nach oben

Erschienen in:

01.12.2014 | Original Article

Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT

verfasst von: J. D. van Dijk, MSc, P. L. Jager, MD, PhD, M. Mouden, MD, C. H. Slump, PhD, J. P. Ottervanger, MD, PhD, J. de Boer, MD, PhD, A. H. J. Oostdijk, MD, J. A. van Dalen, PhD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Guidelines for SPECT myocardial perfusion imaging (MPI) traditionally recommend a fixed tracer dose. Yet, clinical practice shows degraded image quality in heavier patients. The aim was to optimize and validate the tracer dose and scan time to obtain a constant image quality less dependent on patients’ physical characteristics.

Methods

125 patients underwent Cadmium Zinc Telluride (CZT)-SPECT stress MPI using a fixed Tc-99m-tetrofosmin tracer dose. Image quality was scored by three physicians on a 4-point grading scale and related to the number of photon counts normalized to tracer dose and scan time. Counts were correlated with various patient-specific parameters dealing with patient size and weight to find the best predicting parameter. From these data, a formula to provide constant image quality was derived, and subsequently tested in 92 new patients.

Results

Degradation in image quality and photon counts was observed for heavier patients for all patients’ specific parameters (P < .01). We found body weight to be the best-predicting parameter for image quality and derived a new dose formula. After applying this new body weight-depended tracer dose and scan time in a new group, image quality was found to be constant (P > .19) in all patients.

Conclusions

Also in CZT SPECT image quality decreases with weight. The use of a tracer dose and scan time that depends linearly on patient’s body weight corrected for the varying image quality in CZT-SPECT MPI. This leads to better radiation exposure justification.

Flotats A, Knuuti J, Gutberlet M, Marcassa C, Bengel FM, Kaufmann PA, et al. Hybrid cardiac imaging: SPECT/CT and PET/CT. A joint position statement by the European Association of Nuclear Medicine (EANM), the European Society of Cardiac Radiology (ESCR) and the European Council of Nuclear Cardiology (ECNC). Eur J Nucl Med Mol Imaging 2011;38:201-12.PubMedCrossRef

Underwood SR, Anagnostopoulos C, Cerqueira MD, Ell PJ, Flint EJ, Harbinson M, et al. Myocardial perfusion scintigraphy: The evidence. Eur J Nucl Med Mol Imaging 2004;31:261-91.PubMedCentralPubMedCrossRef

Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005;32:855-97.PubMedCrossRef

Notghi A, Williams N, Smith N, Goyle S, Harding LK. Relationship between myocardial counts and patient weight: adjusting the injected activity in myocardial perfusion scans. Nucl Med Commun 2003;24:55-9.PubMedCrossRef

International Commission on Radiological Protection (ICRP). 1990 Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. ICRP Publ. 60. Ann. ICRP 21, 1991.

Notghi A, Sundram FX, O’Brien JW, Smith NB. Assessing the effect of increasing injection activity for myocardial perfusion imaging in overweight patients. Br J Radiol 2008;81:730-4.PubMedCrossRef

Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009;361:849-57.PubMedCentralPubMedCrossRef

Duvall WL, Sweeny JM, Croft LB, Ginsberg E, Guma KA, Henzlova MJ. Reduced stress dose with rapid acquisition CZT SPECT MPI in a non-obese clinical population: Comparison to coronary angiography. J Nucl Cardiol 2012;19:19-27.PubMedCrossRef

Cerqueira MD, Allman KC, Ficaro EP, Hansen CL, Nichols KJ, Thompson RC, et al. Recommendations for reducing radiation exposure in myocardial perfusion imaging. J Nucl Cardiol 2010;17:709-18.PubMedCrossRef

10.

De Groot EH, Post N, Boellaard R, Wagenaar NR, Willemsen AT, van Dalen JA. Optimized dose regimen for whole-body FDG-PET imaging. Eur J Nucl Med Mol Imaging Res 2013;3:63.

11.

Gerber TC, Gibbons RJ. Weighing the risks and benefits of cardiac imaging with ionizing radiation. JACC Cardiovasc Imaging 2010;3:528-35.PubMedCrossRef

12.

Eisenberg MJ, Afilalo J, Lawler PR, Abrahamowicz M, Richard H, Pilote L. Cancer risk related to low-dose ionizing radiation from cardiac imaging in patients after acute myocardial infarction. Can Med Assoc J 2011;183:430-6.CrossRef

13.

Fahey F, Stabin M. Dose optimization in nuclear medicine. Semin Nucl Med 2014;44:193-201.PubMedCrossRef

14.

Mouden M, Timmer JR, Ottervanger JP, Reiffers S, Oostdijk AHJ, Knollema S, et al. Impact of a new ultrafast CZT SPECT camera for myocardial perfusion imaging: Fewer equivocal results and lower radiation dose. Eur J Nucl Med Mol Imaging 2012;39:1048-55.PubMedCrossRef

15.

Buechel RR, Herzog BA, Husmann L, Burger IA, Pazhenkottil AP, Treyer V, et al. Ultrafast nuclear myocardial perfusion imaging on a new gamma camera with semiconductor detector technique: First clinical validation. Eur J Nucl Med Mol Imaging 2010;37:773-8.PubMedCrossRef

16.

