Abstract
BackgroundAttenuation correction (AC) improves the diagnostic outcome of stress-only myocardial perfusion imaging (MPI) using conventional SPECT. Our aim was to determine the value of AC using a cadmium zinc telluride-based (CZT)-SPECT camera. Methods and resultsWe retrospectively included 107 consecutive patients who underwent stress-optional rest MPI CZT-SPECT/CT. Next, we created three types of images for each patient; (1) only displaying reconstructed data without the CT-based AC (NC), (2) only displaying AC, and (3) with both NC and AC (NC + AC). Next, two experienced physicians visually interpreted these 321 randomized images as normal, equivocal, or abnormal. Image outcome was compared with all hard events over a mean follow-up time of 47.7 ± 9.8 months. The percentage of images interpreted as normal increased from 45% using the NC images to 72% using AC and to 67% using NC + AC images (P < .001). Hard event hazard ratios for images interpreted as normal were not different between using NC and AC (1.01, P = .99), or NC and NC + AC images (0.97, P = .97). ConclusionsAC lowers the need for additional rest imaging in stress-first MPI using CZT-SPECT, while long-term patient outcome remained identical. Use of AC reduces the need for additional rest imaging, decreasing the mean effective dose by up to 1.2 mSv.
Highlights
Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) is a van Dijk et al Attenuation correction (AC) in cadmium zinc telluride-based (CZT)-SPECT well validated and frequently used non-invasive method in the evaluation of known or suspected coronary artery disease (CAD).[1,2] Stress-only myocardial perfusion imaging (MPI) is recommended by both European and American guidelines in appropriately selected patients to reduce radiation dose and improve laboratory efficiency.[3,4] attenuation artifacts are common and result in a higher necessity for additional rest imaging and in a lower diagnostic accuracy.[4]
AC lowers the need for additional rest imaging in stress-first MPI using CZTSPECT, while long-term patient outcome remained identical
Use of AC reduces the need for additional rest imaging, decreasing the mean effective dose by up to 1.2 mSv. (J Nucl Cardiol 2017;24:395–401.)
Summary
Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) is a van Dijk et al AC in CZT-SPECT well validated and frequently used non-invasive method in the evaluation of known or suspected coronary artery disease (CAD).[1,2] Stress-only MPI is recommended by both European and American guidelines in appropriately selected patients to reduce radiation dose and improve laboratory efficiency.[3,4] attenuation artifacts are common and result in a higher necessity for additional rest imaging and in a lower diagnostic accuracy.[4]. The recently introduced ultrafast cardiac SPECT cameras with cadmium zinc telluride-based (CZT) detectors provide superior image quality, resulting in shorter acquisition times, lower radiation doses, and less equivocal scans, facilitating stress-only imaging.[9,10]. It is unknown whether this superior image quality obviates the use of AC for such cameras. The aim of this study was to determine the added value of AC in stress-only MPI using a CZT-SPECT camera. Attenuation correction (AC) improves the diagnostic outcome of stress-only myocardial perfusion imaging (MPI) using conventional SPECT. Our aim was to determine the value of AC using a cadmium zinc telluride-based (CZT)-SPECT camera
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