title: Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols.
abstract: OBJECTIVE
  The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity.
  
  
  METHODS
  The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving (201)Tl (n = 120) or (99m)Tc-sestamibi injected at low dose at stress ((99m)Tc-Low; stress/rest 1-day protocol; n = 110) or at high dose at stress ((99m)Tc-High; rest/stress 1-day or 2-day protocol; n = 46). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min).
  
  
  RESULTS
  Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, (201)Tl 92 %, (99m)Tc-Low 86 %, (99m)Tc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r = 0.80) and a little lower for ischaemic areas (r = 0.72), the latter being larger on Anger SPECT (p < 0.001). This larger extent was mainly observed in 50 obese patients who were in the (201)Tl or (99m)Tc-Low group and in whom stress myocardial counts were particularly low with Anger SPECT (228 ± 101 kcounts) and dramatically enhanced with CZT SPECT (+279 ± 251 %).
  
  
  CONCLUSIONS
  Concordance between the results of CZT and Anger SPECT is good regardless of study protocol and especially when excluding obese patients who have low-count Anger SPECT and for whom myocardial counts are dramatically enhanced on CZT SPECT.
authors.affiliation: Department of Nuclear Medicine, CHU-Nancy, Nancy, 54000, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Verger
authors.forename: Wassila
authors.initials: W
authors.lastname: Djaballah
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fourquet
authors.forename: François
authors.initials: F
authors.lastname: Rouzet
authors.forename: Grégoire
authors.initials: G
authors.lastname: Koehl
authors.forename: Laetitia
authors.initials: L
authors.lastname: Imbert
authors.forename: Sylvain
authors.initials: S
authors.lastname: Poussier
authors.forename: Renaud
authors.initials: R
authors.lastname: Fay
authors.forename: Véronique
authors.initials: V
authors.lastname: Roch
authors.forename: Dominique
authors.initials: D
authors.lastname: Le Guludec
authors.forename: Gilles
authors.initials: G
authors.lastname: Karcher
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
mesh_terms: D016477:Artifacts; D002104:Cadmium; 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*; D009765:Obesity / Q000000981:diagnostic imaging / Q000503:physiopathology; D013312:Stress, Physiological; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation*; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium