Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various s
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ORIGINAL ARTICLE
Comparison between stress myocardial perfusion SPECT recorded with cadmium-zinc-telluride and Anger cameras in various study protocols Antoine Verger & Wassila Djaballah & Nicolas Fourquet & François Rouzet & Grégoire Koehl & Laetitia Imbert & Sylvain Poussier & Renaud Fay & Véronique Roch & Dominique Le Guludec & Gilles Karcher & Pierre-Yves Marie
Received: 29 May 2012 / Accepted: 6 November 2012 / Published online: 27 November 2012 # Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose The results of stress myocardial perfusion SPECT could be enhanced by new cadmium-zinc-telluride (CZT) cameras, although differences compared to the results with conventional Anger cameras remain poorly known for most study protocols. This study was aimed at comparing the results of CZT and Anger SPECT according to various study protocols while taking into account the influence of obesity. Methods The study population, which was from three different institutions equipped with identical CZT cameras, comprised 276 patients referred for study using protocols involving 201Tl (n0120) or 99mTc-sestamibi injected at low dose at stress (99mTc-Low; stress/rest 1-day protocol; n0110)
or at high dose at stress (99mTc-High; rest/stress 1-day or 2-day protocol; n046). Each Anger SPECT scan was followed by a high-speed CZT SPECT scan (2 to 4 min). Results Agreement rates between CZT and Anger SPECT were good irrespective of the study protocol (for abnormal SPECT, 201Tl 92 %, 99mTc-Low 86 %, 99mTc-High 98 %), although quality scores were much higher for CZT SPECT with all study protocols. Overall correlations were high for the extent of myocardial infarction (r00.80) and a little lower for ischaemic areas (r00.72), the latter being larger on Anger SPECT (p30 kg m−2), 55 % had a previous history of coronary artery disease (myocardial infarction 26 %), 59 % had taken antianginal medications in the preceding 24 h and 37 % had an abnormal Anger SPECT.
Eur J Nucl Med Mol Imaging (2013) 40:331–340
Study protocols included 201Tl in 120 patients, 99mTcLow in 110 patients and a 99mTc-High in 46 patients. As detailed in Table 2, significant differences were found between patients studied using these three protocols, mainly because a smaller proportion of the 99mTcHigh group had a history of coronary artery disease and thereby antianginal medications and abnormal SPECT. In addition, most SPECT scans were acquired in the prone position, especially in 99mTc-Low and 99mTc-High groups (Table 1). Image quality and myocardial counts As shown in Table 3, there were differences in quality scores and myocardial counts among the three study protocols with both Anger and CZT SPECT. The lower quality scores were always found in the 201Tl group, while the lower myocardial counts were found in the 99mTc-Low group at stress and in the 201Tl group at rest. Furthermore, there were marked enhancements between Anger and CZT SPECT for both myocardial counts and quality scores. The enhancement in myocardial counts ranged from +72 % to +273 % according to
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