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Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Cardiac SPECT imaging needs to become shorter and use lower radiation doses to compete with other available noninvasive imaging modalities. Recently introduced cadmium zinc telluride (CZT) SPECT cameras have the potential to achieve both goals, but clinical experience is so far limited.

Methods

Images of all patients undergoing a stress MPI over a 4-month period using a CZT camera (Discovery NM 530c) were reviewed. Patients were divided into three groups based on imaging protocols: low-dose stress-only, high-dose stress-only, and standard dose rest-stress. Low-dose stress-only patients were matched by gender, stressor, and BMI to high-dose stress-only and rest-stress subjects. Stress image quality was graded on a four-point scale by readers blinded to the imaging protocol. Demographics, tracer dose, stress imaging time, and total counts were recorded.

Results

Of 717 patients imaged, the mean age was 64.0 years, 50.5% were female, 58.9% underwent exercise stress, and the average BMI was 27.9 kg/m2. A total of 103 low-dose stress-only patients were matched to controls. Imaging for 5 minutes in low-dose stress-only patients and for 3 minutes in high-dose stress-only and rest-stress patients, resulted in a similar number of total counts. This produced similar image quality in the three groups with a 57% isotope dose reduction in the low-dose stress-only compared to the high-dose stress-only group.

Conclusion

New SPECT CZT camera technology allows significantly reduced radiation exposure and acquisition time without loss of image quality.

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References

  1. Einstein AJ, Moser KW, Thompson RC, Cerqueira MD, Henzlova MJ. Radiation dose to patients from cardiac diagnostic imaging. Circulation 2007;116:1290-305.

    Article  PubMed  Google Scholar 

  2. Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009;361:849-57.

    Article  CAS  PubMed  Google Scholar 

  3. Slomka PJ, Patton JA, Berman DS, Germano G. Advances in technical aspects of myocardial perfusion SPECT imaging. J Nucl Cardiol 2009;16:255-76.

    Article  PubMed  Google Scholar 

  4. Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Berman DS. High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging. JACC Cardiovasc Imaging 2008;1:156-63.

    Article  PubMed  Google Scholar 

  5. Berman DS, Kang X, Tamarappoo B, Wolak A, Hayes SW, Nakazato R, et al. Stress thallium-201/rest technetium-99m sequential dual isotope high-speed myocardial perfusion imaging. JACC Cardiovasc Imaging 2009;2:273-82.

    Article  PubMed  Google Scholar 

  6. Esteves FP, Raggi P, Folks RD, Keidar Z, Askew JW, Rispler S, et al. Novel solid-state-detector dedicated cardiac camera for fast myocardial perfusion imaging: Multicenter comparison with standard dual detector cameras. J Nucl Cardiol 2009;16:927-34.

    Article  PubMed  Google Scholar 

  7. Henzlova MJ, Cerqueira MD, Hansen CL, Taillefer R, Yao SS. ASNC announcement. J Nucl Cardiol 2009;16:331.

    Article  Google Scholar 

  8. Henzlova MJ, Cerqueira MD, Mahmarian JJ, Yao SS. Stress protocols and tracers. J Nucl Cardiol 2006;13:e80-90.

    Article  PubMed  Google Scholar 

  9. Berman DS, Hachamovitch R, Kiat H, Cohen I, Cabico JA, Wang FP, et al. Incremental value of prognostic testing in patients with known or suspected ischemic heart disease: A basis for optimal utilization of exercise technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol 1995;26:639-47.

    Article  CAS  PubMed  Google Scholar 

  10. Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: Differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.

    CAS  PubMed  Google Scholar 

  11. Duvall WL, Wijetunga M, Klein T, Hingorani R, Henzlova M. The prognosis of normal stress-only SPECT myocardial perfusion imaging studies (abstr). J Am Coll Cardiol 2009;53:287A.

    Google Scholar 

  12. Chang SM, Nabi F, Xu J, Raza U, Mahmarian JJ. Normal stress-only versus standard stress/rest myocardial perfusion imaging similar patient mortality with reduced radiation exposure. J Am Coll Cardiol 2010;55(3):220-9.

    Article  Google Scholar 

  13. ICRP. ICRP Publication 103: The 2007 recommendations of the International Commission on Radiological Protection. Ann ICRP 2007;37:1-332.

    Google Scholar 

  14. Buechel RR, Herzog BA, Husmann L, Burger IA, Pazhenkottil AP, Treyer V, et al. Ultrafast nuclear myocardial perfusion imaging on a new gamma camera with semiconductor detector technique: First clinical validation. Eur J Nucl Med Mol Imaging 2010;37:773-8.

    Article  PubMed  Google Scholar 

  15. Herzog BA, Buechel RR, Katz R, Brueckner M, Husmann L, Burger IA, et al. Nuclear myocardial perfusion imaging with a cadmium-zinc-telluride detector technique: Optimized protocol for scan time reduction. J Nucl Med 2010;51:46-51.

    Article  PubMed  Google Scholar 

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Acknowledgment

The authors thank Dr Andrew Einstein for performing the effective dose calculations.

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Authors and Affiliations

  1. Mount Sinai Heart, Mount Sinai Medical Center, Box 1030, One Gustave L Levy Place, New York, NY, 10029, USA

    W. Lane Duvall MD, Lori B. Croft MD, Titus George CNMT, RT(N) & Milena J. Henzlova MD

  2. Mount Sinai Department of Medicine, Mount Sinai Medical Center, New York, NY, USA

    Tapan Godiwala MD & Eric Ginsberg MD

Authors
  1. W. Lane Duvall MD
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  2. Lori B. Croft MD
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  3. Tapan Godiwala MD
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  4. Eric Ginsberg MD
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  5. Titus George CNMT, RT(N)
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  6. Milena J. Henzlova MD
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Corresponding author

Correspondence to Milena J. Henzlova MD.

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Duvall, W.L., Croft, L.B., Godiwala, T. et al. Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera. J. Nucl. Cardiol. 17, 1009–1014 (2010). https://doi.org/10.1007/s12350-010-9215-5

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  • DOI: https://doi.org/10.1007/s12350-010-9215-5

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