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Low-dose dual-isotope procedure planed for myocardial perfusion CZT-SPECT and assessed through a head-to-head comparison with a conventional single-isotope protocol

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Purpose of the report

This study aimed at assessing an original low-dose dual-isotope procedure in which the abnormal stress Tc-99m Sestamibi SPECT is followed by rest Tl-201 SPECT, along with a head-to-head comparison with a single-isotope procedure.

Methods and results

One hundred two patients, referred for a low-dose stress-SPECT with Sestamibi (123 ± 20 MBq) on a CZT camera and for whom a rest Sestamibi SPECT was warranted, had an additional Tl-201 rest-SPECT (52 ± 5 MBq) between stress and rest Sestamibi SPECT recordings. Tl-201 images were processed for spill-over and scatter corrections, and uptake differences with stress Sestamibi SPECT were analyzed: (1) for rest acquisitions from Tl-201 (dual-isotope procedure) and from Sestamibi (single-isotope procedure) and (2) in segments for which a diagnosis of ischemia, infarct, or normal perfusion was achieved. Mean effective dose was 8.3 mSv for dual-isotope but would decrease to 5.7 mSv for an expected rate of 37% of patients for whom rest-SPECT is not warranted. After a further background correction of Tl-201 images, the rest–stress difference in myocardial uptake was equivalent between dual- and single-procedures for identifying ischemic segments (respective areas-under-curves: 0.83 ± 0.03 and 0.81 ± 0.03).

Conclusion

This original dual-isotope procedure provides acceptable radiation doses and consistent results, as compared with conventional single-isotope.

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Abbreviations

ANSM:

Agence nationale de sécurité du médicament et des produits de santé

BG:

Background

CPP:

Comité de protection des personnes

CZT:

Cadmium-zinc-telluride

ICRP:

International commission on radiological protection

MPI:

Myocardial perfusion imaging

QPS:

Quantitative perfusion software

ROC:

Receiver operating characteristics

ROI:

Region of interest

SPECT:

Single photon emission computed tomography

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Acknowledgements

The authors thank Pierre Pothier, for critical review of the manuscript, and the Nancyclotep experimental imaging platform, for organizational support.

Disclosure

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. CHRU-Nancy, Université de Lorraine, Department of Nuclear Medicine, 54000, Nancy, France

    Laetitia Imbert PhD, Véronique Roch MSc, Wassila Djaballah MD, Mathieu Perrin MD, Marine Claudin MD, Antoine Verger MD, PhD, Gilles Karcher MD, PhD & Pierre-Yves Marie MD, PhD

  2. Nancyclotep Experimental Imaging Platform, 54000, Nancy, France

    Laetitia Imbert PhD, Véronique Roch MSc, Wassila Djaballah MD, Mathieu Perrin MD, Marine Claudin MD, Antoine Verger MD, PhD, Henri Boutley, Gilles Karcher MD, PhD & Pierre-Yves Marie MD, PhD

  3. INSERM, Université de Lorraine, UMR 947, IADI, 54000, Nancy, France

    Laetitia Imbert PhD & Antoine Verger MD, PhD

  4. Department of Radiotherapy, Lorraine Cancerology Institute, 54500, Vandoeuvre, France

    Laetitia Imbert PhD

  5. Department of Nuclear Medicine, Jean Perrin Centre, Université d’Auvergne, 63011, Clermont-Ferrand, France

    Charles Merlin MD & Florent Cachin MD, PhD

  6. INSERM, Université d’Auvergne, UMR 990, IMTV, 63000, Clermont-Ferrand, France

    Charles Merlin MD & Florent Cachin MD, PhD

  7. University of Lorraine, Faculty of Medicine, 54000, Nancy, France

    Henri Boutley & Gilles Karcher MD, PhD

  8. INSERM, Université de Lorraine, UMR 1116, DCAC, 54000, Nancy, France

    Pierre-Yves Marie MD, PhD

Authors
  1. Laetitia Imbert PhD
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  2. Véronique Roch MSc
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  3. Charles Merlin MD
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  4. Wassila Djaballah MD
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  5. Florent Cachin MD, PhD
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  6. Mathieu Perrin MD
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  7. Marine Claudin MD
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  8. Antoine Verger MD, PhD
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  9. Henri Boutley
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  10. Gilles Karcher MD, PhD
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  11. Pierre-Yves Marie MD, PhD
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Corresponding author

Correspondence to Laetitia Imbert PhD.

Additional information

The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.

Wassila Djaballah—deceased.

Laetitia Imbert and Véronique Roch participated equally to the submitted work.

Special funding

Grant from the French health ministry (inter-regional “GIRCI” call for proposal for young searchers, 2012).

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Imbert, L., Roch, V., Merlin, C. et al. Low-dose dual-isotope procedure planed for myocardial perfusion CZT-SPECT and assessed through a head-to-head comparison with a conventional single-isotope protocol. J. Nucl. Cardiol. 25, 2016–2023 (2018). https://doi.org/10.1007/s12350-017-0914-z

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  • DOI: https://doi.org/10.1007/s12350-017-0914-z

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