High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging

• Published in: JACC. Cardiovascular imaging 2008-03, Vol.1 (2), p.156-163
• Main Authors: Sharir, Tali, Ben-Haim, Simona, Merzon, Konstantine, Prochorov, Vitali, Dickman, Dalia, Ben-Haim, Shlomo, Berman, Daniel S
• Format: Article
• Language: English
• Subjects: Aged; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Coronary Circulation; Dipyridamole; Equipment Design; Exercise Test; Feasibility Studies; Female; Gamma Cameras; Humans; Image Enhancement; Image Interpretation, Computer-Assisted; Male; Middle Aged; Myocardial Perfusion Imaging - instrumentation; Myocardial Perfusion Imaging - methods; Pilot Projects; Predictive Value of Tests; Radiopharmaceuticals; Technetium Tc 99m Sestamibi; Time Factors; Tomography, Emission-Computed, Single-Photon - instrumentation
• ISSN: 1876-7591
• DOI: 10.1016/j.jcmg.2007.12.004

The purpose of this study was to compare myocardial perfusion imaging (MPI) with high-speed single-photon emission computed tomography (SPECT) with conventional SPECT imaging for the evaluation of myocardial perfusion in patients with known or suspected coronary artery disease. A novel technology has been developed for high-speed SPECT MPI by employing a bank of independently controlled detector columns with large-hole tungsten collimators and multiple cadmium zinc telluride crystal arrays. A total of 44 patients (39 men) underwent same-day Tc-99m sestamibi stress/rest MPI. High-speed SPECT images were performed within 30 min after conventional SPECT. Stress and rest acquisition times were 16 and 12 min for conventional imaging and 4 and 2 min for high-speed SPECT, respectively. Myocardial counts/min (cpm) were calculated for both conventional SPECT and high-speed SPECT. Images were visually analyzed, and the summed stress score (SSS) and summed rest score (SRS) were calculated. Image quality and diagnostic confidence were qualitatively assessed. High-speed SPECT SSS and SRS correlated linearly with conventional SPECT respective scores (r = 0.93, p < 0.0001 for SSS, and r = 0.93, p < 0.0001 for SRS). Image quality was rated good and higher in 17 (94%) cases for high-speed SPECT and 16 (89%) cases for conventional SPECT. Of the 44 patients studied, 36 (81.8%) and 35 (79.5%) were diagnosed definitely normal or abnormal by conventional and high-speed SPECT, respectively (p = NS). Myocardial count rate was significantly higher in high-speed versus conventional SPECT (384 x 10(-3) +/- 134 x 10(-3) cpm/min vs. 47 x 10(-3) +/- 14 x 10(-3) cpm/min, respectively, p < 0.0001) for stress and (962 x 10(-3) +/- 426 x 10(-3) cpm/min vs. 136 x 10(-3) +/- 37 x 10(-3) cpm/min, respectively, p < 0.001) for rest. High-speed SPECT provides fast MPI with high image quality and up to 8 times increased system sensitivity. The amount of perfusion abnormality visualized by high-speed SPECT is highly correlated to conventional SPECT, with an equivalent level of diagnostic confidence.