High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging.
OBJECTIVE
The purpose of this study was to compare myocardial perfusion imaging (MPI) with high-speed single-photon emission computed tomography (SPECT) with conventional SPECT imaging for the evaluation of myocardial perfusion in patients with known or suspected coronary artery disease.


BACKGROUND
A novel technology has been developed for high-speed SPECT MPI by employing a bank of independently controlled detector columns with large-hole tungsten collimators and multiple cadmium zinc telluride crystal arrays.


METHODS
A total of 44 patients (39 men) underwent same-day Tc-99m sestamibi stress/rest MPI. High-speed SPECT images were performed within 30 min after conventional SPECT. Stress and rest acquisition times were 16 and 12 min for conventional imaging and 4 and 2 min for high-speed SPECT, respectively. Myocardial counts/min (cpm) were calculated for both conventional SPECT and high-speed SPECT. Images were visually analyzed, and the summed stress score (SSS) and summed rest score (SRS) were calculated. Image quality and diagnostic confidence were qualitatively assessed.


RESULTS
High-speed SPECT SSS and SRS correlated linearly with conventional SPECT respective scores (r = 0.93, p < 0.0001 for SSS, and r = 0.93, p < 0.0001 for SRS). Image quality was rated good and higher in 17 (94%) cases for high-speed SPECT and 16 (89%) cases for conventional SPECT. Of the 44 patients studied, 36 (81.8%) and 35 (79.5%) were diagnosed definitely normal or abnormal by conventional and high-speed SPECT, respectively (p = NS). Myocardial count rate was significantly higher in high-speed versus conventional SPECT (384 x 10(-3) +/- 134 x 10(-3) cpm/min vs. 47 x 10(-3) +/- 14 x 10(-3) cpm/min, respectively, p < 0.0001) for stress and (962 x 10(-3) +/- 426 x 10(-3) cpm/min vs. 136 x 10(-3) +/- 37 x 10(-3) cpm/min, respectively, p < 0.001) for rest.


CONCLUSIONS
High-speed SPECT provides fast MPI with high image quality and up to 8 times increased system sensitivity. The amount of perfusion abnormality visualized by high-speed SPECT is highly correlated to conventional SPECT, with an equivalent level of diagnostic confidence.
Sharir
Tali
T
Procardia-Maccabi Healthcare Services, Tel-Aviv, Israel. tsharir@gmail.com
Ben-Haim
Simona
S
Merzon
Konstantine
K
Prochorov
Vitali
V
Dickman
Dalia
D
Ben-Haim
Shlomo
S
Berman
Daniel S
DS
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation; D004176:Dipyridamole; D004867:Equipment Design; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation* / Q000379:methods; D010865:Pilot Projects; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation*
D019275:Radiopharmaceuticals; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi