title: Diagnostic performance of a novel cadmium-zinc-telluride gamma camera system assessed using fractional flow reserve.
abstract: BACKGROUND
  Although the novel cadmium-zinc-telluride (CZT) camera system provides excellent image quality, its diagnostic value using thallium-201 as assessed on coronary angiography (CAG) and fractional flow reserve (FFR) has not been validated. METHODS AND RESULTS: To evaluate the diagnostic accuracy of the CZT ultrafast camera system (Discovery NM 530c), 95 patients underwent stress thallium-201 single-photon emission computed tomography (SPECT) and then CAG within 3 months. Image acquisition was performed in the supine and prone positions after stress for 5 and 3 min, respectively, and in the supine position at rest for 10 min. Significant stenosis was defined as ≥90% diameter narrowing on visual estimation, or a lesion with <90% and ≥50% stenosis and FFR ≤0.75. To detect individual coronary stenosis, the respective sensitivity, specificity, and accuracy were 90%, 64%, and 78% for left anterior descending coronary artery stenosis, 78%, 84%, and 81% for left circumflex stenosis, and 83%, 47%, and 60% for right coronary artery (RCA) stenosis. The combination of prone and supine imaging had a higher specificity for RCA disease than supine imaging alone (65% vs. 47%), with an improvement in accuracy from 60% to 72%.
  
  
  CONCLUSIONS
  Using thallium-201 with short acquisition time, combined with prone imaging, CZT SPECT had a high diagnostic yield in detecting significant coronary stenosis as assessed using FFR.
authors.affiliation: Department of Cardiology, Tokyo Medical University Ibaraki Medical Center.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Taishiro
authors.initials: T
authors.lastname: Chikamori
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hida
authors.forename: Yuko
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Jun
authors.initials: J
authors.lastname: Yamashita
authors.forename: Masashi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Chie
authors.initials: C
authors.lastname: Shiba
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Usui
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D001783:Blood Flow Velocity; D002104:Cadmium; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods; D015032:Zinc
chemical_list: D002104:Cadmium; C026660:tellurous acid; D015032:Zinc; D013691:Tellurium