title: Left ventricular function assessment using123I/99mTc dual-isotope acquisition with two semi-conductor cadmium-zinc-telluride (CZT) cameras: a gated cardiac phantom study.
abstract: BACKGROUND
  The impact of increased energy resolution of cadmium-zinc-telluride (CZT) cameras on the assessment of left ventricular function under dual-isotope conditions (99mTc and123I) remains unknown. The Amsterdam-gated dynamic cardiac phantom (AGATE, Vanderwilt techniques, Boxtel, The Netherlands) was successively filled with a solution of123I alone,99mTc alone, and a mixture of123I and99mTc. A total of 12 datasets was acquired with each commercially available CZT camera (DNM 530c, GE Healthcare and DSPECT, Biosensors International) using both energy windows (99mTc or123I) with ejection fraction set to 33, 45, and 60 %. End-diastolic (EDV) and end-systolic (ESV) volumes, ejection fraction (LVEF), and regional wall motion and thickening (17-segment model) were assessed using Cedars-Sinai QGS Software. Concordance between single- and dual-isotope acquisitions was tested using Lin's concordance correlation coefficient (CCC) and Bland-Altman plots.
  
  
  RESULTS
  There was no significant difference between single- or simultaneous dual-isotope acquisition (123I and99mTc) for EDV, ESV, LVEF, or segmental wall motion and thickening. Myocardial volumes using single- (123I,99mTc) and dual-isotope (reconstructed using both123I and99mTc energy windows) acquisitions were, respectively, the following: EDV (mL) 88 ± 27 vs. 89 ± 27 vs. 92 ± 29 vs. 90 ± 26 for DNM 530c (p = NS) and 82 ± 20 vs. 83 ± 22 vs. 79 ± 19 vs. 77 ± 20 for DSPECT (p = NS); ESV (mL) 40 ± 1 vs. 41 ± 2 vs. 41 ± 2 vs. 42 ± 1 for DNM 530c (p = NS) and 37 ± 5 vs. 37 ± 1 vs. 35 ± 3 vs. 34 ± 2 for DSPECT (p = NS); LVEF (%) 52 ± 14 vs. 51 ± 13 vs. 53 ± 13 vs. 51 ± 13 for DNM 530c (p = NS) and 52 ± 16 vs. 54 ± 13 vs. 54 ± 14 vs. 54 ± 13 for DSPECT (p = NS); regional motion (mm) 6.72 ± 2.82 vs. 6.58 ± 2.52 vs. 6.86 ± 2.99 vs. 6.59 ± 2.76 for DNM 530c (p = NS) and 6.79 ± 3.17 vs. 6.81 ± 2.75 vs. 6.71 ± 2.50 vs. 6.62 ± 2.74 for DSPECT (p = NS). The type of camera significantly impacted only on ESV (p < 0.001).
  
  
  CONCLUSIONS
  The new CZT cameras yielded similar results for the assessment of LVEF and regional motion using different energy windows (123I or99mTc) and acquisition types (single vs. dual). With simultaneous dual-isotope acquisitions, the presence of123I did not impact on LVEF assessment within the99mTc energy window for either CZT camera.
authors.affiliation: Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France. ta.blaire@gmail.com.|Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France. ta.blaire@gmail.com.|Nuclear Medicine, IRIS, Hôpital Privé Le Bois, 144 avenue de Dunkerque, 59000, Lille, France. ta.blaire@gmail.com.
authors.forename: Tanguy
authors.initials: T
authors.lastname: Blaire
authors.affiliation: Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France.|Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France.|Nuclear Medicine, IRIS, Hôpital Privé Le Bois, 144 avenue de Dunkerque, 59000, Lille, France.
authors.forename: Alban
authors.initials: A
authors.lastname: Bailliez
authors.affiliation: Nuclear Medicine, CHU Cote de Nacre, Caen, France.
authors.forename: Fayçal Ben
authors.initials: FB
authors.lastname: Bouallegue
authors.affiliation: Nuclear Medicine, CHU Cote de Nacre, Caen, France.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Bellevre
authors.affiliation: Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France.|Nuclear Medicine, CHU Cote de Nacre, Caen, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Agostini
authors.affiliation: Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France.|Nuclear Medicine, CHU Cote de Nacre, Caen, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Manrique
keywords: CZT; DNM 530c; DSPECT; Dual-isotope acquisition; Dynamic phantom; Myocardial innervation imaging; Myocardial perfusion imaging; SPECT; mIBG