title: High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results.
abstract: OBJECTIVE
  Appropriate use of SPECT imaging is regulated by evidence-based guidelines and appropriateness criteria in an effort to limit the burden of radiation administered to patients. We aimed at establishing whether the use of a low dose for stress-rest single-day nuclear myocardial perfusion imaging on an ultrafast (UF) cardiac gamma camera using cadmium-zinc-telluride solid-state detectors could be used routinely with the same accuracy obtained with standard doses and conventional cameras.
  
  
  METHODS
  To this purpose, 137 consecutive patients (mean age 61 ± 8 years) with known or suspected coronary artery disease (CAD) were enrolled. They underwent single-day low-dose stress-rest myocardial perfusion imaging using UF SPECT and invasive coronary angiography. Patients underwent the first scan with a 7-min acquisition time 10 min after the end of the stress protocol (dose range 185 to 222 MBq of (99m)Tc-tetrofosmin). The rest scan (dose range 370 to 444 MBq of (99m)Tc-tetrofosmin) was acquired with a 6-min acquisition time. The mean summed stress scores (SSS) and mean summed rest scores (SRS) were obtained semiquantitatively.
  
  
  RESULTS
  Coronary angiograms showed significant epicardial CAD in 83% of patients. Mean SSS and SRS were 10 ± 5 and 3 ± 3, respectively. Overall the area under the ROC curve for the SSS values was 0.904, while the areas under the ROC curves for each vascular territory were 0.982 for the left anterior descending artery, 0.931 for the left circumflex artery and 0.889 for the right coronary artery.
  
  
  CONCLUSIONS
  This pilot study demonstrated the feasibility of a low-dose single-day stress-rest fasting protocol performed using UF SPECT, with good sensitivity and specificity in detecting CAD at low patient exposure, opening new perspectives in the use of myocardial perfusion in ischaemic patients.
authors: Fondazione Toscana Gabriele Monasterio, CNR, Pisa, Italy. gimelli@ifc.cnr.it
authors: Alessia
authors: A
authors: Gimelli
authors: Matteo
authors: M
authors: Bottai
authors: Dario
authors: D
authors: Genovesi
authors: Assuero
authors: A
authors: Giorgetti
authors: Fabio
authors: F
authors: Di Martino
authors: Paolo
authors: P
authors: Marzullo
mesh_terms: D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010865:Pilot Projects; D011829:Radiation Dosage; D011874:Radiometry; D012680:Sensitivity and Specificity; D013312:Stress, Physiological; D013997:Time Factors