title: Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera.
abstract: OBJECTIVE
  We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions.
  
  
  METHODS
  Of 27 consecutive patients recruited, 24 (64.5+/-11.8 years of age, 16 men) were injected with 74 MBq of (201)Tl (rest) and 250 MBq (99m)Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest (201)Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress (99m)Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest (201)Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high).
  
  
  RESULTS
  Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest (201)Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, p<0.0001 for all). In six patients stress perfusion defects were significantly larger on stress DR D-SPECT images, and five of these patients were imaged earlier by D-SPECT than by conventional SPECT.
  
  
  CONCLUSIONS
  Fast and high-quality simultaneous DR MPI is feasible with D-SPECT in a single imaging session with comparable diagnostic performance and image quality to conventional SPECT and to a separate rest (201)Tl D-SPECT acquisition.
authors.affiliation: Institute of Nuclear Medicine, University College London Hospitals NHS Trust, London, UK. simona.ben-haim@uclh.nhs.uk
authors.forename: Simona
authors.initials: S
authors.lastname: Ben-Haim
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kacperski
authors.forename: Sharon
authors.initials: S
authors.lastname: Hain
authors.forename: Dean
authors.initials: D
authors.lastname: Van Gramberg
authors.forename: Brian F
authors.initials: BF
authors.lastname: Hutton
authors.forename: Kjell
authors.initials: K
authors.lastname: Erlandsson
authors.forename: Tali
authors.initials: T
authors.lastname: Sharir
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Roth
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Waddington
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ell
mesh_terms: D000328:Adult; D000368:Aged; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D015902:Gamma Cameras; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation*; D012146:Rest; D013312:Stress, Physiological; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
references.citation: J Nucl Med. 1994 Apr;35(4):664-71
references.pmid: 8151391
references.citation: J Am Coll Cardiol. 1993 Nov 1;22(5):1455-64
references.pmid: 8227805
references.citation: J Nucl Cardiol. 2009 Mar-Apr;16(2):255-76
references.pmid: 19242769
references.citation: Nucl Med Commun. 1998 Feb;19(2):119-26
references.pmid: 9548195
references.citation: JACC Cardiovasc Imaging. 2009 Mar;2(3):273-82
references.pmid: 19356571
references.citation: Phys Med Biol. 2009 May 7;54(9):2635-49
references.pmid: 19351981
references.citation: J Nucl Med. 1995 Nov;36(11):2009-15
references.pmid: 7472590
references.citation: J Nucl Med. 2009 Apr;50(4):635-43
references.pmid: 19339672
references.citation: Eur J Nucl Med Mol Imaging. 2003 Jan;30(1):25-31
references.pmid: 12483406
references.citation: JACC Cardiovasc Imaging. 2008 Mar;1(2):156-63
references.pmid: 19356422
references.citation: J Nucl Med. 1989 Oct;30(10):1718-22
references.pmid: 2795212
references.citation: J Nucl Cardiol. 2007 Jul;14(4):501-13
references.pmid: 17679058
references.citation: J Nucl Med. 2008 Jul;49(7):1080-9
references.pmid: 18552149
references.citation: J Nucl Med. 1994 Apr;35(4):542-8
references.pmid: 8151372
references.citation: J Nucl Cardiol. 1997 Jul-Aug;4(4):298-301
references.pmid: 9278876
references.citation: IEEE Trans Med Imaging. 1994;13(4):601-9
references.pmid: 18218538
references.citation: J Nucl Med. 2007 Oct;48(10):1670-5
references.pmid: 17873126