Shortened acquisition time or reduced-activity dose for gated myocardial perfusion SPECT with new reconstruction algorithm

  • Xiao-Xin Sun
  • Yue-Qin Tian
  • Dao-Yu Wang
  • Zuo-Xiang He
Original Paper


To confirm that shortened acquisition time or reduced-activity dose in single-photon emission computed tomography (SPECT) myocardial perfusion imaging reconstructed with Astonish software (AS) does not compromise image quality or diagnostic accuracy. One hundred patients referred for SPECT myocardial perfusion imaging were prospectively studied. The patients were randomly selected to receive the full-dose protocol (group A, n = 54) or the half-dose protocol (group B, n = 46). The patients of group A underwent a 2-day stress/rest protocol. After half-time acquisition, they underwent a full-time acquisition for stress and rest SPECT. Group B underwent a 1-day stress/rest protocol. During peak stress, all patients received an intravenous injection of 99mTc-methoxyisobutylisonitrile (MIBI; 5.2 ± 0.6 mCi). After the full-time stress acquisition, the patients underwent a double-time stress acquisition. If the stress image showed a defect, a patient received 99mTc-MIBI (19.5 ± 1.7 mCi) at rest on the same day. The rest SPECT acquisition protocol was the same in both groups. The low count (LC) and high count (HC) were acquired for each patient. AS and filtered back projection (FBP) reconstructed each set of raw data. Image quality of perfusion was assessed on a four-point scale. Perfusion parameters and function parameters were calculated by quantitative perfusion SPECT and quantitative gated SPECT. Mean image quality for LC-AS and HC-AS (3.5 ± 0.5 and 3.7 ± 0.5, respectively) was superior to HC-FBP (3.1 ± 0.4) in group A (for all, p < 0.001). LC-AS and HC-AS (3.5 ± 0.5 and 3.6 ± 0.5, respectively) in group B were superior to HC-FBP (3.1 ± 0.3) (for all, p < 0.001). LC-AS, HC-AS and LC-FBP showed high diagnostic concordance with HC-FBP (kappa value was 0.92, 0.92, and 0.94, respectively; all p < 0.001). Cardiac SPECT studies can be acquired with half of the scan time or reduced radioactivity dose and reconstructed by using the AS algorithm without compromising image quality.


SPECT Myocardial perfusion imaging Scan time Radiation dose Iterative reconstruction 


