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Semiconductor detectors allow low-dose-low-dose 1-day SPECT myocardial perfusion imaging.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2011
Author Nkoulou Rene, Pazhenkottil Aju P, Kuest Silke M, Ghadri Jelena R, Wolfrum Mathias, Husmann Lars, Fiechter Michael, Buechel Ronny R, Herzog Bernhard A,
Project Entwicklung einer neuen Hybrid-Bildgebungs-Methode zur nicht invasiven kardialen Diagnostik
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Original article (peer-reviewed)

Journal Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume (Issue) 52(8)
Page(s) 1204 - 9
Title of proceedings Journal of nuclear medicine : official publication, Society of Nuclear Medicine
DOI 10.2967/jnumed.110.085415


UNLABELLED Cadmium zinc telluride (CZT) detectors with linear counting rate response enable count subtraction in sequential scanning. We evaluated whether count subtraction eliminated the need for higher activity doses in the second part of the 1-d stress-rest myocardial perfusion imaging (MPI) protocol. METHODS For 50 patients (mean age ± SD, 66 ± 12 y) with visually abnormal (n = 42) or equivocal (n = 8) adenosine-stress MPI (320 MBq of (99m)Tc-tetrofosmin) on a CZT camera, rest MPI was performed with a low dose (320 MBq) and repeated after injection of an additional 640 MBq of (99m)Tc-tetrofosmin to achieve a standard 3-fold increased dose at rest (960 MBq), compared with stress (320 MBq). Low-dose rest myocardial perfusion images were reconstructed after subtracting the background activity of the preceding stress scan. Segmental percentage tracer uptake of the 2 rest myocardial perfusion images (320 vs. 960 MBq) was compared using intraclass correlation and Bland-Altman limits of agreement. Patient- and coronary territory-based clinical agreement was assessed. RESULTS The standard protocol revealed ischemia in 34 (68%) and a fixed defect in 8 (16%) patients, of whom 33 (97%) and 8 (100%) were correctly identified by low-dose MPI (clinical agreement, 98%). Segmental uptake correlated well between low- and standard-dose rest scans (r = 0.94, P < 0.001; Bland-Altman limits of agreement, -11 to +11%). Defect extent was 14.4% (low-dose) versus 13.1% (standard-dose) at rest (P = not statistically significant) and 26.6% at stress (P < 0.001 vs. rest scans). CONCLUSION These promising results suggest that accurate assessment of ischemic myocardial disease is feasible with a low-dose-low-dose 1-d SPECT MPI protocol using a CZT device.