Original ArticleProspective multicenter evaluation of rapid, gated SPECT myocardial perfusion upright imaging
Section snippets
Study Population
A total of 448 patients were enrolled in this prospectively designed study from 11 US nuclear cardiology laboratories in community practices (Table 1). Patients underwent rest–gated stress SPECT imaging using a Tc-99m-labeled agent. All patients were referred for clinically indicated rest–stress myocardial perfusion SPECT imaging. There were 297 males (ranging in age from 30 to 89 years, mean = 67 years) and 151 females (ranging in age from 25 to 95, mean = 68 years).
Stress-Testing Procedures
Patients underwent a
Results
By consensus visual analysis, 269/448 (60%) of the studies were normal and the remaining 177/448 (40%) were abnormal. The proportion of normal and abnormal studies is representative of that generally encountered in office-based nuclear cardiology practices. Body surface area of the study population ranged from 1.40 to 2.80 m2 (2.01 ± 0.26 m2).
Discussion
In this study, we observed a very high qualitative and quantitative correlation between nSPEED and STD SPECT images. As the number of iterations of the OSEM algorithm and choice of post-filters in nSPEED will influence image results, in a separate pilot study we had optimized the nSPEED package to make the nSPEED half-time images equivalent to the conventional 2D-OSEM full-time images, both qualitatively and quantitatively.
In this study, for nSPEED reconstruction, Butterworth cutoff frequency
Conclusion
This study demonstrated that, as compared to 2D-OSEM iterative reconstruction, 3D-OSEM image reconstruction technique allows reduction of imaging time to one half and yields diagnostically equivalent images for rest and stress studies, reliable measurement of EDV, ESV, and LVEF from gated stress SPECT images, and reliable quantitation of perfusion defect severity on stress and rest SPECT images.
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Advances in Software for Faster Procedure and Lower Radiotracer Dose Myocardial Perfusion Imaging
2015, Progress in Cardiovascular DiseasesCitation Excerpt :In another clinical trial it was shown that adaptive noise control with WBR improves uniformity of myocardium compared to FBP techniques, and results in improved diagnostic certainty while preserving normalcy and accuracy.20 In yet another large multicenter trial using half-time upright SPECT acquisition reconstructed with another version of resolution recovery, it was shown this methodology yielded results similar to conventional full acquisition times without compromising perfusion and function information.21 In general, it can be concluded from the results of these and other clinical trials that half time acquisitions reconstructed with resolution recovery improve image quality over FBP or standard OSEM and provide perfusion information, which is very similar to FBP.
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2014, Seminars in Nuclear MedicineCitation Excerpt :Using the IQ SPECT cardio-focused collimator in conjunction with 3D Flash reduced count density reconstruction software (Siemens Medical Solution) and attenuation correction, Vija et al44 demonstrated in Data Spectrum phantoms studies and one clinical patient example that myocardial perfusion SPECT image quality was comparable in 4-minute IQ SPECT scans as compared with standard 20-minute acquisitions acquired with a LEHR collimator45 (Fig. 19). In a prospective, multicenter trial of 448 patients in whom full-time gated SPECT acquisitions and simulated “half-time” acquisitions were compared qualitatively and quantitatively regarding perfusion defect characteristics and functional parameters, Maddahi et al46 reported the results of reduced-time myocardial perfusion SPECT acquired on the Cardius upright camera employing CsI solid-state detectors and reduced count density nSPEED software, incorporating OSEM reconstruction and resolution recovery (Digirad, Inc). They demonstrated that reduced-time acquisition image quality was at least as good as and often superior to that obtained with full-time acquisitions.
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Financial support for this study was partly provided by Digirad Corporation, Poway, CA.