The magic of improved crystal technology coupled with better resolution: Novel imaging findings may promise improved dis
- PDF / 165,970 Bytes
- 3 Pages / 593.972 x 792 pts Page_size
- 70 Downloads / 140 Views
New England Heart and Vascular Institute, Manchester Division of Cardiology, Department of Medicine, National Jewish Health, Denver
Received Sep 9, 2020; accepted Sep 9, 2020 doi:10.1007/s12350-020-02380-1
See related article, https://doi.org/10.10 07/s12350-020-02333-8.
Myocardial perfusion imaging (MPI) with singlephoton emission tomography (SPECT) is widely performed for the diagnosis and management of patients with suspected or known coronary artery disease (CAD).1,2 Non-invasive assessment with MPI not only has an excellent diagnostic and prognostic accuracy but also provides good insight into the cardiac function. Over the past few years, there has been significant advances made in terms of SPECT equipment, with newer scanners dedicated to cardiac imaging utilizing solid-state crystals and novel collimator designs.1 Newer cardiac-dedicated camera designs vary in whether Sodium Iodide (NaI), Cesium Idodie (CSI) or Cadmium Zinc Telluride (CZT) solid-state detectors are used and also the number and type of scanning or stationary detectors. 2 With the CZT camera there is simultaneous improvement in image resolution (up to two times higher) due to improved energy resolution of the solidstate crystals, the sensitivity being more than five times higher due to the collimator, and improved spatial resolution in comparison to the conventional SPECT cameras.3 These innovations have facilitated significant improvement in image quality with reductions in
Reprint requests: Andrew M. Freeman, MD, FACC, Division of Cardiology, Department of Medicine, National Jewish Health, Denver; [email protected] J Nucl Cardiol 1071-3581/$34.00 Copyright Ó 2020 American Society of Nuclear Cardiology.
imaging time as well as radiation dose while maintaining high levels of diagnostic accuracy.4 The D.SPECT camera (Spectrum Dynamics, Caesarea, Israel) involves the use of nine rotating columns associated with a wide-angle square hole collimator made of Tungsten with CZT crystals aligned behind each collimator and the columns are arranged in a curved configuration to conform to the shape of the left side of the subject’s chest.5 This collimator has greater than 10 times the count sensitivity and a high level of spatial resolution that can be reached owing to a specific reconstruction method.5 Better delineation of the myocardial walls due to higher spatial resolution and more focused imaging of the heart with the reduction of attenuation artifacts due to rotational parallel-hole collimation have led to studies showing that the MPI acquired with newer cardiac dedicated cameras with CZT have a diagnostic accuracy significantly higher than that obtained with standard SPECT.1,4,6 Despite the advances in SPECT MPI, there are certain limitations irrespective of the technology. An underestimation of the assessment of high-risk anatomic CAD, especially due to balanced ischemia, has been well described with SPECT MPI.7 The careful assessment of other variables derived with SPECT MPI including transient ischemic dilation (TID), drop in ejection
Data Loading...
