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Accurate and efficient rapid acquisition early post-injection stress-first CZT SPECT myocardial perfusion imaging with tetrofosmin and attenuation correction

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Introduction

Myocardial perfusion imaging (MPI) protocols have not changed significantly despite advances in instrumentation and software. We compared an early post-injection, stress-first SPECT protocol to standard delayed imaging.

Methods

95 patients referred for SPECT MPI were imaged upright and supine on a Spectrum Dynamics D-SPECT CZT system with CT attenuation correction. Patients received injection of 99mTc tetrofosmin at peak of regadenoson stress and were imaged. Early post-stress (mean 17 ± 2 minutes) and Standard 1-h delay (mean 61 ± 13 min). Three blinded readers evaluated images for overall interpretation, perceived need for rest imaging, image quality, and reader confidence. Laboratory efficiency was also evaluated.

Results

Blinded readers had the same response for the need for rest in 77.9% of studies. Studies also had the same interpretation in 89.5% of studies. Reader confidence was high (86.0% (Early) and 90.3% (Standard p = 0.52. Image quality was good or excellent in 87.4% Early vs 96.8% Standard (p = 0.09). Time between patient check-in and end of stress imaging was 104 ± (Standard) to 60 ± 18 minutes (Early) (p < 0.001).

Conclusion

Early post-injection stress-only imaging using CZT SPECT/CT appears promising with Tc-99m tetrofosmin with similar image quality, reader confidence, diagnosis, and need for a rest scan.

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Abbreviations

AC:

Attenuation correction

ASNC:

American Society of Nuclear Cardiology

CAD:

Coronary artery disease

CCTA:

Coronary computed tomographic angiography

CT:

Computed tomography

CZT:

Cadmium zinc telluride

GI:

Gastrointestinal

IAEA:

International Atomic Energy Agency

PET:

Positron emission tomography

ROI:

Region of interest

SCCT:

Society of Cardiac Computed Tomography

SNMMI:

Society of Nuclear Medicine and Molecular Imaging

SPECT:

Single photon emission computed tomography

99mTc:

Technetium-99m

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Authors and Affiliations

  1. Cardiovascular Imaging Technologies, Kansas City, MO, USA

    James A. Case, Staci A. Courter, Katrina O. Case & Timothy M. Bateman

  2. Mid America Heart Institute and the University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    AIain McGhie, Krishna K. Patel, Brett W. Sperry, Erin Moloney, Eric V. Burgett & Timothy M. Bateman

  3. Boston University, Boston, MA, USA

    Katrina O. Case

  4. Icahn School of Medicine at Mount Sinai Medical Center, New York, New York, USA

    Krishna K. Patel

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  1. James A. Case
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Correspondence to James A. Case.

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Case, J.A., Courter, S.A., McGhie, A. et al. Accurate and efficient rapid acquisition early post-injection stress-first CZT SPECT myocardial perfusion imaging with tetrofosmin and attenuation correction. J. Nucl. Cardiol. 30, 2644–2654 (2023). https://doi.org/10.1007/s12350-023-03336-x

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  • DOI: https://doi.org/10.1007/s12350-023-03336-x

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