Original Article

Journal of Nuclear Cardiology

, Volume 18, Issue 5, pp 847-857

First online:

Reduced isotope dose and imaging time with a high-efficiency CZT SPECT camera

  • W. Lane DuvallAffiliated withMount Sinai Division of Cardiology (Mount Sinai Heart), Mount Sinai Medical Center
  • , Lori B. CroftAffiliated withMount Sinai Division of Cardiology (Mount Sinai Heart), Mount Sinai Medical Center
  • , Eric S. GinsbergAffiliated withMount Sinai Department of Medicine, Mount Sinai Medical Center
  • , Andrew J. EinsteinAffiliated withDivision of Cardiology, Department of Medicine, and Department of Radiology, Columbia University Medical Center
  • , Krista A. GumaAffiliated withMount Sinai Division of Cardiology (Mount Sinai Heart), Mount Sinai Medical Center
  • , Titus GeorgeAffiliated withMount Sinai Division of Cardiology (Mount Sinai Heart), Mount Sinai Medical Center
  • , Milena J. HenzlovaAffiliated withMount Sinai Division of Cardiology (Mount Sinai Heart), Mount Sinai Medical Center Email author 

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Abstract

Background

In light of recent focus on diagnostic imaging, cardiac SPECT imaging needs to become a shorter test with lower radiation exposure to patients. Recently introduced Cadmium Zinc Telluride (CZT) cameras have the potential to achieve both goals.

Methods

During a 2-month period patients presenting for a Tc-99m sestamibi SPECT MPI study were imaged using a CZT camera using a low-dose rest-stress protocol (5 mCi rest and 15 mCi stress doses). Patients ≥250 lbs or a BMI ≥35 kg/m2 were excluded. Rest images were processed at 5- and 8-minute acquisition times and stress images at 3- and 5-minute acquisition times. A subset of patients had stress imaging performed using both conventional and CZT SPECT cameras. Image acquisition times and SPECT camera images were compared based on total counts, count rate, image quality, and summed rest and stress scores. Twelve month clinical follow-up was also obtained.

Results

131 patients underwent the study protocol (age 64.9 ± 9.8 years, 54.2% male). There was no significant difference in image quality and mean summed scores between 5- and 8-minute rest images and between 3- and 5-minute stress images. When compared to a conventional SPECT camera in 27 patients, total rest and stress perfusion deficits and calculated LVEF were similar (r = 0.94 and 0.96, respectively). At 12 months there was a benign prognosis in patients with normal perfusion. The effective dose was 5.8 mSv for this protocol which is 49.2% less than conventional Tc-99m studies and 75.7% less than conventional Tl-201/Tc-99m dual isotope studies.

Conclusions

New SPECT camera technology with low isotope dose significantly reduces ionizing radiation exposure and imaging times compared to traditional protocols while maintaining image quality and diagnostic accuracy.

Keywords

Myocardial perfusion imaging: SPECT radiopharmaceuticals diagnostic and prognostic application image quality