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Cadmium-zinc-telluride myocardial perfusion imaging in obese patients.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2012
Author Fiechter Michael, Gebhard Cathérine, Fuchs Tobias A, Ghadri Jelena R, Stehli Julia, Kazakauskaite Egle, Herzog Bernhard A, Pazhenkottil Aju P, Gaemperli Oliver, Kaufmann Philipp 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) 53(9)
Page(s) 1401 - 6
Title of proceedings Journal of nuclear medicine : official publication, Society of Nuclear Medicine
DOI 10.2967/jnumed.111.102434

Abstract

UNLABELLED We have evaluated the impact of increased body mass on the quality of myocardial perfusion imaging using a latest-generation γ-camera with cadmium-zinc-telluride semiconductor detectors in patients with high (≥40 kg/m(2)) or very high (≥45 kg/m(2)) body mass index (BMI). METHODS We enrolled 81 patients, including 18 with no obesity (BMI < 30 kg/m(2)), 17 in World Health Organization obese class I (BMI, 30-34.9 kg/m(2)), 15 in class II (BMI, 35-39.9 kg/m(2)), and 31 in class III (BMI ≥ 40 kg/m(2)), including 15 with BMI ≥ 45 kg/m(2). Image quality was scored as poor (1), moderate (2), good (3), or excellent (4). Patients with BMI ≥ 45 kg/m(2) and nondiagnostic image quality (≤2) were rescanned after repositioning to better center the heart in the field of view. Receiver-operating-curve analysis was applied to determine the BMI cutoff required to obtain diagnostic image quality (≥3). RESULTS Receiver-operating-curve analysis resulted in a cutoff BMI of 39 kg/m(2) (P < 0.001) for diagnostic image quality. In patients with BMI ≥ 40 kg/m(2), image quality was nondiagnostic in 81%; after CT-based attenuation correction this decreased to 55%. Repositioning further improved image quality. Rescanning on a conventional SPECT camera resulted in diagnostic image quality in all patients with BMI ≥ 45 kg/m(2). CONCLUSION Patients with BMI ≥ 40 kg/m(2) should be scheduled for myocardial perfusion imaging on a conventional SPECT camera, as it is difficult to obtain diagnostic image quality on a cadmium-zinc-telluride camera.
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