Evaluation of patients with coronary artery disease

F. Caobelli; C. Pizzocaro; B. Paghera; U. P. Guerra

doi:10.3413/Nukmed-0570-13-03

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2013; 52(05): 178-185
DOI: 10.3413/Nukmed-0570-13-03

Original article

Schattauer GmbH

Evaluation of patients with coronary artery disease

IQ-SPECT protocol in myocardial perfusion imaging: Preliminary resultsBeurteilung von Patienten mit koronarer Herzkrankheit IQ-SPECT Protokoll zur Darstellung der Myokard-Perfusionvorläufige Ergebnisse

F. Caobelli

¹Department of Nuclear Medicine, Fondazione Poliambulanza, Brescia, Italy

,

C. Pizzocaro

¹Department of Nuclear Medicine, Fondazione Poliambulanza, Brescia, Italy

,

B. Paghera

²Department of Nuclear Medicine, Spedali Civili di Brescia, Italy

,

U. P. Guerra

¹Department of Nuclear Medicine, Fondazione Poliambulanza, Brescia, Italy

› Author Affiliations

Abstract

Summary

Quantification of myocardial perfusion scintigraphy is often performed to assist physicians in detecting coronary artery disease (CAD). Modern software and hardware packages provide improvements able to shorten scan time and/or reduce administered activity, without compromising image quality in radionuclide myocardial perfusion imaging (MPI). Recently, multifocal collimators were introduced with dedicated reconstruction software, named IQ-SPECT, able to shorten considerably scan time. The aim of our study was to compare this new protocol to the already validated standard ones. Patients, methods: We enrolled 43 patients with suspected or diagnosed CAD. All patients underwent a two-days protocol radionuclide myocardial perfusion scan at rest and after a standard stress test (exercise or dipyridamole) after administering ^99mTc-tetrofosmin. Images were acquired on a 2-head gamma camera and reconstructed with attenuation correction. All the images were scored using a 17-segments model by three experienced physicians, blind to clinical data and to acquisition and processing modality. Results, conclusion: No significant differences were recorded in perfusion scores on paired t-test and Wilcoxon among the full-time images reconstructed with standard protocol or IQSPECT, both overall on a 17-segments evaluation and when considering different territories of distribution. MPI with IQ-SPECT protocol can be acquired at about a quarter scan time without disagreement compared to full time scan acquisition performed with standard protocols.

Zusammenfassung

Häufig werden myokardiale Perfusionsszintigraphien quantifiziert, um den Arzt bei der Diagnose der koronaren Herzkrankheit (KHK) zu unterstützen. Moderne Hard- und Software bietet Verbesserungen, die verkürzte Aufnahmezeiten und/oder geringere Strahlenbelastungen ermöglichen ohne die Bildqualität der myokardialen Perfusionsszintigraphie (MPS) zu beeinträchtigen. Kürzlich wurden multifokale Kollimatoren mit Rekonstruktionssoftware, genannt IQ-SPECT, eingeführt, womit die Scanzeit erheblich verkürzt werden kann. In unserer Studie sollte dieses neue Protokoll mit dem bereits validierten Standardvorgehen verglichen werden. Patienten, Methoden: Eingeschlossen wurden 43 Patienten mit vermuteter oder diagnostizierter KHK. Sie wurden einem zweitägigen Protokoll mit Radionuklid- Myokard-Perfusionsscan in Ruhe und nach standardisiertem Belastungstest (Ergometrie oder Dipyridamol) nach Gabe von ^99mTc-Tetrofosmin unterzogen. Die Aufnahmen mit einer Doppelkopf-Gammakamera wurden mittels Abschwächungskorrektur rekonstruiert. Alle Aufnahmen wurden von drei erfahrenen Ärzten, die bezüglich der klinischen Angaben sowie der Aufnahme- und Verarbeitungsmodalitäten verblindet waren, anhand eines 17-Segment-Modells ausgewertet. Ergebnisse, Schlussfolgerung: Im t-Test für verbundene Stichproben und Wilcoxon- Test wurden keine wesentlichen Unterschiede bei den Perfusionswerten zwischen den Vollzeit-Aufnahmen mit Standardprotokoll und IQ-SPECT festgestellt, sowohl insgesamt in der 17-Segment-Auswertung als auch unter Berücksichtigung verschiedener Verteilungsgebiete. Die MPS mit einem IQ-SPECT-Protokoll kann ohne Abweichungen in etwa einem Viertel der Scanzeit akquiriert werden, die für die Aufnahmen in Vollzeit mit dem Standardprotokoll benötigt wird.

Keywords

Coronary artery disease - ^99mTc tetrofosmin SPECT/CT - IQ-SPECT - low counts acquisition - myocardial perfusion imaging

Schlüsselwörter

Koronare Herzkrankheit - ^99mTc-Tetrofosmin SPECT/CT - IQ-SPECT - Erfassung niedriger Counts - Myokard-Perfusions-aufnahmen

Full Text

References

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