RT Journal Article
SR Electronic
T1 Cadmium-Zinc-Telluride Myocardial Perfusion Imaging in Obese Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1401
OP 1406
DO 10.2967/jnumed.111.102434
VO 53
IS 9
A1 Michael Fiechter
A1 Cathérine Gebhard
A1 Tobias A. Fuchs
A1 Jelena R. Ghadri
A1 Julia Stehli
A1 Egle Kazakauskaite
A1 Bernhard A. Herzog
A1 Aju P. Pazhenkottil
A1 Oliver Gaemperli
A1 Philipp A. Kaufmann
YR 2012
UL http://jnm.snmjournals.org/content/53/9/1401.abstract
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.