Esteves FP, Raggi P, Folks RD, Keidar Z, Askew JW, Rispler S, et al. Novel solid-state-detector dedicated cardiac camera for fast myocardial perfusion imaging: Multicenter comparison with standard dual detector cameras. J Nucl Cardiol 2009;16:927-34.PubMedCentralPubMedCrossRef

17.

Duvall WL, Croft LB, Godiwala T, Ginsberg E, George T, Henzlova MJ. Reduced isotope dose with rapid SPECT MPI imaging: Initial experience with a CZT SPECT camera. J Nucl Cardiol 2010;17:1009-14.PubMedCrossRef

18.

Hume R. Prediction of lean body mass from height and weight. J Clin Pathol 1966;19:389-91.PubMedCentralPubMedCrossRef

19.

Hallynck T, Soep H, Thomis J, Boelaert J, Daneels R, Dettli L. Should clearance be normalised to body surface or to lean body mass? Br J Clin Pharmacol 1981;11:523-6.PubMedCentralPubMedCrossRef

20.

Oddstig J, Hedeer F, Jögi J, Carlsson M, Hindorf C, Engblom H. Reduced administered activity, reduced acquisition time, and preserved image quality for the new CZT camera. J Nucl Cardiol 2013;20:38-44.PubMedCrossRef

21.

Bocher M, Blevis IM, Tsukerman L, Shrem Y, Kovalski G, Volokh L. A fast cardiac gamma camera with dynamic SPECT capabilities: Design, system validation and future potential. Eur J Nucl Med Mol Imaging 2010;37:1887-902.PubMedCentralPubMedCrossRef

22.

Heller GV, Links J, Bateman TM, Ziffer JA, Ficaro E, Cohen MC, et al. American Society of Nuclear Cardiology and Society of Nuclear Medicine joint position statement: Attenuation correction of myocardial perfusion SPECT scintigraphy. J Nucl Cardiol 2004;11:229-30.PubMedCrossRef

23.

Garcia EV, Faber TL, Esteves FP. Cardiac dedicated ultrafast SPECT cameras: New designs and clinical implications. J Nucl Med 2011;52:210-7.PubMedCrossRef

24.

Gambhir SS, Berman DS, Ziffer J, Nagler M, Sandler M, Patton J, et al. A novel high-sensitivity Rapid-acquisition single-photon cardiac imaging camera. J Nucl Med 2009;50:635-43.PubMedCrossRef

25.

Sharir T, Ben-Haim S, Merzon K, Prochorov V, Dickman D, Ben-Haim S, et al. High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging. JACC Cardiovasc Imaging 2008;1:156-63.PubMedCrossRef

26.

Higley B, Smith FW, Smith T, Gemmell HG, Das Gupta P, Gvozdanovic DV, et al. Technetium-99m-1,2-bis[bis(2-ethoxyethyl) phosphino]ethane: Human biodistribution, dosimetry and safety of a new myocardial perfusion imaging agent. J Nucl Med 1993;34:30-8.PubMed

27.

Jain D, Wackers FJ, Mattera J, McMahon M, Sinusas AJ, Zaret BL. Biokinetics of technetium-99m-tetrofosmin: Myocardial perfusion imaging agent: Implications for a 1-day imaging protocol. J Nucl Med 1993;34:1254-9.PubMed

28.

Nakazato R, Berman DS, Hayes SW, Fish M, Padgett R, Xu Y, et al. Myocardial perfusion imaging with a solid-state camera: Simulation of a very low dose imaging protocol. J Nucl Med 2013;54:373-9.PubMedCentralPubMedCrossRef

Titel: Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT
verfasst von: J. D. van Dijk, MSc
P. L. Jager, MD, PhD
M. Mouden, MD
C. H. Slump, PhD
J. P. Ottervanger, MD, PhD
J. de Boer, MD, PhD
A. H. J. Oostdijk, MD
J. A. van Dalen, PhD
Publikationsdatum: 01.12.2014
Verlag: Springer US
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 6/2014
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-014-9942-0

Neu im Fachgebiet Kardiologie

16.04.2024 | Chronische Herzinsuffizienz | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using CZT-SPECT

Abstract

Background

Methods

Results

Conclusions

Neu im Fachgebiet Kardiologie

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Selbstexpandierende TAVI-Klappen bei kleinem Aortenanulus im Vorteil

Verbesserung der HDL-Funktion als Lipidtherapie floppt in Mega-Studie

Update Kardiologie

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2014

CME QUIZ & REGISTRATION FORM

Myocardial perfusion SPECT horizontal motion artifact

Absolute myocardial blood flow quantification with SPECT/CT: Is it possible?

Imaging cardiac amyloidosis: An opportunity for nuclear cardiology

Relation of early post-stress left ventricular dyssynchrony and the extent of angiographic coronary artery disease

Single-photon emission computed tomography myocardial perfusion imaging-assessed stress perfusion defect severity is associated with mortality independent of ethnicity in an Asian population

Neu im Fachgebiet Kardiologie

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Selbstexpandierende TAVI-Klappen bei kleinem Aortenanulus im Vorteil

Verbesserung der HDL-Funktion als Lipidtherapie floppt in Mega-Studie

Update Kardiologie