis of Coronary Artery Disease. Diagnostics (Basel) 2021; 11:diagnostics11112130. [PMID: 34829477 PMCID: PMC8620025 DOI: 10.3390/diagnostics11112130] [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: 10/15/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022] Open
Abstract
This paper presents a review of the literature concerning the clinical application of modern semiconductor (CZT) gamma cameras in the radioinuclide diagnosis of coronary artery disease. It contains information on the diagnostic efficacy of myocardial perfusion studies performed with those cameras compared with the widely used scintillation (Anger) cameras, an overview of their effectiveness in comparison with coronary angiography (also fractional flow reserve) and currently available clinical results of a myocardial flow reserve measured with a dynamic SPECT study. Introduction of this imaging modality to the measurement of a myocardial flow reserve aims to facilitate access to this type of study compared to the less available and more expensive PET method used so far.
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Affiliation(s)
- Michał Błaszczyk
- Department of Quality Control and Radiological Protection, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland; (M.B.); (A.P.)
| | - Zbigniew Adamczewski
- Department of Nuclear Medicine, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland
- Correspondence:
| | - Anna Płachcińska
- Department of Quality Control and Radiological Protection, Medical University of Łódź, Czechosłowacka 8/10 Street, 92-216 Łódź, Poland; (M.B.); (A.P.)
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Mannarino T, Assante R, Ricciardi C, Zampella E, Nappi C, Gaudieri V, Mainolfi CG, Di Vaia E, Petretta M, Cesarelli M, Cuocolo A, Acampa W. Head-to-head comparison of diagnostic accuracy of stress-only myocardial perfusion imaging with conventional and cadmium-zinc telluride single-photon emission computed tomography in women with suspected coronary artery disease. J Nucl Cardiol 2021; 28:888-897. [PMID: 31222530 DOI: 10.1007/s12350-019-01789-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Breast attenuation may impact the diagnostic accuracy of stress myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT). We compared the performance of conventional (C)-SPECT and cadmium-zinc-telluride (CZT)-SPECT systems in women with low-intermediate likelihood of coronary artery disease (CAD). METHODS AND RESULTS A total of 109 consecutive women underwent stress-optional rest MPI by both C-SPECT and CZT-SPECT. In the overall study population, a weak albeit significant correlation between total perfusion defect (TPD) measured by C-SPECT and CZT-SPECT was observed (r = 0.38, P < .001) and at Bland-Altman analysis the mean difference in TPD (C-SPECT minus CZT-SPECT) was 2.40% (P < .001). Overall concordance of semi-quantitative diagnostic performance between C-SPECT and CZT-SPECT was observed in 52 (48%) women with a κ value of 0.09. Normalcy rate was significantly higher using CZT-SPECT compared to C-SPECT (P < .001). Machine learning analysis performed through the implementation of J48 algorithm proved that CZT-SPECT has higher sensitivity, specificity, and accuracy than C-SPECT. CONCLUSIONS In women with low-intermediate likelihood of CAD, there is a poor concordance of diagnostic performance between C-SPECT and CZT-SPECT, and CZT-SPECT allows better normalcy rate detection compared to C-SPECT.
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Affiliation(s)
- Teresa Mannarino
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carlo Ricciardi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Carmela Nappi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Valeria Gaudieri
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Ciro Gabriele Mainolfi
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Eugenio Di Vaia
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Mario Petretta
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Mario Cesarelli
- Department of Electrical Engineering and Information Technology, University Federico II, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
- Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
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Yamada Y, Nakano S, Gatate Y, Okano N, Muramatsu T, Nishimura S, Kuji I, Fukushima K, Matsunari I. Feasibility of simultaneous 99mTc-tetrofosmin and 123I-BMIPP dual-tracer imaging with cadmium-zinc-telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction. J Nucl Cardiol 2021; 28:187-195. [PMID: 30603890 DOI: 10.1007/s12350-018-01585-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/17/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simultaneous dual-tracer imaging using isotopes with close photo-peaks may benefit from improved properties of cadmium-zinc-telluride (CZT)-based scanners. METHODS Thirty patients having undergone primary percutaneous coronary intervention for acute myocardial infarction underwent single-(99mTc-tetrofosmin (TF) or 123I-BMIPP first) followed by simultaneous 99mTc-TF /123I-BMIPP dual-tracer imaging using a Discovery NM/CT 670 CZT. The values for the quantitative gated-SPECT (QGS) and the quantitative perfusion SPECT (QPS) were assessed. RESULTS The intra-class correlation (ICC) coefficients between the single- and dual-tracer imaging were high in all the QGS and QPS data (Summed motion score: 0.95, summed thickening score: 0.94, ejection fraction: 0.98, SRS for 99mTc-TF: 0.97/ for 123I-BMIPP: 0.95). Wall motion, wall thickening and rest scores per coronary-territory-based regions were also comparable between the single- and dual imaging (ICC coefficient > 0.91). The interrater concordance in the visual analysis for the infarction and perfusion-metabolism mismatch was significant for the global and regional left ventricle (P < 0.001). CONCLUSION The quantitative/semi-quantitative values for global and regional left-ventricular function, perfusion, and fatty acid metabolism were closely comparable between the dual-tracer imaging and the single-tracer mode. These data suggests the feasibility of the novel CZT-based scanner for the simultaneous 99mTc-TF /123I-BMIPP dual-tracer acquisitions in clinical settings.
