Abstract
The aim of the present study was to test an individualised dose without compromising the ease of analysing data when performing equilibrium radionuclide angiography (ERNA) using cadmium–zinc–telluride (CZT) SPECT. From March 2018 to January 2019, 1650 patients referred for ERNA received either an individualised dose of 99mTc-labeled human serum albumin (HSA) according to their age, sex, height, and weight (n = 1567), or a standard dose of 550 MBq (n = 83). The target count rate (CRT) was reduced every two months from 2.7 to 1.0 kcps. A final test with a CRT of 1.7 kcps was run for three months to test whether an agreement within 2% points for the determination of LVEF, on the basis of only two analyses, was obtainable in at least 95% of acquisitions. All the included ERNAs were performed on a dedicated cardiac CZT SPECT camera. When using the algorithm for an individualised dose, we found that agreement between the measured and predicted count rate was 80%. With a CRT of 1.7 kcps, the need for more than two analyses to obtain sufficient agreement for LVEF was 4.9%. Furthermore, this resulted in a mean dose reduction from 550 to 258 MBq. Patients’ weight, height, sex, and age can, therefore, be used for individualising a tracer dose while reducing the mean dose.
Highlights
Technological advances in cancer treatment and screening procedures have resulted in an increase in long-term cancer survivors [1,2,3]
Patients undergoing potentially cardiotoxic chemotherapy are often monitored by quantifying left ventricular ejection fraction (LVEF)
In 27 cases, acquisitions were excluded because NaI detector SPECT or planar was performed instead, 18 cases were excluded if the patient received another dose than scheduled, and 1 case was excluded due to an injection of 18-F-FDG prior to equilibrium radionuclide angiography (ERNA)
Summary
Technological advances in cancer treatment and screening procedures have resulted in an increase in long-term cancer survivors [1,2,3]. This has led to an increased need for managing the potential long-term side effects of chemotherapy and radiotherapy, among which, cardiovascular complications are frequent [2,3]. Accurate monitoring of cardiac function during potentially cardiotoxic chemotherapy is of importance. Chemotherapy-induced cardiac damage may be caused by a direct toxic effect or as an accelerated development of cardiovascular disease and appears up to years after the initiation of treatment [4,5]
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