title: Rapid-acquisition myocardial perfusion scintigraphy (MPS) on a novel gamma camera using multipinhole collimation and miniaturized cadmium-zinc-telluride (CZT) detectors: prognostic value and diagnostic accuracy in a 'real-world' nuclear cardiology service.
abstract: OBJECTIVE
  To study the prognostic value of rapid-acquisition adenosine stress-rest myocardial perfusion scintigraphy (MPS) on a gamma camera using multipinhole collimation and cadmium-zinc-telluride (CZT) detectors. The secondary aim was to assess the diagnostic accuracy of the technique compared with invasive coronary angiography.
  
  
  RESULTS
  Retrospective analysis of 1109 consecutive patients undergoing MPS in a routine clinical setting on a high-efficiency multipinhole gamma camera. MPS acquisition, performed with a standard injection of 550 MBq of (99m)Tc-tetrofosmin, required a mean (±SD) scanning time of 322 ± 51 s. The hard cardiac event rate at a median (inter-quartile range) follow-up of 624 (552-699) days was 0.4% (95% CI 0.1-1.1) in patients with no significant perfusion abnormality versus 6.8% (95% CI 4.3-10.7%, P < 0.001) in those with an abnormal scan. In a sub-group of 165 patients, comparison with obstructive coronary artery disease on X-ray angiography gave a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for rapid-acquisition MPS of 84% (95% CI 74-91), 79% (95% CI 68-87), 82% (95% CI 72-89), 81% (95% CI 70-89), and 82% (95% CI 73-89), respectively.
  
  
  CONCLUSIONS
  MPS performed on a CZT solid-state detector camera with multipinhole collimation is an evolutionary development that provides reliable prognostic and diagnostic information, while significantly reducing image acquisition time.
authors: Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: F U
authors: FU
authors: Chowdhury
authors: S
authors: S
authors: Vaidyanathan
authors: M
authors: M
authors: Bould
authors: J
authors: J
authors: Marsh
authors: C
authors: C
authors: Trickett
authors: K
authors: K
authors: Dodds
authors: T P R
authors: TP
authors: Clark
authors: R J
authors: RJ
authors: Sapsford
authors: C J
authors: CJ
authors: Dickinson
authors: C N
authors: CN
authors: Patel
authors: P J
authors: PJ
authors: Thorley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002104:Cadmium; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000295:instrumentation / Q000379:methods*; D002309:Cardiology / Q000379:methods; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation* / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013691:Tellurium; D055815:Young Adult; D015032:Zinc
chemical_list: C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium
keywords: cadmium–zinc–telluride; coronary artery disease; high efficiency; multipinhole collimation; myocardial perfusion scintigraphy