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Feasibility of one-eighth time gated myocardial perfusion SPECT functional imaging using IQ-SPECT

  • Federico Caobelli
  • James T. Thackeray
  • Alberto Soffientini
  • Frank M. Bengel
  • Claudio Pizzocaro
  • Ugo Paolo Guerra
Original Article

Abstract

Purpose

IQ-SPECT, an add-on to general purpose cameras based on multifocal collimation, can reduce myocardial perfusion imaging (MPI) acquisition times to one-fourth that of standard procedures (to 12 s/view). In a phantom study, a reduction of the acquisition time to one-eighth of the standard time (to 6 s/view) was demonstrated as feasible. It remains unclear whether such a reduction could be extended to clinical practice.

Methods

Fifty patients with suspected or diagnosed CAD underwent a 2-day stress–rest 99mTc-sestamibi MPI protocol. Two consecutive SPECT acquisitions (6 and 12 s/view) were performed. Electrocardiogram-gated images were reconstructed with and without attenuation correction (AC). Polar maps were generated and visually scored by two blinded observers for image quality and perfusion in 17 segments. Global and regional summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) were determined. Left ventricular volumes and ejection fraction were calculated based on automated contour detection.

Results

Image quality was scored higher with the 12 s/view acquisition, both with and without AC. Summed scores were statistically comparable between the 6 s/view and the 12 s/view acquisition, both globally and in individual coronary territories (e.g. in images with AC, SSS were 6.6 ± 8.3 and 6.2 ± 8.2 with 6 s and 12 s/view, respectively, p = 0.10; SRS were 3.9 ± 5.6 and 3.5 ± 5.3, respectively, p = 0.19; and SDS were 2.8 ± 5.7 and 2.6 ± 5.7, respectively, p = 0.59). Both acquisitions allowed MPI-based diagnosis of CAD in 25 of the 50 patients (with AC). Calculated end-diastolic volume (EDV) and end-systolic volume (ESV) were modestly higher with the 6 s/view acquisition than with the 12 s/view acquisition (EDV +4.8 ml at rest and +3.7 ml after stress, p = 0.003; ESV +4.1 ml at rest and +2.6 ml after stress, p = 0.01), whereas the ejection fraction did not differ (−1.2 % at rest, p = 0.20, and −0.9 % after stress, p = 0.27).

Conclusion

Image quality and LV functional parameters obtained with a one-eighth acquisition time were statistically comparable to the previously validated one-fourth time protocol using IQ-SPECT. Shorter acquisition times without loss of diagnostic accuracy provide improved patient comfort and streamlined departmental efficiency.

Keywords

Coronary artery disease 99mTc-sestamibi SPECT/CT IQ SPECT Low-count acquisition Myocardial perfusion imaging 

Notes

Compliance with ethical standards

Financial support

Dr. Caobelli is supported by a fellowship grant from Mallinckrodt Pharma.

Dr. Bengel receives research grants from Mallinckrodt Pharma and Siemens, and speaker honoraria from Bayer, Siemens, GE Healthcare and Mallinckrodt.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

259_2015_3142_Fig7_ESM.gif (123 kb)
Supplementary Fig. 1

Assignment of each segment to the respective territory of distribution. LAD left anterior descending artery, LCX left circumflex artery, RCA right coronary artery. (GIF 122 kb).

259_2015_3142_MOESM1_ESM.tif (175 kb)
High Resolution (TIFF 175 kb).
259_2015_3142_MOESM2_ESM.pptx (153 kb)
Supplementary Fig. 2 Perfusion scores do not differ between gender-matched groups (32 men, 18 women). Values are shown for global myocardium (a) and for the LAD regional territory (b) in AC images. Similarly, LVEF is consistent between men and women (c). Large white square average value in men at 12 s/view, large black square average value in men at 6 s/view, large white circle average value in women at 12 s/view, large black circle average value in women at 6 s/view, (PPTX 153 kb).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Federico Caobelli
    • 1
  • James T. Thackeray
    • 1
  • Alberto Soffientini
    • 2
  • Frank M. Bengel
    • 1
  • Claudio Pizzocaro
    • 2
  • Ugo Paolo Guerra
    • 2
  1. 1.Klinik für NuklearmedizinMedizinische Hochschule HannoverHannoverGermany
  2. 2.Department of Nuclear MedicineFondazione PoliambulanzaBresciaItaly

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