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Affiliation(s)
- Yoshihiro Yamada
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shintaro Nakano
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan.
| | - Youdou Gatate
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Nanami Okano
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
| | - Toshihiro Muramatsu
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Shigeyuki Nishimura
- Department of Cardiology International Medical Center, Saitama Medical University, 1397-1 Yamane Hidaka, Saitama, 350-1298, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine International Medical Center, Saitama Medical University, Saitama, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University, Saitama, Japan
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Tsuboi K, Nagaki A, Shibutani T, Onoguchi M. Optimal choice of OSEM and SD reconstruction algorithms in CZT SPECT for hypertrophic cardiomyopathy patients. J Nucl Cardiol 2021; 28:236-244. [PMID: 30847855 DOI: 10.1007/s12350-019-01677-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/21/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND The spectrum dynamics (SD) algorithm is a cardiac reconstruction algorithm of D-SPECT, which improves spatial resolution compared with the ordered-subsets expectation maximization (OSEM) algorithm. We evaluated the wall thickness and left ventricular (LV) volume in patients with hypertrophic cardiomyopathy (HCM) using the SD algorithm. METHODS In a phantom study, the myocardial wall was scanned with varying wall thicknesses (10-40 mm). In the clinical study, 30 and 27 normal and HCM patients underwent myocardial perfusion imaging. RESULTS In a phantom study, LV volume using the SD algorithm was increased by thickening the wall of the phantom. In the clinical study, the wall thickness and LV volume of OSEM and SD algorithms showed a difference between HCM and normal groups. The wall thickness using OSEM and SD algorithms were 19.4 ± 2.0 and 16.7 ± 1.5 mm in patients with normal, and 27.9 ± 4.9 and 21.8 ± 2.6 mm in patients with HCM. CONCLUSION The SD algorithm in cases of HCM may not be able to correctly assess wall thickness and LV volume. Our study suggests that the OSEM is more suitable in cases of HCM than the SD algorithm.
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Affiliation(s)
- Kunihito Tsuboi
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan.
| | - Akio Nagaki
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
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Plateau A, Bouvet C, Merlin C, Pereira B, Barres B, Clerfond G, Cachin F, Cassagnes L. Assessment of four different cardiac softwares for evaluation of LVEF with CZT-SPECT vs CMR in 48 patients with recent STEMI. J Nucl Cardiol 2020; 27:2017-2026. [PMID: 30426398 DOI: 10.1007/s12350-018-01493-y] [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: 03/04/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare, vs CMR, four softwares: quantitative gated SPECT (QGS), myometrix (MX), corridor 4DM (4DM), and Emory toolbox (ECTb) to evaluate left ventricular ejection fraction (LVEF), end-systolic (ESV), and end-diastolic volumes (EDVs) by gated MPI CZT-SPECT. METHODS 48 patients underwent MPI CZT-SPECT and CMR 6 weeks after STEMI, LV parameters were measured with four softwares at MPI CZT-SPECT vs CMR. We evaluated (i) concordance and correlation between MPI CZT-SPECT and CMR, (ii) concordance MPI CZT-SPECT/CMR for the categorical evaluation of the left ventricular dysfunction, and (iii) impacts of perfusion defects > 3 segments on concordance. RESULTS LVEF: LCC QGS/CMR = 0.81 [+ 2.2% (± 18%)], LCC MX/CMR = 0.83 [+ 1% (± 17.5%)], LCC 4DM/CMR = 0.73 [+ 3.9% (± 21%)], LCC ECTb/CMR = 0.69 [+ 6.6% (± 21.1%)]. ESV: LCC QGS/CMR = 0.90 [- 8 mL (± 40 mL)], LCC MX/CMR = 0.90 [- 9 mL (± 36 mL)], LCC 4DM/CMR = 0.89 [+ 4 mL (± 45 mL)], LCC ECTb/CMR = 0.87 [- 3 mL (± 45 mL)]. EDV: LCC QGS/CMR = 0.70 [- 16 mL (± 67 mL)], LCC MX/CMR = 0.68 [- 21 mL (± 63 mL], LCC 4DM/CMR = 0.72 [+ 9 mL (± 73 mL)], LCC ECTb/CMR = 0.69 [+ 10 mL (± 70 mL)]. CONCLUSION QGS and MX were the two best-performing softwares to evaluate LVEF after recent STEMI.
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Affiliation(s)
- Antoine Plateau
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Clément Bouvet
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
| | - Charles Merlin
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Bruno Pereira
- DRCI, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Bertrand Barres
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- UMR INSERM 1240 "Molecular Imaging and Theranostic Strategy", Clermont Auvergne University, Clermont-Ferrand, France
| | - Guillaume Clerfond
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France
- Department of Cardiology, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Florent Cachin
- Nuclear Medicine Department, Jean Perrin Comprehensive Cancer, Clermont-Ferrand, France
- UMR INSERM 1240 "Molecular Imaging and Theranostic Strategy", Clermont Auvergne University, Clermont-Ferrand, France
| | - Lucie Cassagnes
- Department of Radiology, CHU Gabriel Montpied, Clermont-Ferrand, France.
- Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, 63000, Clermont-Ferrand, France.
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Giorgetti A, Marzullo P. Children of a lesser god: From radiocardiogram to CZT GSPECT. J Nucl Cardiol 2020; 27:2027-2030. [PMID: 30506154 DOI: 10.1007/s12350-018-01512-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: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Assuero Giorgetti
- Fondazione Toscana Gabriele Monasterio, Via G. Moruzzi 1, 56124, Pisa, Italy.
| | - Paolo Marzullo
- Fondazione Toscana Gabriele Monasterio, Via G. Moruzzi 1, 56124, Pisa, Italy
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Andrikopoulou E. Diastolic assessment by CZT-SPECT: Could it be the next best thing for the detection of subclinical chemotherapy-induced cardiotoxicity? J Nucl Cardiol 2020; 27:1202-1206. [PMID: 31309461 DOI: 10.1007/s12350-019-01792-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 11/29/2022]
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Piekarski E, Manrique A, Rouzet F, Le Guludec D. Current Status of Myocardial Perfusion Imaging With New SPECT/CT Cameras. Semin Nucl Med 2020; 50:219-226. [PMID: 32284108 DOI: 10.1053/j.semnuclmed.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Myocardial perfusion imaging (MPI) with Single-Photon Emission Computed Tomography (SPECT) has a major role in the management of coronary artery disease. Recent technological advances regarding SPECT detectors with the use of solid-state detectors has allowed for improved imaging quality since a decade with dramatic dose and/or time reduction of imaging protocols due to improved sensitivity and spatial resolution, and is now performed as a routine exam. Interestingly, this new technology has modified our everyday practice, from acquisition protocols (low dose and ultra-fast protocols) to image semiology. Numerous studies have shown how these technical advances have allowed for improved patient management, with similar or improved diagnostic and prognostic information derived from MPI. These improvements have also led to the straightforward implementation of myocardial blood flow measurement. This article reviews the current status of MPI using new SPECT and SPECT/CT cameras.
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Affiliation(s)
- Eve Piekarski
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France
| | - Alain Manrique
- Normandie Univ, UNICAEN, Caen, France; Médecine Nucléaire, CHU de Caen, Caen, France; GIP Cyceron, Campus Jules Horowitz, Caen, France
| | - François Rouzet
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France
| | - Dominique Le Guludec
- Nuclear Medicine Department, Bichat Hospital, AP-HP, Paris, France; Université de Paris, Paris, France; Laboratory for Vascular Translational Science, INSERM, Paris, France.
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Nkoulou R, Wolfrum M, Pazhenkottil AP, Fiechter M, Buechel RR, Gaemperli O, Kaufmann PA. Gated SPECT myocardial perfusion imaging with cadmium-zinc-telluride detectors allows real-time assessment of dobutamine-stress-induced wall motion abnormalities. J Nucl Cardiol 2019; 26:1734-1742. [PMID: 29340989 DOI: 10.1007/s12350-018-1187-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 12/18/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Left ventricular (LV) ejection fraction (EF) during high dobutamine stress (HD) by real-time gated-SPECT myocardial perfusion imaging (MPI) on a cadmium-zinc-telluride (CZT) gamma camera was validated versus cardiac magnetic resonance imaging (CMR). METHODS AND RESULTS After injecting 99mTc-tetrofosmin (320 MBq) in 50 patients (mean age 64 +/- 11 years), EF at rest and post-stress as well as relevant changes in EF at HD (ΔEF ≥ 5%) were assessed. CZT and CMR rest EF values yielded an excellent correlation and agreement (r = 0.96; P < 0.001; Bland-Altman limits of agreement (BA): + 0 to 14.8%). HD EF acquisition was feasible using CZT and correlated better to HD CMR EF than did post-stress CZT EF (r = 0.85 vs 0.76, respectively, all P < 0.001). Agreement in ΔEF detection between HD CMR and immediate post-stress CZT (reflecting standard acquisition using conventional SPECT camera unable to scan during stress) was 45%, while this increased to 85% with real-time HD CZT scan. CONCLUSION Real-time ultrafast dobutamine gated-SPECT MPI with a CZT device is feasible and provides accurate measurements of HD LV performance.
