RT Journal Article
SR Electronic
T1 Minimizing patient-specific tracer dose in myocardial perfusion imaging using CZT-SPECT
JF Journal of Nuclear Medicine Technology
JO J. Nucl. Med. Technol.
FD Society of Nuclear Medicine
SP jnmt.114.148601
DO 10.2967/jnmt.114.148601
A1 van Dijk, Joris D.
A1 Jager, Pieter L.
A1 Ottervanger, Jan Paul
A1 Slump, Cornelis H.
A1 de Boer, Jaep
A1 Oostdijk, Adrianus H.J.
A1 van Dalen, Jorn A.
YR 2015
UL http://tech.snmjournals.org/content/early/2015/01/21/jnmt.114.148601.abstract
AB Aim: Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) is widely adopted in clinical practice but is associated with a relatively high radiation dose. The aim of this study was to determine the minimum product of tracer dose and scan time, while maintaining diagnostic value for cadmium zinc telluride (CZT)-SPECT MPI. Methods: 24 patients underwent clinically indicated stress MPI using CZT-SPECT and a body weight depending (3 MBq/kg) Tc-99m-tetrofosmin tracer dose. Data were acquired for 8 minutes in list mode. Next, images were reconstructed using 2, 4, 6 and 8 minutes time frames. Differences between the 8 minutes reference scan and the shorter scans were determined in segmental uptake values (using the 17 segment cardiac model), ejection fraction (EF) and end diastolic volume (EDV). A 5% difference in segmental uptake was considered to significantly influence the diagnostic value. Next, image quality of the 4, 6 and 8 minutes scans were scored by consensus of three experienced nuclear medicine physicians on a 4 point grading scale. Physicians were blinded for scan time and patient information. Results: Differences in segmental uptake values, EF and EDV increased using shorter scans times as compared to the 8 minutes reference scan. On average, the diagnostic value was influenced in 7.7 segments per patient using the 2 minutes scans, in comparison to 2.0 and 0.8 segments per patient using the 4 or 6 minutes scans, respectively. In addition, the 4 minutes scans led to a significantly lower image quality compared to the 8 minutes scans (P < 0.05). This was not the case for the 6 minutes scan. Conclusion: Six minutes was the shortest acquisition time in stress MPI using CZT-SPECT that did not affect the diagnostic value when administrating a tracer dose of 3 MBq/kg. Hence, the patient-specific product of tracer dose and scan time can be minimized to 18 MBq∙min/kg. This may lower the effective radiation dose for patients to values below 1 mSv.