Abstract
BackgroundCadmium-zinc-telluride (CZT) cameras have improved the evaluation of patients with chest pain. However, inferior/inferolateral attenuation artifacts similar to those seen with conventional Anger cameras persist. We added prone acquisitions and CT attenuation correction (CTAC) to the standard supine image acquisition and analyzed the resulting examinations.Methods and resultsSeventy-two patients referred for invasive coronary angiography (CAG), and who also underwent rest/stress myocardial perfusion imaging (MPI) on a CZT camera in the supine and prone positions plus CTAC imaging, to examine known or suspected CAD between April 2013 and March 2014 were included. A sixteen-slice CT scan acquired on a SPECT/CT scanner between rest and stress imaging provided data for iterative reconstruction. Sensitivity, specificity, accuracy, and positive and negative likelihood ratios (LRs) were calculated to compare MPI with CAG on a per-patient basis. Per-patient sensitivity, specificity, and accuracy of supine images to predict coronary abnormalities on CAG were 35% [95% confidence interval (CI) 19–52], 86% (95% CI 80–92), and 74% (95% CI 66–82); those of prone imaging were 65% (95% CI 45–81), 82% (95% CI 76–87), and 78% (95% CI 68–85); and those of CTAC were 59% (95% CI 41–71), 93% (95% CI 87–97), and 85% (95% CI 76–91), respectively.ConclusionsProne acquisition and CTAC images improve the ability to assess the inferior/inferolateral area.
Highlights
Myocardial perfusion imaging (MPI) is useful for evaluating patients for coronary artery disease (CAD), assessing patients’ risk of future cardiac events, and evaluating therapeutic efficacy.A recently developed high-efficiency ultrafast multipinhole cardiac camera with cadmium-zinc-telluride (CZT) detectors shows higher photon sensitivity and spatial resolution compared with conventional Anger cameras
Seventy-two patients referred for invasive coronary angiography (CAG), and who underwent rest/stress myocardial perfusion imaging (MPI) on a CZT camera in the supine and prone positions plus CT attenuation correction (CTAC) imaging, to examine known or suspected CAD between April 2013 and March 2014 were included
Per-patient sensitivity, specificity, and accuracy of supine images to predict coronary abnormalities on CAG were 35% [95% confidence interval (CI) 19–52], 86%, and 74%; those of prone imaging were 65%, 82%, and 78%; and those of CTAC were 59%, 93%, and 85%, respectively
Summary
Myocardial perfusion imaging (MPI) is useful for evaluating patients for coronary artery disease (CAD), assessing patients’ risk of future cardiac events, and evaluating therapeutic efficacy.A recently developed high-efficiency ultrafast multipinhole cardiac camera with cadmium-zinc-telluride (CZT) detectors shows higher photon sensitivity and spatial resolution compared with conventional Anger cameras. Methods and results Seventy-two patients referred for invasive coronary angiography (CAG), and who underwent rest/stress myocardial perfusion imaging (MPI) on a CZT camera in the supine and prone positions plus CTAC imaging, to examine known or suspected CAD between April 2013 and March 2014 were included. Per-patient sensitivity, specificity, and accuracy of supine images to predict coronary abnormalities on CAG were 35% [95% confidence interval (CI) 19–52], 86% (95% CI 80–92), and 74% (95% CI 66–82); those of prone imaging were 65% (95% CI 45–81), 82% (95% CI 76–87), and 78% (95% CI 68–85); and those of CTAC were 59% (95% CI 41–71), 93% (95% CI 87–97), and 85% (95% CI 76–91), respectively
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