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Affiliation(s)
- Rene Nkoulou
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
- Department of Cardiology, University Hospital Geneva, Geneva, Switzerland.
| | - Mathias Wolfrum
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Michael Fiechter
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Oliver Gaemperli
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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Assante R, Cuocolo A. Real-time gated-SPECT myocardial perfusion imaging with CZT detectors: A promising tool for monitoring left ventricular function. J Nucl Cardiol 2019; 26:1743-1745. [PMID: 29546490 DOI: 10.1007/s12350-017-0924-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: 05/11/2017] [Accepted: 05/11/2017] [Indexed: 10/17/2022]
Affiliation(s)
- Roberta Assante
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
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Prospective diagnostic performance of semiconductor SPECT myocardial perfusion imaging: wall thickening analysis reduces the need for an additional prone acquisition. Eur J Nucl Med Mol Imaging 2019; 46:2042-2050. [PMID: 31321484 DOI: 10.1007/s00259-019-04415-3] [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: 02/05/2019] [Accepted: 06/25/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE To determine whether the assessment of regional wall thickening (WT) in addition to myocardial perfusion from stress supine acquisitions could compensate for the lack of prone acquisition and the corresponding decrease in the diagnostic performance of SPECT myocardial perfusion imaging (MPI) in patients with known or suspected coronary artery disease (CAD). METHODS The study group comprised 41 patients (123 vessels) with known or suspected CAD prospectively recruited for systematic prone and supine 201Tl stress SPECT MPI. The diagnostic performance of SPECT MPI was determined for various image sets including nongated supine images (supine NG), nongated combined prone and supine images (prone and supine NG) and gated supine images, allowing WT evaluation from NG images in addition to perfusion (supine NG + WT) using invasive coronary angiography and fractional flow reserve as the gold standards. RESULTS The rate of false positives was significantly higher among the supine NG images (20.8%) than among either the prone and supine NG or the supine NG + WT images (3.3% and 2.7%, respectively, P < 0.05 vs. supine NG). Consequently, specificity was higher for the prone and supine NG images than for the supine NG images (96.1% vs. 76.1%, P < 0.01) and was highest for the supine NG + WT images (96.8%, P not significant vs. prone and supine NG), without significant differences in sensitivity (80.0%, 86.6% and 73.3%, respectively, P not significant for all comparisons). CONCLUSION The diagnostic performance of supine stress SPECT MPI is improved when WT assessment of ischaemic segments is used as an additional diagnostic criterion to values not significantly different from those with combined prone and supine acquisitions.
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Yamane T, Kondo A, Takahashi M, Miyazaki Y, Ehara T, Koga K, Kuji I, Matsunari I. Ultrafast bone scintigraphy scan for detecting bone metastasis using a CZT whole-body gamma camera. Eur J Nucl Med Mol Imaging 2019; 46:1672-1677. [DOI: 10.1007/s00259-019-04329-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/02/2019] [Indexed: 01/12/2023]
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14
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Wu D, Zhang Z, Ma R, Guo F, Wang L, Fang W. Comparison of CZT SPECT and conventional SPECT for assessment of contractile function, mechanical synchrony and myocardial scar in patients with heart failure. J Nucl Cardiol 2019; 26:443-452. [PMID: 28623525 DOI: 10.1007/s12350-017-0952-6] [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: 03/01/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
AIM The aim of this study was to compare CZT-SPECT (CZT SPECT) to conventional SPECT (C-SPECT) in the assessment of left ventricular myocardial scar, contractile function, and mechanical synchrony in patients with heart failure (HF). METHODS Fifty-nine patients with HF who were referred for myocardial perfusion/metabolism imaging were enrolled. All patients underwent resting 99mTc-MIBI gated myocardial perfusion imaging using a CZT SPECT camera and a C-SPECT camera, respectively, and 18F-FDG PET myocardial metabolism imaging within three days. Summed rest score (SRS) and total perfusion defect (TPD) (as indices of perfusion abnormality), left ventricular (LV), end diastolic volume (EDV), end systolic volume (ESV), and ejection fraction (EF) (as indices of LV systolic function), and histogram band width (BW) and standard deviation (SD) (as indices of mechanical synchrony) were analyzed by automated software while the perfusion/metabolism patterns were analyzed visually. RESULTS There was a good correlation between CZT SPECT and C-SPECT for SRS and TPD. CZT SPECT tended to underestimate SRS and TPD compared to C-SPECT. CZT-SPECT and C-SPECT showed excellent agreement in assessing the perfusion/metabolism pattern though a small proportion of normal segments (6.6%) identified by CZT/PET exhibited mismatch pattern on C-SPECT/PET. CZT SPECT also showed excellent correlation with C-SPECT in measuring EDV, ESV, and EF. Finally, BW and SD measured by CZT SPECT correlated well with C-SPECT but CZT SPECT tended to overestimate BW and SD compared to C-SPECT. CONCLUSION CZT SPECT provided comparable data to C-SPECT for measuring LV scar, function and synchrony at a considerable reduction in imaging time. CZT SPECT holds a promise for comprehensive evaluation of myocardial performance in patients with HF.
