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Initial multicentre experience of high-speed myocardial perfusion imaging: comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

High-speed (HS) single-photon emission computed tomography (SPECT) with a recently developed solid-state camera shows comparable myocardial perfusion abnormalities to those seen in conventional SPECT. We aimed to compare HS and conventional SPECT images from multiple centres with coronary angiographic findings.

Methods

The study included 50 patients who had sequential conventional SPECT and HS SPECT myocardial perfusion studies and coronary angiography within 3 months. Stress and rest perfusion images were visually analysed and scored semiquantitatively using a 17-segment model by two experienced blinded readers. Global and coronary territorial summed stress scores (SSS) and summed rest scores (SRS) were calculated. Global SSS ≥3 or coronary territorial SSS ≥2 was considered abnormal. In addition the total perfusion deficit (TPD) was automatically derived. TPD >5 % and coronary territorial TPD ≥3 % were defined as abnormal. Coronary angiograms were analysed for site and severity of coronary stenosis; ≥50 % was considered significant.

Results

Of the 50 patients, 13 (26 %) had no stenosis, 22 (44 %) had single-vessel disease, 6 (12 %) had double-vessel disease and 9 (18 %) had triple-vessel disease. There was a good linear correlation between the visual global SSS and SRS (Spearman’s ρ 0.897 and 0.866, respectively; p < 0.001). In relation to coronary angiography, the sensitivities, specificities and accuracies of HS SPECT and conventional SPECT by visual assessment were 92 % (35/38), 83 % (10/12) and 90 % (45/50) vs. 84 % (32/38), 50 % (6/12) and 76 % (38/50), respectively (p < 0.001). The sensitivities, specificities and accuracies of HS SPECT and conventional SPECT in relation to automated TPD assessment were 89 % (31/35), 57 % (8/14) and 80 % (39/49) vs. 86 % (31/36), 77 % (10/13) and 84 % (41/49), respectively.

Conclusion

HS SPECT allows fast acquisition of myocardial perfusion images that correlate well with angiographic findings with overall accuracy by visual assessment better than conventional SPECT. Further assessment in a larger patient population may be needed to confirm this observation.

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Acknowledgment

This work was undertaken at UCLH/UCL which received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.

Conflicts of interest

Drs. Tali Sharir, William H. Martin and Simona Ben-Haim are consultants for Spectrum-Dynamics. Dr. Daniel Berman owns shares in Spectrum-Dynamics and is a member of the Medical Advisory Board and consultant for Spectrum-Dynamics. Dr Jack A. Ziffer has equity in Spectrum-Dynamics. Dalia Shiti is employed by Spectrum-Dynamics.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, University College London Hospital, 235 Euston Road, London, NW1 2BU, UK

    Johanne Neill, Elizabeth M. Prvulovich, Jamshed B. Bomanji & Simona Ben-Haim

  2. Sacred Heart Medical Center (SHMC), Springfield, OR, USA

    Matthews B. Fish

  3. Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Daniel S. Berman & Piotr J. Slomka

  4. Procardia Maccabi Healthcare Services (PMHS), Tel Aviv, Israel

    Tali Sharir

  5. Vanderbilt University Medical Center (VUMC), Nashville, TN, USA

    William H. Martin

  6. Brigham and Women’s Hospital (BWH), Boston, MA, USA

    Marcelo F. DiCarli

  7. Baptist Hospital of Miami (BHM), Miami, FL, USA

    Jack A. Ziffer

  8. Spectrum-Dynamics, Caesarea, Israel

    Dalia Shiti

  9. Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel

    Simona Ben-Haim

  10. The Prince Charles Hospital, Brisbane, Australia

    Johanne Neill

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  1. Johanne Neill
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Correspondence to Simona Ben-Haim.

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Neill, J., Prvulovich, E.M., Fish, M.B. et al. Initial multicentre experience of high-speed myocardial perfusion imaging: comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation. Eur J Nucl Med Mol Imaging 40, 1084–1094 (2013). https://doi.org/10.1007/s00259-013-2399-6

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  • DOI: https://doi.org/10.1007/s00259-013-2399-6

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