  1. 1.
    Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Berman DS (2008) High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging. JACC Cardiovasc Imaging 1:156–163PubMedCrossRefGoogle Scholar
  2. 2.
    Duvall WL, Sweeny JM, Croft LB, Ginsberg E, Guma KA, Henzlova MJ (2012) Reduced stress dose with rapid acquisition CZT SPECT MPI in a non-obese clinical population: comparison to coronary angiography. J Nucl Cardiol 19:19–27PubMedCrossRefGoogle Scholar
  3. 3.
    Gimelli A, Bottai M, Genovesi D, Giorgetti A, Di Martino F, Marzullo P (2012) High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results. Eur J Nucl Med Mol Imaging 39:83–90PubMedCrossRefGoogle Scholar
  4. 4.
    Nkoulou R, Pazhenkottil AP, Kuest SM, Ghadri JR, Wolfrum M, Husmann L et al (2011) Semiconductor detectors allow low-dose-low-dose 1-day SPECT myocardial perfusion imaging. J Nucl Med 52:1204–1209PubMedCrossRefGoogle Scholar
  5. 5.
    Borges-Neto S, Pagnanelli RA, Shaw LK, Honeycutt E, Shwartz SC, Adams GL et al (2007) Clinical results of a novel wide beam reconstruction method for shortening scan time of Tc-99m cardiac SPECT perfusion studies. J Nucl Cardiol 14:555–565PubMedCrossRefGoogle Scholar
  6. 6.
    DePuey EG, Gadiraju R, Clark J, Thompson L, Anstett F, Shwartz SC (2008) Ordered subset expectation maximization and wide beam reconstruction “half-time” gated myocardial perfusion SPECT functional imaging: a comparison to “full-time” filtered backprojection. J Nucl Cardiol 15:547–563PubMedCrossRefGoogle Scholar
  7. 7.
    Han PP, Tian YQ, Fang W, Yang MF, Zhang XL, Shen R et al (2011) Impact of myocardial perfusion imaging on in-hospital coronary angiography and revascularization of patients with suspected coronary artery disease. Chin Med J (Engl) 124:1603–1609Google Scholar
  8. 8.
    Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542PubMedCrossRefGoogle Scholar
  9. 9.
    Germano G, Kavanagh PB, Waechter P, Areeda J, Van Kriekinge S, Sharir T et al (2000) A new algorithm for the quantitation of myocardial perfusion SPECT. I: technical principles and reproducibility. J Nucl Med 41:712–719PubMedGoogle Scholar
  10. 10.
    Hansen CL, Goldstein RA, Akinboboye OO, Berman DS, Botvinick EH, Churchwell KB et al (2007) Myocardial perfusion and function: single photon emission computed tomography. J Nucl Cardiol 14:e39–e60PubMedCrossRefGoogle Scholar
  11. 11.
    Venero CV, Heller GV, Bateman TM, McGhie AI, Ahlberg AW, Katten D et al (2009) A multicenter evaluation of a new post-processing method with depth-dependent collimator resolution applied to full-time and half-time acquisitions without and with simultaneously acquired attenuation correction. J Nucl Cardiol 16:714–725PubMedCrossRefGoogle Scholar
  12. 12.
    Maddahi J, Mendez R, Mahmarian JJ, Thomas G, Babla H, Bai C et al (2009) Prospective multicenter evaluation of rapid, gated SPECT myocardial perfusion upright imaging. J Nucl Cardiol 16:351–357PubMedCrossRefGoogle Scholar
  13. 13.
    DePuey EG, Bommireddipalli S, Clark J, Thompson L, Srour Y (2009) Wide beam reconstruction “quarter-time” gated myocardial perfusion SPECT functional imaging: a comparison to “full-time” ordered subset expectation maximum. J Nucl Cardiol 16:736–752PubMedCrossRefGoogle Scholar
  14. 14.
    DePuey EG, Bommireddipalli S, Clark J, Leykekhman A, Thompson LB, Friedman M (2011) A comparison of the image quality of full-time myocardial perfusion SPECT vs wide beam reconstruction half-time and half-dose SPECT. J Nucl Cardiol 18:273–280PubMedCrossRefGoogle Scholar
  15. 15.
    Basso D, Passmore G, Holman M, Rogers W, Walters L, Zecchin T et al (2009) Semiqualitative visual and quantitative morphometric evaluations of reduced scan time and wide-beam reconstruction in rest-gated stress SPECT myocardial perfusion imaging. J Nucl Med Technol 37:233–239PubMedCrossRefGoogle Scholar
  16. 16.
    Berrington de Gonzalez A, Kim KP, Smith-Bindman R, McAreavey D (2010) Myocardial perfusion scans: projected population cancer risks from current levels of use in the United States. Circulation 122:2403–2410PubMedCrossRefGoogle Scholar
  17. 17.
    Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH et al (2009) Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 361:849–857PubMedCrossRefGoogle Scholar
  18. 18.
    Schroeder-Tanka JM, Tiel-van Buul MM, van der Wall EE, Roolker W, Lie KI, van Royen EA (1997) Should imaging at stress always be followed by imaging at rest in Tc-99 m MIBI SPECT? A proposal for a selective referral and imaging strategy. Int J Card Imaging 13:323–329PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Xiao-Xin Sun
    • 1
  • Yue-Qin Tian
    • 1
  • Dao-Yu Wang
    • 1
  • Zuo-Xiang He
    • 1
  1. 1.Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China

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