PT  - JOURNAL ARTICLE
AU  - Michael Fiechter
AU  - Cathérine Gebhard
AU  - Tobias A. Fuchs
AU  - Jelena R. Ghadri
AU  - Julia Stehli
AU  - Egle Kazakauskaite
AU  - Bernhard A. Herzog
AU  - Aju P. Pazhenkottil
AU  - Oliver Gaemperli
AU  - Philipp A. Kaufmann
TI  - Cadmium-Zinc-Telluride Myocardial Perfusion Imaging in Obese Patients
AID  - 10.2967/jnumed.111.102434
DP  - 2012 Sep 01
TA  - Journal of Nuclear Medicine
PG  - 1401--1406
VI  - 53
IP  - 9
4099  - http://jnm.snmjournals.org/content/53/9/1401.short
4100  - http://jnm.snmjournals.org/content/53/9/1401.full
SO  - J Nucl Med2012 Sep 01; 53
AB  - We have evaluated the impact of increased body mass on the quality of myocardial perfusion imaging using a latest-generation γ-camera with cadmium-zinc-telluride semiconductor detectors in patients with high (≥40 kg/m2) or very high (≥45 kg/m2) body mass index (BMI). Methods: We enrolled 81 patients, including 18 with no obesity (BMI < 30 kg/m2), 17 in World Health Organization obese class I (BMI, 30–34.9 kg/m2), 15 in class II (BMI, 35–39.9 kg/m2), and 31 in class III (BMI ≥ 40 kg/m2), including 15 with BMI ≥ 45 kg/m2. Image quality was scored as poor (1), moderate (2), good (3), or excellent (4). Patients with BMI ≥ 45 kg/m2 and nondiagnostic image quality (≤2) were rescanned after repositioning to better center the heart in the field of view. Receiver-operating-curve analysis was applied to determine the BMI cutoff required to obtain diagnostic image quality (≥3). Results: Receiver-operating-curve analysis resulted in a cutoff BMI of 39 kg/m2 (P < 0.001) for diagnostic image quality. In patients with BMI ≥ 40 kg/m2, image quality was nondiagnostic in 81%; after CT-based attenuation correction this decreased to 55%. Repositioning further improved image quality. Rescanning on a conventional SPECT camera resulted in diagnostic image quality in all patients with BMI ≥ 45 kg/m2. Conclusion: Patients with BMI ≥ 40 kg/m2 should be scheduled for myocardial perfusion imaging on a conventional SPECT camera, as it is difficult to obtain diagnostic image quality on a cadmium-zinc-telluride camera.