title: Optimization of a simultaneous dual-isotope201Tl/123I-MIBG myocardial SPECT imaging protocol with a CZT camera for trigger zone assessment after myocardial infarction for routine clinical settings: Are delayed acquisition and scatter correction necessary?
abstract: Dual-isotope201Tl/123I-MIBG SPECT can assess trigger zones (dysfunctions in the autonomic nervous system located in areas of viable myocardium) that are substrate for ventricular arrhythmias after STEMI. This study evaluated the necessity of delayed acquisition and scatter correction for dual-isotope201Tl/123I-MIBG SPECT studies with a CZT camera to identify trigger zones after revascularization in patients with STEMI in routine clinical settings.
  
  
  
  Sixty-nine patients were prospectively enrolled after revascularization to undergo201Tl/123I-MIBG SPECT using a CZT camera (Discovery NM 530c, GE). The first acquisition was a single thallium study (before MIBG administration); the second and the third were early and late dual-isotope studies. We compared the scatter-uncorrected and scatter-corrected (TEW method) thallium studies with the results of magnetic resonance imaging or transthoracic echography (reference standard) to diagnose myocardial necrosis.
  
  
  
  Summed rest scores (SRS) were significantly higher in the delayed MIBG studies than the early MIBG studies. SRS and necrosis surface were significantly higher in the delayed thallium studies with scatter correction than without scatter correction, leading to less trigger zone diagnosis for the scatter-corrected studies. Compared with the scatter-uncorrected studies, the late thallium scatter-corrected studies provided the best diagnostic values for myocardial necrosis assessment.
  
  
  
  Delayed acquisitions and scatter-corrected dual-isotope201Tl/123I-MIBG SPECT acquisitions provide an improved evaluation of trigger zones in routine clinical settings after revascularization for STEMI.
authors.affiliation: Nuclear Medicine Department, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France. emmanuel.destanque@gmail.com.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: D'estanque
authors.affiliation: Cardiology Department, Montpellier University Hospital, Montpellier, France.|U1046 INSERM, UMR9214 CNRS, Montpellier University Hospital, Montpellier, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hedon
authors.affiliation: Cardiology Department, Montpellier University Hospital, Montpellier, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Lattuca
authors.affiliation: Nuclear Medicine Department, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bourdon
authors.affiliation: Nuclear Medicine Department, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Meriem
authors.initials: M
authors.lastname: Benkiran
authors.affiliation: Nuclear Medicine Department, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Verd
authors.affiliation: Cardiology Department, Montpellier University Hospital, Montpellier, France.|U1046 INSERM, UMR9214 CNRS, Montpellier University Hospital, Montpellier, France.
authors.forename: François
authors.initials: F
authors.lastname: Roubille
authors.affiliation: Nuclear Medicine Department, Montpellier University Hospital, 371, Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.|U1046 INSERM, UMR9214 CNRS, Montpellier University Hospital, Montpellier, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Mariano-Goulart
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D002104:Cadmium; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012542:Scattering, Radiation; D013691:Tellurium; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D015032:Zinc
chemical_list: C474490:CdZnTe; D007457:Iodine Radioisotopes; D013794:Thallium Radioisotopes; D002104:Cadmium; D019797:3-Iodobenzylguanidine; C000615114:Thallium-201; D015032:Zinc; D013691:Tellurium
keywords: MIBG; Trigger zone; cardiac SPECT; myocardial infarction; scatter correction