The current status of CZT SPECT myocardial blood flow and reserve assessment: Tips and tricks

Cardiac PET-derived measurements of myocardial blood flow (MBF) and myocardial flow reserve (MFR) are proven robust indexes of the severity of coronary artery disease (CAD). They facilitate the diagnosis of diffuse epicardial and microvascular disease and are also of prognostic significance. However...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2022-12, Vol.29 (6), p.3137-3151
Main Authors: Zavadovsky, Konstantin V., Mochula, Andrew V., Maltseva, Alina N., Shipulin, Vladimir V., Sazonova, Svetlana I., Gulya, Marina O., Liga, Ricardo, Gimelli, Alessia
Format: Article
Language:English
Subjects:
CAD
Cadmium
Cardiology
Cardiovascular disease
Coronary Artery Disease - diagnostic imaging
CZT
Fractional Flow Reserve, Myocardial
Humans
Imaging
Medicine
Medicine & Public Health
Myocardial blood flow
Myocardial flow reserve
Myocardial ischemia
Myocardial Perfusion Imaging - methods
Nuclear Medicine
Radiology
Review Article
SPECT
Tellurium
Tomography, Emission-Computed, Single-Photon - methods
Tomography, X-Ray Computed
Zinc
Zinc telluride
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Summary:Cardiac PET-derived measurements of myocardial blood flow (MBF) and myocardial flow reserve (MFR) are proven robust indexes of the severity of coronary artery disease (CAD). They facilitate the diagnosis of diffuse epicardial and microvascular disease and are also of prognostic significance. However, low availability and high cost have limited their wide clinical implementation. Over the last 15 years, cadmium zinc telluride (CZT)-based detectors have been implemented into SPECT imaging devices. Myocardial perfusion scintigraphy can be performed faster and with less radiation exposure as compared with standard gamma cameras. Rapid dynamic SPECT studies with higher count rates can be performed. This technological breakthrough has renewed the interest in SPECT MBF assessment in patients with CAD. Currently, two cardiac-centered CZT gamma cameras are available commercially—Discovery NM530c and D-SPECT. They differ in parameters such as collimator design, number of detectors, sensitivity, spatial resolution and image reconstruction. A number of publications have focused on the feasibility of dynamic CZT SPECT and on the correlation with cardiac PET and invasive coronary angiography measurements of fractional flow reserve. Current study reviews the present status of MBF and MFR assessment with CZT SPECT. It also aims to provide an overview of specific issues related to acquisition, processing and interpretation of quantitative studies in patients with CAD.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-021-02620-y