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Radiation exposure after myocardial perfusion imaging with Cadmium-Zinc-Telluride camera versus conventional camera

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Patient exposure to radiation during the management of coronary heart disease (CHD) can be reduced with more efficient technologies in nuclear medicine, such as the Cadmium-Zinc-Telluride (CZT) gamma-camera for myocardial perfusion imaging (MPI) studies. However, it has been suggested that CZT has lower specificity, which might lead to more downstream radiological procedures, particularly among obese individuals.

Methods and Results

We evaluated 244 patients with suspected CHD who underwent CZT-SPECT and matched 1:1 according to sex, age, and body mass index (BMI) with those undergoing MPI study with the Anger gamma-camera (Anger-SPECT). The outcome was the total radiation exposure from the MPI study added to the radiation exposure from all subsequent cardiac examinations during a 90-day follow-up. The total radiation dose after 90 days was significantly lower in the CZT-SPECT group (6.4 ± 4.8 vs 9.5±4.9 mSv, P < .001). After adjusting for potential confounders, CZT-SPECT remained associated with lower total radiation dose, but it significantly attenuated among obese individuals (Beta coefficient − 3.73 ± 0.86 for BMI < 30 vs − 2.30 ± 0.92 for BMI ≥ 30 Kg/m2, P for interaction < 0.032).

Conclusions

CZT-SPECT was associated with lower total radiation doses compared to Anger-SPECT, albeit this benefit may be attenuated in obese individuals.

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Abbreviations

99mTc:

Technetium-99m

BMI:

Body mass index

CAD:

Coronary artery disease

CCTA:

Coronary computed tomography angiography

CHD:

Coronary heart disease

CZT:

Cadmium-Zinc-Telluride

ICA:

Invasive coronary angiography

MBq:

Megabecquerel

MPI:

Myocardial perfusion imaging

mSv:

Millisievert

PCI:

Percutaneous coronary intervention

SPECT:

Single-photon emission computed tomograph

SRS:

Summed rest score

SSS:

Summed stress score

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Acknowledgments

The authors thank the staff and patients of Quanta Diagnostico por Imagem for their important contributions to this study.

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Authors and Affiliations

  1. Quanta Diagnóstico por Imagem, 1000 Almirante Tamandare street, Curitiba, PR, 80045170, Brazil

    Ricardo Baumgarten, Rodrigo Julio Cerci, Amanda de Nadai Costa, Carlos Cunha Pereira-Neto, Pedro Prado, Marcello Zapparoli, Margaret Masukawa, Juliano Julio Cerci, João Vicente Vitola & Miguel Morita Fernandes-Silva

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  1. Ricardo Baumgarten
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Correspondence to Miguel Morita Fernandes-Silva.

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Baumgarten, R., Cerci, R.J., de Nadai Costa, A. et al. Radiation exposure after myocardial perfusion imaging with Cadmium-Zinc-Telluride camera versus conventional camera. J. Nucl. Cardiol. 28, 992–999 (2021). https://doi.org/10.1007/s12350-020-02146-9

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