Comparison of image quality, myocardial perfusion, and left ventricular function between standard imaging and single-injection ultra-low-dose imaging using a high-efficiency SPECT camera: the MILLISIEVERT study.
Publication/Presentation Date
9-1-2014
Abstract
UNLABELLED: SPECT myocardial perfusion imaging plays a central role in coronary artery disease diagnosis, but concerns exist regarding its radiation burden. Compared with standard Anger SPECT (A-SPECT) cameras, new high-efficiency (HE) cameras with specialized collimators and solid-state cadmium-zinc-telluride detectors offer potential to maintain image quality (IQ), while reducing administered activity and thus radiation dose to patients. No previous study has compared IQ, interpretation, total perfusion deficit (TPD), or ejection fraction (EF) in patients receiving both ultra-low-dose (ULD) imaging on an HE SPECT camera and standard low-dose (SLD) A-SPECT imaging.
METHODS: We compared ULD HE SPECT with SLD A-SPECT imaging by dividing the rest dose in 101 patients at 3 sites scheduled to undergo clinical A-SPECT myocardial perfusion imaging using a same day rest-stress (99m)Tc protocol. Patients underwent HE SPECT imaging after an initial approximately 130-MBq (3.5 mCi) dose and SLD-A-SPECT imaging after the remainder of the planned dose. Images were scored visually by 2 masked readers for IQ and summed rest score. TPD and EF were assessed quantitatively.
RESULTS: Mean activity was 134 MBq (3.62 mCi) for ULD HE SPECT (effective dose, 1.15 mSv) and 278 MBq (7.50 mCi, 2.39 mSv) for SLD A-SPECT. Overall IQ was superior for ULD HE SPECT (P < 0.0001), with twice as many studies graded excellent quality. Extracardiac activity and overall perfusion assessment were similar. Between-method correlations were high for summed rest score (r = 0.87), TPD (r = 0.91), and EF (r = 0.88).
CONCLUSION: ULD HE SPECT rest imaging correlates highly with SLD A-SPECT. It has improved image quality, comparable extracardiac activity, and achieves radiation dose reduction to 1 mSv for a single injection.
Volume
55
Issue
9
First Page
1430
Last Page
1437
ISSN
1535-5667
Published In/Presented At
Einstein, Andrew J et al. “Comparison of image quality, myocardial perfusion, and left ventricular function between standard imaging and single-injection ultra-low-dose imaging using a high-efficiency SPECT camera: the MILLISIEVERT study.” Journal of nuclear medicine : official publication, Society of Nuclear Medicine vol. 55,9 (2014): 1430-7. doi:10.2967/jnumed.114.138222
Disciplines
Medicine and Health Sciences
PubMedID
24982439
Department(s)
Department of Medicine
Document Type
Article