Tetrofosmin early time gated post-stress single-photon emission computed tomography imaging: feasibility and potential benefits.
BACKGROUND
The purpose of this study is to evaluate the feasibility, the image quality, and the clinical relevance of an early gated post-stress (GPS) single-photon emission computed tomography (SPECT) tetrofosmin (Myoview™-GE Healthcare) acquisition protocol. Time delay between myocardial technetium-labeled tracer administration and SPECT acquisition is usually about 30 minutes after stress, and 45 to 60 minutes at rest: because of the absence of significant redistribution, perfusion images are related to stress even 30 minutes after stress injection, while function and thickening data obtained with gated acquisition 30 minutes after stress are mainly related to rest conditions.


METHODS
194 patients were prospectively included and analyzed, in a multicenter registry. Three gated-SPECT 99(m)Tc-Tetrofosmin studies were performed per patient: GPS-SPECT, 30 minutes post-stress (GS30), and at rest (GR30).


RESULTS
GPS image quality was excellent/good (93.9%), and similar to GS30 images (96.6%). The presence of adjacent myocardial sub-diaphragmatic activity on GPS images was similar to GS30 images (24% vs 22%), and less frequent than on GR30 images (31%). For perfusion, thickening, and motion scores, there was no significant difference between early and 30 minute post-stress in the global patient population, but significant differences were observed between GPS and GS30 for LVEF (65% ± 15% vs 63% ± 14%). In the ischemic patients, with the stress-rest protocol, the perfusion score was 14.2 on GPS images and 12.4 on GS30 images (P = .002).


CONCLUSIONS
Tetrofosmin early GPS-SPECT is feasible without impairment of image quality (better count rate). Ischemic defect size on early post-stress images is slightly more pronounced than at 30 minutes: this could modify therapeutic decision. This technique produces reliable function information during early post-stress period, and might be useful for disclosing transient motion abnormalities.
Vinci Nuclear Medicine Center, Chambray-les-Tours, France. lphilippe@mednuc-tours.fr
Laurent
L
Philippe
Bertrand
B
Mérino
Tanguy
T
Blaire
Alban
A
Bailliez
Danielle
D
Casset-Senon
Maurice
M
Levy
Arnaud
A
Halley
Guillaume
G
Divry
D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D005080:Exercise Test / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin