Reduced stress dose with rapid acquisition CZT SPECT MPI in a non-obese clinical population: Comparison to coronary angiography
- 432 Downloads
Cadmium Zinc Telluride (CZT) SPECT camera technology has the potential to reduce patient’s radiation exposure and shorten imaging time. This study evaluated the correlation of low stress tracer dose, rapid CZT SPECT myocardial perfusion imaging (MPI) to coronary angiography in a <200-lbs population to further validate its ability to achieve both goals while preserving diagnostic accuracy.
All patients who had a low-dose stress (≤15 mCi) Tc-99m sestamibi SPECT MPI study using a CZT camera (GE Discovery NM 530c) with 3- to 5-minute image acquisition over a 2-year period followed by a coronary angiogram within 2 months were included. Patients with a history of coronary revascularization, left ventricular dysfunction, and LBBB or paced rhythms were excluded. Both MPI studies and coronary angiograms were interpreted by blinded readers and coronary artery disease (CAD) was defined as ≥70% stenosis.
A total of 71 patients were included with a mean age of 64 years, 55% male, and a BMI of 25.4 kg/m2 with an average stress dose of 13.3 mCi. Exercise stress was performed in 54% of patients and vasodilator pharmacologic stress in 46%. Sensitivity was 89%, specificity was 66%, and accuracy was 78% for detecting obstructive CAD.
In this group of non-obese patients undergoing low stress dose imaging, high-efficiency CZT SPECT imaging demonstrated a high sensitivity, specificity, and accuracy for detecting obstructive epicardial CAD with a greatly reduced imaging time.
KeywordsSPECT radionuclides coronary artery disease diagnostic and prognostic application
- 5.Sharir T, Slomka PJ, Hayes SW, DiCarli MF, Ziffer JA, Martin WH, et al. Multicenter trial of high-speed versus conventional single-photon emission computed tomography imaging: Quantitative results of myocardial perfusion and left ventricular function. J Am Coll Cardiol 2010;55:1965-74.PubMedCrossRefGoogle Scholar
- 16.Fiechter M, Ghadri JR, Kuest SM, Pazhenkottil AP, Wolfrum M, Nkoulou RN, et al. Nuclear myocardial perfusion imaging with a novel cadmium-zinc-telluride detector SPECT/CT device: First validation versus invasive coronary angiography. Eur J Nucl Med Mol Imaging 2011;38:2025-30.PubMedCrossRefGoogle Scholar
- 17.Gimelli A, Bottai M, Genovesi D, Giorgetti A, Di Martino F, Marzullo P. High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: Preliminary clinical results. Eur J Nucl Med Mol Imaging 2011. Sept 2 [Epub ahead of print].Google Scholar
- 21.Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. Circulation 2009;119:e561-87.PubMedCrossRefGoogle Scholar
- 22.Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. 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. J Nucl Cardiol 2002;9:240-5.PubMedCrossRefGoogle Scholar
- 25.Cerqueira MD, Allman KC, Ficaro EP, Hansen CL, Nichols KJ, Thompson RC, et al. ASNC Information Statement: Recommendations for reducing radiation exposure in myocardial perfusion imaging 2010. http://www.asnc.org/imageuploads/RadiationReduction060110.pdf.