Nuclear myocardial perfusion imaging with a cadmium-zinc-telluride detector technique: optimized protocol for scan time reduction.
We aimed at establishing the optimal scan time for nuclear myocardial perfusion imaging (MPI) on an ultrafast cardiac gamma-camera using a novel cadmium-zinc-telluride (CZT) solid-state detector technology.


METHODS
Twenty patients (17 male; BMI range, 21.7-35.5 kg/m(2)) underwent 1-d (99m)Tc-tetrofosmin adenosine stress and rest MPI protocols, each with a 15-min acquisition on a standard dual-detector SPECT camera. All scans were immediately repeated on an ultrafast CZT camera over a 6-min acquisition time and reconstructed from list-mode raw data to obtain scan durations of 1 min, 2 min, etc., up to a maximum of 6 min. For each of the scan durations, the segmental tracer uptake value (percentage of maximum myocardial uptake) from the CZT camera was compared by intraclass correlation with standard SPECT camera data using a 20-segment model, and clinical agreement was assessed per coronary territory. Scan durations above which no further relevant improvement in uptake correlation was found were defined as minimal required scan times, for which Bland-Altman limits of agreement were calculated.


RESULTS
Minimal required scan times were 3 min for low dose (r = 0.81; P < 0.001; Bland-Altman, -11.4% to 12.2%) and 2 min for high dose (r = 0.80; P < 0.001; Bland-Altman, -7.6% to 12.9%), yielding a clinical agreement of 95% and 97%, respectively.


CONCLUSIONS
We have established the minimal scan time for a CZT solid-state detector system, which allows 1-d stress/rest MPI with a substantially reduced acquisition time resulting in excellent agreement with regard to uptake and clinical findings, compared with MPI from a standard dual-head SPECT gamma-camera.
Herzog
Bernhard A
BA
Cardiac Imaging, University Hospital Zurich, CH-8091 Zurich, Switzerland.
Buechel
Ronny R
RR
Katz
Ruth
R
Brueckner
Michael
M
Husmann
Lars
L
Burger
Irene A
IA
Pazhenkottil
Aju P
AP
Valenta
Ines
I
Gaemperli
Oliver
O
Treyer
Valerie
V
Kaufmann
Philipp A
PA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003326:Coronary Circulation / Q000502:physiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D015902:Gamma Cameras; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010477:Perfusion; D019047:Phantoms, Imaging; D019275:Radiopharmaceuticals; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon; D015032:Zinc
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D002104:Cadmium; C078700:technetium tc-99m tetrofosmin; D015032:Zinc; D013691:Tellurium