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Affiliation(s)
- Dayong Wu
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Zongyao Zhang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongzheng Ma
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Guo
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Wang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Wei Fang
- Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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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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16
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Diastolic dysfunction can precede systolic dysfunction on MUGA in cancer patients receiving trastuzumab-based therapy. Nucl Med Commun 2018; 40:22-29. [PMID: 30418380 PMCID: PMC6282666 DOI: 10.1097/mnm.0000000000000941] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Trastuzumab (T) and anthracycline (A)-based chemotherapy is considered the standard of care in human epidermal growth factor receptor-2+ overexpressing breast cancer, but requires monitoring for known cardiotoxicity using left ventricular (LV) ejection fraction (EF) every 3–4 months during treatment. It is not conclusively established whether diastolic dysfunction (DD) precedes LVEF decrease in patients developing trastuzumab-induced cardiotoxicity (TIC). Objective The aim was to elucidate whether DD precedes LVEF decrease in trastuzumab-treated patients being monitored with radionuclide multigated acquisition for TIC. Patients and methods Patients treated with T±A-based chemotherapy who had undergone multigated acquisition were selected by date range (January 2006–September 2015). Up to four scans were analyzed per patient: (a) pre-A therapy, (b) pre-T therapy, (c) 4 months into T therapy, and (d) at end of T therapy. Baseline referred to the first scan of each patient (i.e. pre-A or pre-T). LV systolic and DD were defined as follows: EF less than 50% or a 10-point decrease from baseline and LV peak filling rate (PFR) less than 2.5 end-diastolic volume/s and time to peak LV filling rates (TPFR) greater than 180 ms, respectively. Results A total of 202 patients were screened for this study, of whom 153 had received A therapy (5.1±4.1 months duration) before T, 192 had 4 months of follow-up data, and 146 had 4 months of follow-up data and beyond (10.5±5.0 months). LVEF decreased with A and T therapy (P<0.005), but remained stable between 4 months and the final exam (P=0.26). In patients with normal diastolic function at baseline (45.5%), PFR decreased with A and T, and DD preceded SD by 73 days on average. In the remaining patients, with abnormal diastolic function at baseline (54.5%), PFR did not change over the course of treatment (P>0.1), nor did TPFR (P>0.3). Conclusion Patients with normal diastolic function at baseline receiving trastuzumab±anthracycline adjuvant therapy may develop DD before SD, therefore offering an opportunity for early referral to cardiologists to optimize cardiovascular risk factors and manage cardiotoxicity.
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Blaire T, Bailliez A, Ben Bouallegue F, Bellevre D, Agostini D, Manrique A. First assessment of simultaneous dual isotope ( 123I/ 99mTc) cardiac SPECT on two different CZT cameras: A phantom study. J Nucl Cardiol 2018; 25:1692-1704. [PMID: 28275896 DOI: 10.1007/s12350-017-0841-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND We studied the impact of simultaneous dual-isotope acquisition on 123I/99mTc mismatch assessment using two CZT cameras (DNM 530c, GE Healthcare and DSPECT, Biosensors International). METHODS We used an anthropomorphic torso phantom (respectively filled with a solution of 123I alone, 99mTc alone, and a mixture of 123I and 99mTc) and its cardiac insert with two defects mimicking two matched and mismatched defects. Mismatch extent and reconstructed image contrast were evaluated. RESULTS The acquisition mode (single vs dual) significantly impacted (i) 99mTc (but not 123I) reconstructed segmental activities using both camera (P < .001), and (ii) image contrast (using 123I and DNM 530c, P < .0001; and using both 123I and 99mTc with DSPECT, P < .0001). However, the defect and mismatch size were not impacted by the type of acquisition. With both DNM 530c and DSPECT, Lin's concordance correlation coefficient and Bland-Altman analysis demonstrated an almost perfect concordance and agreement between single- and simultaneous dual-isotope segmental activity (123I and 99mTc). CONCLUSIONS This study found no impact of the acquisition mode (single vs dual) or the type of camera (DSPECT vs DNM 530c) on 123I and 99mTc defect size and mismatch, providing a new step toward simultaneous dual-isotope acquisition for combined innervation and perfusion assessment.
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Affiliation(s)
- Tanguy Blaire
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France.
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, 14000, Caen, France.
- Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France.
| | - Alban Bailliez
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, 14000, Caen, France
- Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France
| | | | | | - Denis Agostini
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, 14000, Caen, France
- Department of Nuclear Medicine, CHU Cote de Nacre, Caen, France
| | - Alain Manrique
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, 14000, Caen, France
- Department of Nuclear Medicine, CHU Cote de Nacre, Caen, France
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Ben Bouallègue F, Mariano-Goulart D, Agostini D, Manrique A. Feasibility of biventricular volume and function assessment using first-pass gated 15O-water PET. EJNMMI Res 2018; 8:92. [PMID: 30225682 PMCID: PMC6141411 DOI: 10.1186/s13550-018-0445-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/07/2018] [Indexed: 01/17/2023] Open
Abstract
Background We investigated the feasibility of left ventricular (LV) and right ventricular (RV) volume and function estimation using a first-pass gated 15O-water PET. This prospective study included 19 patients addressed for myocardial perfusion reserve assessment using 15O-water PET. PET data were acquired at rest and after regadenoson stress, and gated first-pass images were reconstructed over the time range corresponding to tracer first-pass through the cardiac cavities and post-processed using TomPool software; LV and RV were segmented using a semi-automated 4D immersion algorithm. LV volumes were computed using a count-based model and a fixed threshold at 30% of the maximal activity. RV volumes were computed using a geometrical model and an adjustable threshold that was set so as to fit LV and RV stroke volumes. Ejection curves were fitted using a deformable reference curve model. LV results were compared to those obtained using 99mTc-sestamibi gated myocardial SPECT in terms of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF). Results There was an excellent concordance between rest and stress PET in terms of EDV and ESV (Lin’s coefficient ~ 0.85–0.90), SV (~ 0.80), and EF (~ 0.75) for both ventricles. Correlation with myocardial SPECT was high for LV EDV (Pearson’s R = 0.89, p < 0.001) and ESV (R = 0.87, p < 0.001) and satisfying for LV SV (R = 0.67, p < 0.001) and EF (R = 0.67, p < 0.001). Minimal LV ESV overestimation (+ 4 mL, p = 0.03) and EF underestimation (− 4%, p = 0.01) were observed using PET. Conclusions Biventricular volume and function assessment are achievable using the first-pass PET, and LV parameters correlate well with those derived from gated myocardial SPECT.
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Affiliation(s)
- Fayçal Ben Bouallègue
- Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France. .,PhyMedExp, INSERM - CNRS, Montpellier University, Montpellier, France. .,Nuclear Medicine Department, CHU de Caen, Caen, France.
| | - Denis Mariano-Goulart
- Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM - CNRS, Montpellier University, Montpellier, France
| | | | - Alain Manrique
- Nuclear Medicine Department, CHU de Caen, Caen, France.,UNICAEN, EA 4650 SEILIRM, GIP Cyceron, Normandie University, Caen, France
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19
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Kotha VK, Deva DP, Connelly KA, Freeman MR, Yan RT, Mangat I, Kirpalani A, Barfett JJ, Sloninko J, Lin HM, Graham JJ, Crean AM, Jimenez-Juan L, Dorian P, Yan AT. Cardiac MRI and radionuclide ventriculography for measurement of left ventricular ejection fraction in ICD candidates. Magn Reson Imaging 2018; 52:69-74. [PMID: 29859946 DOI: 10.1016/j.mri.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/26/2018] [Accepted: 05/27/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Current guidelines provide left ventricular ejection fraction (LVEF) criterion for use of implantable cardioverter defibrillators (ICD) but do not specify which modality to use for measurement. We compared LVEF measurements by radionuclide ventriculography (RNV) vs cardiac MRI (CMR) in ICD candidates to assess impact on clinical decision making. METHODS This single-centre study included 124 consecutive patients referred for assessment of ICD implantation who underwent RNV and CMR within 30 days for LVEF measurement. RNV and CMR were interpreted independently by experienced readers. RESULTS Among 124 patients (age 64 ± 11 years, 77% male), median interval between CMR and RNV was 1 day; mean LVEF was 32 ± 12% by CMR and 33 ± 11% by RNV (p = 0.60). LVEF by CMR and RNV showed good correlation, but Bland-Altman analysis showed relatively wide limits of agreement (-12.1 to 11.4). CMR LVEF reclassified 26 (21%) patients compared to RNV LVEF (kappa = 0.58). LVEF by both modalities showed good interobserver reproducibility (ICC 0.96 and 0.94, respectively) (limits of agreement -7.27 to 5.75 and -8.63 to 6.34, respectively). CONCLUSION Although LVEF measurements by CMR and RNV show moderate agreement, there is frequent reclassification of patients for ICD placement based on LVEF between these modalities. Future studies should determine if a particular imaging modality for LVEF measurement may enhance ICD decision making and treatment benefit.
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Affiliation(s)
- Vamshi K Kotha
- Department of Radiology, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
| | - Djeven P Deva
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Kim A Connelly
- University of Toronto, Toronto, ON, Canada; Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Michael R Freeman
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | | | - Iqwal Mangat
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Anish Kirpalani
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Joseph J Barfett
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Joanna Sloninko
- Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Hui Ming Lin
- Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - John J Graham
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Andrew M Crean
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging and Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Laura Jimenez-Juan
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Paul Dorian
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Andrew T Yan
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
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Sharir T. What is the value of motion and thickening in gated myocardial perfusion SPECT? J Nucl Cardiol 2018; 25:754-757. [PMID: 29476455 DOI: 10.1007/s12350-018-1239-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 02/05/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Tali Sharir
- Nuclear Cardiology Department, Assuta Medical Center, 96 Igal Alon, C Building, 67891, Tel Aviv, Israel.
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel.
