Diagnostic performance of a semiconductor gamma-camera system as studied by multicenter registry

• Published in: Journal of cardiology 2017-02, Vol.69 (2), p.449-455
• Main Authors: Chikamori, Taishiro, MD, PhD, FJCC, Goto, Kenji, MD, PhD, Hida, Satoshi, MD, PhD, FJCC, Miyagawa, Masao, MD, PhD, Ishimura, Hayato, RT, Uchida, Kenji, RT, Fukuyama, Takaya, MD, PhD, FJCC, Mochizuki, Teruhito, MD, PhD, Yamashina, Akira, MD, PhD, FJCC
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cadmium; Cadmium–zinc–telluride camera; Cardiovascular; Coronary Angiography; Coronary artery disease; Coronary Stenosis - diagnosis; Diagnosis; Exercise Test; Female; Humans; Japan; Male; Middle Aged; Radiopharmaceuticals; Registries; Sensitivity and Specificity; Single-photon emission computed tomography; Technetium; Tellurium; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Vasodilator Agents - administration & dosage; Zinc
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2016.02.020

Abstract Background Despite the introduction of the novel cadmium–zinc–telluride (CZT) single-photon emission computed tomography (SPECT) in Japan; its diagnostic value in clinical practice remains largely unknown. Methods The Semiconductor SPECT Study group is a multicenter Japanese registry which registered 1000 patients to evaluate the diagnostic utility of the CZT camera system (Discovery NM530c; GE Healthcare, Haifa, Israel). The patients underwent stress myocardial SPECT and coronary angiography within a 3-month interval. A significant stenosis was defined as ≥75% diameter narrowing based on the American Heart Association classification. Results Technetium (99m Tc) radiotracer (555–1110 MBq) was used in 71% and thallium-201 (201 Tl) (74–148 MBq) in 29%. The scan times with99m Tc-radiotracer were 5–10 min for stress and 3–10 min for rest, whereas those with201 Tl were 5–9 min for stress and 8–10 min for rest. To detect individual coronary stenosis, the respective sensitivities, specificities, and accuracies were 74%, 85%, and 81% for left anterior descending coronary artery (LAD) stenosis, 76%, 89%, and 85% for left circumflex stenosis, and 72%, 86%, and 82% for right coronary artery stenosis. However, 66% sensitivity and 91% specificity for LAD stenosis were observed with99m Tc-radiotracer, whereas 88% sensitivity and 63% specificity were found with201 Tl. Conclusions The novel CZT SPECT system facilitated a short scan time with reduced radiotracer dose, yielding an acceptable diagnostic performance for angiographical coronary artery disease, although the low sensitivity for LAD detection with99m Tc-radiotracer needs to be refined.