Abstract
BackgroundPET scanners using silicon photomultipliers with digital readout (SiPM PET) have an improved temporal and spatial resolution compared to PET scanners using conventional photomultiplier tubes (PMT PET). However, the effect on image quality and visibility of perfusion defects in myocardial perfusion imaging (MPI) is unknown. Our aim was to determine the value of a SiPM PET scanner in MPI. MethodsWe prospectively included 30 patients who underwent rest and regadenoson-induced stress Rubidium-82 (Rb-82) MPI on the D690 PMT PET (GE Healthcare) and within three weeks on the Vereos SiPM PET (Philips Healthcare). Two expert readers scored the image quality and assessed the existence of possible defects. In addition, interpreter’s confidence, myocardial blood flow (MBF), and myocardial flow reserve (MFR) values were compared. ResultsImage quality improved (P = 0.03) using the Vereos as compared to the D690. Image quality of the Vereos and the D690 was graded fair in 20% and 10%, good in 60% and 50%, and excellent in 20% and 40%, respectively. Defect interpretation and interpreter’s confidence did not differ between the D690 and the Vereos (P > 0.50). There were no significant differences in rest MBF (P ≥ 0.29), stress MBF (P ≥ 0.11), and MFR (P ≥ 0.51). ConclusionSiPM PET provides an improved image quality in comparison with PMT PET. Defect interpretation, interpreter’s confidence, and absolute blood flow measurements were comparable between both systems. SiPM PET is therefore a reliable technique for MPI using Rb-82. Trial registrationToetsingOnline NL63853.075.17. Registered 13 November, 2017.
Highlights
Myocardial perfusion imaging (MPI) using positron emission tomography (PET) is increasing in popularity over single photon emission computed tomography (SPECT) in the last years due to the increased availability of strontium-82/rubidium-82 (Rb-82) generators, higher spatial resolution, and higher sensitivity and specificity.[1]
Image quality of the Vereos and the D690 was graded fair in 20% and 10%, good in 60% and 50%, and excellent in 20% and 40%, respectively
We showed that the Vereos SiPM PET scanner provided an improved image quality for myocardial perfusion imaging (MPI) using Rb-82 as compared to the D690 PET scanner using conventional photomultiplier tubes
Summary
Myocardial perfusion imaging (MPI) using positron emission tomography (PET) is increasing in popularity over single photon emission computed tomography (SPECT) in the last years due to the increased availability of strontium-82/rubidium-82 (Rb-82) generators, higher spatial resolution, and higher sensitivity and specificity.[1]. New PET systems using silicon photomultipliers with digital readout (SiPM PET) have become available for clinical use.[5,6,7,8] In terms of system performance, the SiPM PET design results in an improved spatial and timing resolution and a relatively high count-rate capability as compared to PET scanners using conventional photomultiplier tubes (PMT PET).[5,6,7,9,10] First oncology-PET studies showed that SiPM PET provides an improved image quality over PMT PET.[10,11,12,13] studies demonstrating the value of SiPM PET for MPI are still lacking. Our aim was to determine the value of SiPM PET in comparison with PMT PET in MPI using Rb-82. Our aim was to determine the value of a SiPM PET scanner in MPI
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