title: Diagnostic Performance of a Cadmium-Zinc-Telluride Single-Photon Emission Computed Tomography System With Low-Dose Technetium-99m as Assessed by Fractional Flow Reserve.
abstract: BACKGROUND
  Although stress single-photon emission computed tomography (SPECT) using a cadmium-zinc-telluride (CZT) camera facilitates radiation dose reduction, only a few studies have evaluated its diagnostic accuracy in Japanese patients by applying fractional flow reserve (FFR) measurements.
  
  
  RESULTS
  We prospectively evaluated 102 consecutive patients with suspected or known coronary artery disease with a low-dose stress/rest protocol ((99m)Tc radiotracer 185/370 MBq) using CZT SPECT. Within 3 months, coronary angiography was performed and a significant stenosis was defined as ≥90% diameter narrowing on visual estimation, or as a lesion of <90% and ≥ 50% stenosis with FFR ≤0.80. To detect individual coronary stenosis, the respective sensitivity, specificity, and accuracy were 86%, 75%, and 82% for left anterior descending artery stenosis, 76%, 81%, and 79% for left circumflex artery stenosis, and 87%, 92%, and 90% for right coronary artery stenosis. When limited to 92 intermediate stenotic lesions in which FFR was measured, stress SPECT showed 77% sensitivity, 91% specificity, and 84% accuracy, whereas the diagnostic value decreased to 52% sensitivity, 68% specificity, and 58% accuracy based only on visual estimation of ≥75% diameter narrowing.
  
  
  CONCLUSIONS
  CZT SPECT demonstrated a good diagnostic yield in detecting hemodynamically significant coronary stenoses as assessed by FFR, even when using a low-dose (99m)Tc protocol with an effective dose ≤5 mSv. (Circ J 2016; 80: 1217-1224).
authors.affiliation: Department of Cardiology, Tokyo Medical University.
authors.forename: Taishiro
authors.initials: T
authors.lastname: Chikamori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hida
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Jun
authors.initials: J
authors.lastname: Yamashita
authors.forename: Chie
authors.initials: C
authors.lastname: Shiba
authors.forename: Naotaka
authors.initials: N
authors.lastname: Murata
authors.forename: Kou
authors.initials: K
authors.lastname: Hoshino
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hokama
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D002104:Cadmium; D003324:Coronary Artery Disease / Q000175:diagnosis; D023921:Coronary Stenosis / Q000175:diagnosis*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D015032:Zinc
chemical_list: C474490:CdZnTe; D019275:Radiopharmaceuticals; D002104:Cadmium; D017256:Technetium Tc 99m Sestamibi; D015032:Zinc; D013691:Tellurium