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Research ArticleImaging

Minimizing Patient-Specific Tracer Dose in Myocardial Perfusion Imaging Using CZT SPECT

Joris D. van Dijk, Pieter L. Jager, Jan Paul Ottervanger, Cornelis H. Slump, Jaep de Boer, Adrianus H.J. Oostdijk and Jorn A. van Dalen
Journal of Nuclear Medicine Technology March 2015, 43 (1) 36-40; DOI: https://doi.org/10.2967/jnmt.114.148601
Joris D. van Dijk
1Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
2MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
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Pieter L. Jager
1Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
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Jan Paul Ottervanger
3Department of Cardiology, Isala Hospital, Zwolle, The Netherlands; and
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Cornelis H. Slump
2MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
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Jaep de Boer
1Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
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Adrianus H.J. Oostdijk
1Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
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Jorn A. van Dalen
4Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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  • FIGURE 1.
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    FIGURE 1.

    Example of stress MPI using CZT SPECT scans with varying scan times and their corresponding measured photon counts. Scans are from the typical patient (55-y-old woman, 61 kg, 21.1 kg/m2 body mass index, administered 187 MBq). Shown from top to bottom are corresponding bull’s-eye image, 3 short-axis slices (from apical to basal), vertical long-axis slice, and horizontal long-axis slice. For all axes, the same locations are shown for each scan time.

  • FIGURE 2.
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    FIGURE 2.

    Percentage of patients who had more than a 5% absolute difference in segmental uptake between 8-min reference scan and 2-, 4-, and 6-min scans, for each of the 17 segments. For example, segment 7 was affected in 42% of patients when the scan time was reduced to 2 min, whereas this percentage was 17% and 0% for the 4- and 6-min scans, respectively. The vertical dashed line represents the separation between the inner and outer segments.

  • FIGURE 3.
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    FIGURE 3.

    Box plot of the number of segments per patient that showed segmental uptake difference of 5% or more for 2-, 4-, and 6-min scans compared with the 8-min reference scan. Black lines within the box represent median, box demarks 25th and 75th percentiles (interquartile range), and whiskers demark highest and lowest numbers of segments that are not outliers. Values that are more than 1.5 times interquartile range are represented by dots.

  • FIGURE 4.
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    FIGURE 4.

    Scored image quality for myocardial scans for all 24 patients using scan times of 4, 6, and 8 min. Image quality was scored on 4-point grading scale by consensus of 3 experienced, masked nuclear medicine physicians. Image quality was lower for 4-min scans than for 6- or 8-min scans (P < 0.05).

Tables

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    TABLE 1

    Baseline Characteristics and Scan Results for All 24 Stable Patients with Suspected Coronary Artery Disease Referred for CZT SPECT

    CharacteristicData
    Age (y)65.2 ± 12.6
    Male sex (%)41.7
    Body weight (kg)78.3 ± 15.6
    Height (cm)171 ± 10
    Body mass index (kg/m2)26.7 ± 4.6
    Normal MPI scan (%)75.0
    Ischemic defect (%)16.7
    Nonreversible defect (%)25.0
    • Data are percentages or mean ± SD.

    • View popup
    TABLE 2

    Absolute Differences and Segmental Uptake Values, EFs, and EDVs Comparing the 8-Minute Reference Scan with the Shorter Scans

    Parameter2 vs. 8 min4 vs. 8 min6 vs. 8 min
    Uptake values of all segments (%)6.2 ± 4.83.4 ± 3.02.2 ± 2.1
    Uptake values of inner segments (%)6.0 ± 4.32.9 ± 2.41.7 ± 1.4
    Uptake values of outer segment (%)6.7 ± 5.54.2 ± 3.73.2 ± 2.7
    EF (%)6.1 ± 4.84.3 ± 4.73.6 ± 3.2
    EDV (mL)6.4 ± 5.44.0 ± 2.33.8 ± 3.9
    • Data are mean ± SD.

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Journal of Nuclear Medicine Technology: 43 (1)
Journal of Nuclear Medicine Technology
Vol. 43, Issue 1
March 1, 2015
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Minimizing Patient-Specific Tracer Dose in Myocardial Perfusion Imaging Using CZT SPECT
Joris D. van Dijk, Pieter L. Jager, Jan Paul Ottervanger, Cornelis H. Slump, Jaep de Boer, Adrianus H.J. Oostdijk, Jorn A. van Dalen
Journal of Nuclear Medicine Technology Mar 2015, 43 (1) 36-40; DOI: 10.2967/jnmt.114.148601
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Minimizing Patient-Specific Tracer Dose in Myocardial Perfusion Imaging Using CZT SPECT
Joris D. van Dijk, Pieter L. Jager, Jan Paul Ottervanger, Cornelis H. Slump, Jaep de Boer, Adrianus H.J. Oostdijk, Jorn A. van Dalen
Journal of Nuclear Medicine Technology Mar 2015, 43 (1) 36-40; DOI: 10.2967/jnmt.114.148601

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