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Gabrani-Juma H, Clarkin OJ, Pourmoghaddas A, Driscoll B, Wells RG, deKemp RA, Klein R. Validation of a Multimodality Flow Phantom and Its Application for Assessment of Dynamic SPECT and PET Technologies. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:132-141. [PMID: 28055829 DOI: 10.1109/tmi.2016.2599779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Simple and robust techniques are lacking to assess performance of flow quantification using dynamic imaging. We therefore developed a method to qualify flow quantification technologies using a physical compartment exchange phantom and image analysis tool. We validate and demonstrate utility of this method using dynamic PET and SPECT. Dynamic image sequences were acquired on two PET/CT and a cardiac dedicated SPECT (with and without attenuation and scatter corrections) systems. A two-compartment exchange model was fit to image derived time-activity curves to quantify flow rates. Flowmeter measured flow rates (20-300 mL/min) were set prior to imaging and were used as reference truth to which image derived flow rates were compared. Both PET cameras had excellent agreement with truth ( [Formula: see text]). High-end PET had no significant bias (p > 0.05) while lower-end PET had minimal slope bias (wash-in and wash-out slopes were 1.02 and 1.01) but no significant reduction in precision relative to high-end PET (<15% vs. <14% limits of agreement, p > 0.3). SPECT (without scatter and attenuation corrections) slope biases were noted (0.85 and 1.32) and attributed to camera saturation in early time frames. Analysis of wash-out rates from non-saturated, late time frames resulted in excellent agreement with truth ( [Formula: see text], slope = 0.97). Attenuation and scatter corrections did not significantly impact SPECT performance. The proposed phantom, software and quality assurance paradigm can be used to qualify imaging instrumentation and protocols for quantification of kinetic rate parameters using dynamic imaging.
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Giubbini R, Milan E. The time for radionuclide ventriculography resurrection is coming. J Nucl Cardiol 2016; 23:1139-1141. [PMID: 26253328 DOI: 10.1007/s12350-015-0245-x] [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: 07/05/2015] [Revised: 07/10/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - Elisa Milan
- San Giacomo Apostolo Hospital, Castelfranco Veneto, TV, Italy
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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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Bailliez A, Lairez O, Merlin C, Piriou N, Legallois D, Blaire T, Agostini D, Valette F, Manrique A. Left Ventricular Function Assessment Using 2 Different Cadmium-Zinc-Telluride Cameras Compared with a γ-Camera with Cardiofocal Collimators: Dynamic Cardiac Phantom Study and Clinical Validation. J Nucl Med 2016; 57:1370-5. [DOI: 10.2967/jnumed.115.168575] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/26/2016] [Indexed: 11/16/2022] Open
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Acampa W, Buechel RR, Gimelli A. Low dose in nuclear cardiology: state of the art in the era of new cadmium–zinc–telluride cameras. Eur Heart J Cardiovasc Imaging 2016; 17:591-5. [DOI: 10.1093/ehjci/jew036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/13/2016] [Indexed: 01/22/2023] Open
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Haarmark C, Haase C, Jensen MM, Zerahn B. Pre-chemotherapy values for left and right ventricular volumes and ejection fraction by gated tomographic radionuclide angiography using a cadmium-zinc-telluride detector gamma camera. J Nucl Cardiol 2016; 23:87-97. [PMID: 26338424 DOI: 10.1007/s12350-015-0177-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/06/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Estimation of left ventricular ejection fraction (LVEF) using equilibrium radionuclide angiography is an established method for assessment of left ventricular function. The purpose of this study was to establish normative data on left and right ventricular volumes and ejection fraction, using cadmium-zinc-telluride SPECT camera. METHODS AND RESULTS From routine assessments of left ventricular function in 1172 patients, we included 463 subjects (194 men and 269 women) without diabetes, previous potentially cardiotoxic chemotherapy, known cardiovascular or pulmonary disease. The lower limits defined as mean value minus two standard deviations for ventricular ejection fraction and end diastolic volume were LVEF (men: 50%, women: 50%), LEDV (men: 45 mL, women: 40 mL), RVEF (men: 29%, women: 28%), and REDV (men: 73 mL, women: 57 mL).There was a significant negative correlation between age and both left and right ventricular volumes in women (r = -0.4, P < .001) but only for right end systolic ventricular volume in men (r = -0.3, P = .001). CONCLUSION A set of reference values for cardiac evaluation prior to chemotherapy in cancer patients without other known cardiopulmonary disease is presented. There are age-related changes in cardiac dimensions with age depending on gender, although with only limited influence on LVEF or RVEF.
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Affiliation(s)
- Christian Haarmark
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark.
- Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, Building 60, Floor A, 2400, Copenhagen, Denmark.
| | - Christine Haase
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
| | - Maria Maj Jensen
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark
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Timmins R, Ruddy TD, Wells RG. Patient position alters attenuation effects in multipinhole cardiac SPECT. Med Phys 2015; 42:1233-40. [DOI: 10.1118/1.4908015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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28
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Bailliez A, Blaire T, Mouquet F, Legghe R, Etienne B, Legallois D, Agostini D, Manrique A. Segmental and global left ventricular function assessment using gated SPECT with a semiconductor Cadmium Zinc Telluride (CZT) camera: phantom study and clinical validation vs cardiac magnetic resonance. J Nucl Cardiol 2014; 21:712-22. [PMID: 24810429 DOI: 10.1007/s12350-014-9899-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/26/2014] [Accepted: 02/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND We evaluated gated-SPECT using a Cadmium-Zinc-Telluride (CZT) camera for assessing global and regional left ventricular (LV) function. METHODS A phantom study evaluated the accuracy of wall thickening assessment using systolic count increase on both Anger and CZT (Discovery 530NMc) cameras. The refillable phantom simulated variable myocardial wall thicknesses. The apparent count increase (%CI) was compared to the thickness increase (%Th). CZT gated-SPECT was compared to cardiac magnetic resonance (CMR) in 27 patients. Global and regional LV function (wall thickening and motion) were quantified and compared between SPECT and CMR data. RESULTS In the phantom study using a 5-mm object, the regression between %CI and %Th was significantly closer to the line of identity (y = x) with the CZT (R (2) = 0.9955) than the Anger (R (2) = 0.9995, P = .03). There was a weaker correlation for larger objects (P = .003). In patients, there was a high concordance between CZT and CMR for ESV, EDV, and LVEF (all CCC >0.80, P < .001). CZT underestimated %CI and wall motion (WM) compared to CMR (P < .001). The agreement to CMR was better for WM than wall thickening. CONCLUSION The Discovery 530NMc provided accurate measurements of global LV function but underestimated regional wall thickening, especially in patients with increased wall thickness.
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Affiliation(s)
- Alban Bailliez
- Nuclear Medicine Department, IRIS, Polyclinique du Bois, 144 avenue de Dunkerque, 59000, Lille, France,
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Giorgetti A, Masci PG, Marras G, Rustamova YK, Gimelli A, Genovesi D, Lombardi M, Marzullo P. Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: comparison to cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging 2013; 40:1869-75. [PMID: 23884280 DOI: 10.1007/s00259-013-2505-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/28/2013] [Indexed: 12/20/2022]
Abstract
PURPOSE CZT technology allows ultrafast low-dose myocardial scintigraphy but its accuracy in assessing left ventricular function is still to be defined. METHODS The study group comprised 55 patients (23 women, mean age 63 ± 9 years) referred for myocardial perfusion scintigraphy. The patients were studied at rest using a CZT camera (Discovery NM530c; GE Healthcare) and a low-dose (99m)Tc-tetrofosmin clinical protocol (mean dose 264 ± 38 MBq). Gated SPECT imaging was performed as a 6-min list-mode acquisition, 15 min after radiotracer injection. Images were reformatted (8-frame to 16-frame) using Lister software on a Xeleris workstation (GE Healthcare) and then reconstructed with a dedicated iterative algorithm. Analysis was performed using Quantitative Gated SPECT (QGS) software. Within 2 weeks patients underwent cardiac magnetic resonance imaging (cMRI, 1.5-T unit CVi; GE Healthcare) using a 30-frame acquisition protocol and dedicated software for analysis (MASS 6.1; Medis). RESULTS The ventricular volumes obtained with 8-frame QGS showed excellent correlations with the cMRI volumes (end-diastolic volume (EDV), r = 0.90; end-systolic volume (ESV), r = 0.94; p < 0.001). However, QGS significantly underestimated the ventricular volumes (mean differences: EDV, -39.5 ± 29 mL; ESV, -15.4 ± 22 mL; p < 0.001). Similarly, the ventricular volumes obtained with 16-frame QGS showed an excellent correlations with the cMRI volumes (EDV, r = 0.92; ESV, r = 0.95; p < 0.001) but with significant underestimations (mean differences: EDV, -33.2 ± 26 mL; ESV, -17.9 ± 20 mL; p < 0.001). Despite significantly lower values (47.9 ± 16 % vs. 51.2 ± 15 %, p < 0.008), 8-frame QGS mean ejection fraction (EF) was closely correlated with the cMRI values (r = 0.84, p < 0.001). The mean EF with 16-frame QGS showed the best correlation with the cMRI values (r = 0.91, p < 0.001) and was similar to the mean cMRI value (49.6 ± 16 %, p not significant). Regional analysis showed a good correlation between both 8-frame and 16-frame QGS and cMRI wall motion score indexes (8-frame WMSI, r = 0.85; 16-frame WMSI, r = 0.89; p < 0.01). CONCLUSION Low-dose gated SPECT with a CZT camera provides ventricular volumes that correlate well with cMRI results despite significant underestimation in the measure values. EF estimation appeared to be more accurate with 16-frame reformatted images than with 8-frame images.
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Affiliation(s)
- Assuero Giorgetti
- Fondazione CNR/Regione Toscana "G. Monasterio", Via Moruzzi 1, 56124, Pisa, Italy,
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