title: Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: a review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM).
abstract: The trade-off between resolution and count sensitivity dominates the performance of standard gamma cameras and dictates the need for relatively high doses of radioactivity of the used radiopharmaceuticals in order to limit image acquisition duration. The introduction of cadmium-zinc-telluride (CZT)-based cameras may overcome some of the limitations against conventional gamma cameras. CZT cameras used for the evaluation of myocardial perfusion have been shown to have a higher count sensitivity compared to conventional single photon emission computed tomography (SPECT) techniques. CZT image quality is further improved by the development of a dedicated three-dimensional iterative reconstruction algorithm, based on maximum likelihood expectation maximization (MLEM), which corrects for the loss in spatial resolution due to line response function of the collimator. All these innovations significantly reduce imaging time and result in a lower patient's radiation exposure compared with standard SPECT. To guide current and possible future users of the CZT technique for myocardial perfusion imaging, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, has decided to examine the current literature regarding procedures and clinical data on CZT cameras. The committee hereby aims 1) to identify the main acquisitions protocols; 2) to evaluate the diagnostic and prognostic value of CZT derived myocardial perfusion, and finally 3) to determine the impact of CZT on radiation exposure.
authors.affiliation: Department of Nuclear Medicine, CHU Caen and Normandy University, EA 4650, Caen, France. agostini-de@chu-caen.fr.|Normandy University, EA 4650, Caen, France. agostini-de@chu-caen.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Agostini
authors.affiliation: Nancyclotep Experimental Imaging Platform, University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France.|CHU Nancy, Department of Nuclear Medicine, University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France.|University of Lorraine, Faculty of Medicine, INSERM, U1116, Nancy, F-54000, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marie
authors.affiliation: Institute of Nuclear Medicine, University College London, University College Hospital, London, UK.|Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Simona
authors.initials: S
authors.lastname: Ben-Haim
authors.affiliation: Department of Nuclear Medicine, University Hospital of Paris-Bichat, UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France.|UMR 1148, Inserm and Paris Diderot-Paris 7 University Paris, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Rouzet
authors.affiliation: Centre Cardiologique du Nord, Saint-Denis, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Songy
authors.affiliation: Department of Bioimages and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of Sacred Heart, Largo A. Gemelli, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
authors.affiliation: Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Gimelli
authors.affiliation: Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique - Hôpitaux de Paris, UMR 1148, Inserm and Paris Diderot-Paris 7 University, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Hyafil
authors.affiliation: Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sciagrà
authors.affiliation: Department of Nuclear Medicine, Maastricht University Medical Center, Maastricht University Medical Center, Maastricht, The Netherlands.|Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.|Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Bucerius
authors.affiliation: Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands.|Faculty of Science and Technology, Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands.
authors.forename: Riemer H J A
authors.initials: RH
authors.lastname: Slart
authors.affiliation: Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Lindner
authors.forename: Christopher
authors.initials: C
authors.lastname: Übleis
authors.forename: Marcus
authors.initials: M
authors.lastname: Hacker
mesh_terms: D019187:Cadmium Compounds / Q000528:radiation effects; D057791:Cardiac Imaging Techniques / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005060:Europe; D019317:Evidence-Based Medicine; D005720:Gamma Rays; D006801:Humans; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis* / Q000517:prevention & control*; D011877:Radionuclide Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013691:Tellurium / Q000528:radiation effects; D015032:Zinc / Q000528:radiation effects
chemical_list: D019187:Cadmium Compounds; D015032:Zinc; D013691:Tellurium; C028337:cadmium telluride
keywords: CZT camera; Coronary artery disease; Diagnosis; Perfusion; Prognosis