Ultrafast nuclear myocardial perfusion imaging on a new gamma camera with semiconductor detector technique: first clinical validation
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To assess the diagnostic performance of a novel ultrafast cardiac gamma camera with cadmium-zinc-telluride (CZT) solid-state semiconductor detectors for nuclear myocardial perfusion imaging (MPI).
The study group comprised 75 consecutive patients (55 men, BMI range 19–45 kg/m2) who underwent a 1-day 99mTc-tetrofosmin adenosine-stress/rest imaging protocol. Scanning was performed first on a conventional dual-detector SPECT gamma camera (Ventri, GE Healthcare) with a 15-min acquisition time each for stress and rest. All scans were immediately repeated on an ultrafast CZT camera (Discovery 530 NMc, GE Healthcare) with a 3-min scan time for stress and a 2-min scan time for rest. Clinical agreement (normal, ischaemia, scar) between CZT and SPECT was assessed for each patient and for each coronary territory using SPECT MPI as the reference standard. Segmental myocardial tracer uptake values (percent of maximum) using a 20-segment model and left ventricular ejection fraction (EF) values obtained using CZT were compared with those obtained using conventional SPECT by intraclass correlation and by calculating Bland-Altman limits of agreement.
There was excellent clinical agreement between CZT and conventional SPECT on a per-patient basis (96.0%) and on a per-vessel territory basis (96.4%) as shown by a highly significant correlation between segmental tracer uptake values (r=0.901, p<0.001). Similarly, EF values for both scanners were highly correlated (r=0.976, p<0.001) with narrow Bland-Altman limits of agreement (−5.5–10.6%).
The novel CZT camera allows a more than fivefold reduction in scan time and provides clinical information equivalent to conventional standard SPECT MPI.
KeywordsUltrafast cardiac gamma camera Myocardial perfusion imaging Scan time reduction Cadmium-zinc-telluride
This study was supported by a grant from the Swiss National Science Foundation and by the ZIHP (Zurich Center for Integrative Human Physiology, University of Zurich). We would like to thank Edlira Loga, Ennio Mueller, Josephine Trinckauf, Verena Wechselbaumer and Mirjam De Bloeme for their technical support.
Conflicts of interest
The University Hospital Zurich holds a research contract with GE Healthcare.
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