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High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Appropriate use of SPECT imaging is regulated by evidence-based guidelines and appropriateness criteria in an effort to limit the burden of radiation administered to patients. We aimed at establishing whether the use of a low dose for stress–rest single-day nuclear myocardial perfusion imaging on an ultrafast (UF) cardiac gamma camera using cadmium-zinc-telluride solid-state detectors could be used routinely with the same accuracy obtained with standard doses and conventional cameras.

Methods

To this purpose, 137 consecutive patients (mean age 61 ± 8 years) with known or suspected coronary artery disease (CAD) were enrolled. They underwent single-day low-dose stress–rest myocardial perfusion imaging using UF SPECT and invasive coronary angiography. Patients underwent the first scan with a 7-min acquisition time 10 min after the end of the stress protocol (dose range 185 to 222 MBq of 99mTc-tetrofosmin). The rest scan (dose range 370 to 444 MBq of 99mTc-tetrofosmin) was acquired with a 6-min acquisition time. The mean summed stress scores (SSS) and mean summed rest scores (SRS) were obtained semiquantitatively.

Results

Coronary angiograms showed significant epicardial CAD in 83% of patients. Mean SSS and SRS were 10 ± 5 and 3 ± 3, respectively. Overall the area under the ROC curve for the SSS values was 0.904, while the areas under the ROC curves for each vascular territory were 0.982 for the left anterior descending artery, 0.931 for the left circumflex artery and 0.889 for the right coronary artery.

Conclusion

This pilot study demonstrated the feasibility of a low-dose single-day stress–rest fasting protocol performed using UF SPECT, with good sensitivity and specificity in detecting CAD at low patient exposure, opening new perspectives in the use of myocardial perfusion in ischaemic patients.

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Acknowledgments

We are grateful to Claudio Marcassa, MD, and Ornella Rimoldi, MD, for their excellent help in reviewing the paper.

Conflicts of interest

None.

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Authors and Affiliations

  1. Fondazione Toscana Gabriele Monasterio, CNR, Via Moruzzi, 1, 56124, Pisa, Italy

    Alessia Gimelli, Dario Genovesi, Assuero Giorgetti & Paolo Marzullo

  2. Division of Biostatistics, University of South Carolina, Columbia, SC, USA

    Matteo Bottai

  3. Division of Biostatistics, Karolinska Institutet, Stockholm, Sweden

    Matteo Bottai

  4. UO Fisica Sanitaria, AOUP, Pisa, Italy

    Fabio Di Martino

Authors
  1. Alessia Gimelli
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  2. Matteo Bottai
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  3. Dario Genovesi
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  4. Assuero Giorgetti
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  5. Fabio Di Martino
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  6. Paolo Marzullo
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Correspondence to Alessia Gimelli.

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Gimelli, A., Bottai, M., Genovesi, D. et al. High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results. Eur J Nucl Med Mol Imaging 39, 83–90 (2012). https://doi.org/10.1007/s00259-011-1918-6

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  • DOI: https://doi.org/10.1007/s00259-011-1918-6

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