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Estimation of Myocardial Perfusion and Viability Using Simultaneous ^99mTc-Tetrofosmin-FDG Collimated SPECT

Department of Radiology, National Cardiovascular Center, Suita, Osaka, Japan

Correspondence: For correspondence or reprints contact: Yoshio Ishida, MD, PhD, Department of Radiology, National Cardiovascular Center, Fujishiro-dai 5-7-1, Suita, Osaka 565-8565 Japan.

ABSTRACT

This study was designed to elucidate the usefulness of crosstalk correction for dual-isotope simultaneous acquisition (DISA) with ^99mTc-tetrofosmin and FDG in estimating myocardial perfusion and viability. Methods: Eighteen patients with coronary artery disease were studied. First, SPECT was performed with a low-energy high-resolution collimator after a single injection of ^99mTc-tetrofosmin (single ^99mTc-tetrofosmin). Second, PET and DISA with an ultra-high-energy collimator were performed after glucose loading and an injection of FDG. DISA was designed to operate with simultaneous 3-channel acquisition, and weighted scatter correction of crosstalk from the ¹⁸F photopeak to the ^99mTc photopeak was performed by modification of an existing dual-window technique. The FDG SPECT images were compared with the images obtained by PET. Both crosstalk-corrected and uncorrected ^99mTc-tetrofosmin images were generated and compared with the single ^99mTc-tetrofosmin images. Results: Regional percentage uptake of FDG agreed well between DISA and PET. However, regional percentage uptake of ^99mTc-tetrofosmin was generally higher on the uncorrected ^99mTc-tetrofosmin images than on the single Tc-tetrofosmin images, especially in areas of low flow (percentage count of Tc-tetrofosmin 50%). The crosstalk correction contributed to improving the agreement between regional percentage uptakes and significantly improved the detectability of myocardial perfusion-metabolism mismatching. Conclusion: With 3-channel acquisition and weighted-scatter correction of crosstalk from the ¹⁸F photopeak to the ^99mTc photopeak, DISA with Tc-tetrofosmin and FDG is feasible for assessing regional myocardial perfusion and viability.

Key Words: FDG • SPECT • ^99mTc-tetrofosmin • dual-isotope acquisition

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