Ultrafast nuclear myocardial perfusion imaging on a new gamma camera with semiconductor detector technique: first clinical validation.
OBJECTIVE
To assess the diagnostic performance of a novel ultrafast cardiac gamma camera with cadmium-zinc-telluride (CZT) solid-state semiconductor detectors for nuclear myocardial perfusion imaging (MPI).


METHODS
The study group comprised 75 consecutive patients (55 men, BMI range 19-45 kg/m(2)) who underwent a 1-day (99m)Tc-tetrofosmin adenosine-stress/rest imaging protocol. Scanning was performed first on a conventional dual-detector SPECT gamma camera (Ventri, GE Healthcare) with a 15-min acquisition time each for stress and rest. All scans were immediately repeated on an ultrafast CZT camera (Discovery 530 NMc, GE Healthcare) with a 3-min scan time for stress and a 2-min scan time for rest. Clinical agreement (normal, ischaemia, scar) between CZT and SPECT was assessed for each patient and for each coronary territory using SPECT MPI as the reference standard. Segmental myocardial tracer uptake values (percent of maximum) using a 20-segment model and left ventricular ejection fraction (EF) values obtained using CZT were compared with those obtained using conventional SPECT by intraclass correlation and by calculating Bland-Altman limits of agreement.


RESULTS
There was excellent clinical agreement between CZT and conventional SPECT on a per-patient basis (96.0%) and on a per-vessel territory basis (96.4%) as shown by a highly significant correlation between segmental tracer uptake values (r=0.901, p<0.001). Similarly, EF values for both scanners were highly correlated (r=0.976, p<0.001) with narrow Bland-Altman limits of agreement (-5.5-10.6%).


CONCLUSIONS
The novel CZT camera allows a more than fivefold reduction in scan time and provides clinical information equivalent to conventional standard SPECT MPI.
Buechel
Ronny R
RR
Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, CH-8091 Zurich, Switzerland.
Herzog
Bernhard A
BA
Husmann
Lars
L
Burger
Irene A
IA
Pazhenkottil
Aju P
AP
Treyer
Valerie
V
Valenta
Ines
I
von Schulthess
Patrick
P
Nkoulou
René
R
Wyss
Christophe A
CA
Kaufmann
Philipp A
PA
D000241:Adenosine; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium; D004867:Equipment Design; D005080:Exercise Test; D005260:Female; D015902:Gamma Cameras; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation* / Q000379:methods; D015588:Observer Variation; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012666:Semiconductors; D016037:Single-Blind Method; D013691:Tellurium; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation*; D015032:Zinc
C474490:CdZnTe; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D002104:Cadmium; C078700:technetium tc-99m tetrofosmin; D015032:Zinc; D000241:Adenosine; D013691:Tellurium