title: Impact of a new ultrafast CZT SPECT camera for myocardial perfusion imaging: fewer equivocal results and lower radiation dose.
abstract: OBJECTIVE
  The new ultrafast cardiac single photon emission computed tomography (SPECT) cameras with cadmium-zinc-telluride (CZT)-based detectors are faster and produce higher quality images as compared to conventional SPECT cameras. We assessed the need for additional imaging, total imaging time, tracer dose and 1-year outcome between patients scanned with the CZT camera and a conventional SPECT camera.
  
  
  METHODS
  A total of 456 consecutive stable patients without known coronary artery disease underwent myocardial perfusion imaging on a hybrid SPECT/CT (64-slice) scanner using either conventional (n = 225) or CZT SPECT (n = 231). All patients started with low-dose stress imaging, combined with coronary calcium scoring. Rest imaging was only done when initial stress SPECT testing was equivocal or abnormal. Coronary CT angiography was subsequently performed in cases of ischaemic or equivocal SPECT findings. Furthermore, 1-year clinical follow-up was obtained with regard to coronary revascularization, nonfatal myocardial infarction or death.
  
  
  RESULTS
  Baseline characteristics were comparable between the two groups. With the CZT camera, the need for rest imaging (35 vs 56%, p < 0.001) and additional coronary CT angiography (20 vs 28%, p = 0.025) was significantly lower as compared with the conventional camera. This resulted in a lower mean total administered isotope dose per patient (658 ± 390 vs 840 ± 421 MBq, p < 0.001) and shorter imaging time (6.39 ± 1.91 vs 20.40 ± 7.46 min, p < 0.001) with the CZT camera. After 1 year, clinical outcome was comparable between the two groups.
  
  
  CONCLUSIONS
  As compared to images on a conventional SPECT camera, stress myocardial perfusion images acquired on a CZT camera are more frequently interpreted as normal with identical clinical outcome after 1-year follow-up. This lowers the need for additional testing, results in lower mean radiation dose and shortens imaging time.
authors.affiliation: Department of Cardiology, Isala Klinieken, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mouden
authors.forename: Jorik R
authors.initials: JR
authors.lastname: Timmer
authors.forename: Jan Paul
authors.initials: JP
authors.lastname: Ottervanger
authors.forename: Stoffer
authors.initials: S
authors.lastname: Reiffers
authors.forename: Ad H J
authors.initials: AH
authors.lastname: Oostdijk
authors.forename: Siert
authors.initials: S
authors.lastname: Knollema
authors.forename: Pieter L
authors.initials: PL
authors.lastname: Jager
mesh_terms: D002104:Cadmium; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation / Q000379:methods*; D011379:Prognosis; D011829:Radiation Dosage; D012189:Retrospective Studies; D013312:Stress, Physiological; D013691:Tellurium; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods*; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium