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Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM)

European Journal of Nuclear Medicine and Molecular Imaging volume 43, pages 2423–2432 (2016)Cite this article

An Erratum to this article was published on 07 October 2016

Abstract

The trade-off between resolution and count sensitivity dominates the performance of standard gamma cameras and dictates the need for relatively high doses of radioactivity of the used radiopharmaceuticals in order to limit image acquisition duration. The introduction of cadmium-zinc-telluride (CZT)-based cameras may overcome some of the limitations against conventional gamma cameras. CZT cameras used for the evaluation of myocardial perfusion have been shown to have a higher count sensitivity compared to conventional single photon emission computed tomography (SPECT) techniques. CZT image quality is further improved by the development of a dedicated three-dimensional iterative reconstruction algorithm, based on maximum likelihood expectation maximization (MLEM), which corrects for the loss in spatial resolution due to line response function of the collimator. All these innovations significantly reduce imaging time and result in a lower patient’s radiation exposure compared with standard SPECT. To guide current and possible future users of the CZT technique for myocardial perfusion imaging, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, has decided to examine the current literature regarding procedures and clinical data on CZT cameras. The committee hereby aims 1) to identify the main acquisitions protocols; 2) to evaluate the diagnostic and prognostic value of CZT derived myocardial perfusion, and finally 3) to determine the impact of CZT on radiation exposure.

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Abbreviations

AC:

Attenuation correction

BMI:

Body mass index

CAD:

Coronary artery disease

CCTA:

Coronary CT angiography

CT:

Computed tomography

CZT:

Cadmium-zinc-telluride

EF:

Ejection fraction

ERNA:

Equilibrium radio nuclide acquisition

FBP:

Filtered back projection

FWHM:

Full-width at half-maximum

HMR:

Heart mediastinum ratio

i.v.:

Intravenous

LEHR:

Low-energy high-resolution (collimator)

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

MIBG:

meta-iodo-benzylguanidine

ML-EM:

Maximum likelihood expectation maximization

MPI:

Myocardial perfusion imaging

MRI:

Magnetic resonance imaging

MUGA:

Multi gated acquisition

OS-EM:

Ordered subsets expectation maximization

RV EF:

Right ventricular ejection fraction

SPECT:

Single photon emission computed tomography

QC:

Quality control

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Affiliations

  1. Department of Nuclear Medicine, CHU Caen and Normandy University, EA 4650, Caen, France

    Denis Agostini

  2. Normandy University, EA 4650, Caen, France

    Denis Agostini

  3. Nancyclotep Experimental Imaging Platform, University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France

    Pierre-Yves Marie

  4. CHU Nancy, Department of Nuclear Medicine, University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France

    Pierre-Yves Marie

  5. University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France

    Pierre-Yves Marie

  6. Institute of Nuclear Medicine, University College London, University College Hospital, London, UK

    Simona Ben-Haim

  7. Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

    Simona Ben-Haim

  8. Department of Nuclear Medicine, University Hospital of Paris-Bichat, UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France

    François Rouzet

  9. UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France

    François Rouzet

  10. Centre Cardiologique du Nord, Saint-Denis, France

    Bernard Songy

  11. Department of Bioimages and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of Sacred Heart, Largo A. Gemelli, Rome, Italy

    Alessandro Giordano

  12. Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Alessia Gimelli

  13. Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique - Hôpitaux de Paris, UMR 1148, Inserm and Paris Diderot-Paris 7 University, Paris, France

    Fabien Hyafil

  14. Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy

    Roberto Sciagrà

  15. Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht University Medical Center, Maastricht, The Netherlands

    Jan Bucerius

  16. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands

    Jan Bucerius

  17. Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany

    Jan Bucerius

  18. Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands

    Hein J. Verberne

  19. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

    Riemer H. J. A. Slart

  20. Faculty of Science and Technology, Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands

    Riemer H. J. A. Slart

  21. Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany

    Oliver Lindner

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  1. Denis Agostini
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on behalf of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM)

  • Christopher Übleis
  •  & Marcus Hacker

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Correspondence to Denis Agostini.

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Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s00259-016-3540-0.

Appendix

Appendix

On behalf of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM)

Department of Clinical Radiology, Ludwig-Maximilians Universität München, München, Germany

Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria

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Agostini, D., Marie, PY., Ben-Haim, S. et al. Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 43, 2423–2432 (2016). https://doi.org/10.1007/s00259-016-3467-5

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Keywords

  • Perfusion
  • CZT camera
  • Coronary artery disease
  • Diagnosis
  • Prognosis