ASNC Imaging Guidelines for Nuclear Cardiology ProceduresSingle photon-emission computed tomography
Introduction
The current document is an update of an earlier version of single photon emission tomography (SPECT) guidelines that was developed by the American Society of Nuclear Cardiology. Although that document was only published a few years ago, there have been significant advances in camera technology, imaging protocols, and reconstruction algorithms that prompted the need for a revised document. This publication is designed to provide imaging guidelines for physicians and technologists who are qualified to practice nuclear cardiology. While the information supplied in this document has been carefully reviewed by experts in the field, the document should not be considered medical advice or a professional service. We are cognizant that SPECT technology is evolving rapidly and that these recommendations may need further revision in the near future. Hence, the imaging guidelines described in this publication should not be used in clinical studies until they have been reviewed and approved by qualified physicians and technologists from their own particular institutions.
Section snippets
Instrumentation Quality Assurance and Performance
The proper choice of equipment to acquire clinical data and a well-designed quality assurance (QA) program are both essential requirements for optimizing diagnostic accuracy and ensuring consistent, high-quality imaging. The following guidelines are intended to provide an appropriate means of assessing equipment function in conjunction with nuclear cardiology imaging. Because the optimal manner in which to perform specific tests varies considerably between models of imaging equipment, this
Acquisition Protocols
Protocols for the various nuclear cardiology SPECT acquisition studies using Anger camera technology and conventional filtered backprojection reconstruction are presented in Tables Table 12, Table 13, Table 14, Table 15, Table 16, Table 17. For each of the protocols the acquisition parameters and values are listed for the stress and rest portions of the protocol. A description for each of the acquisition parameters is listed below.
Implementation of these protocol acquisition parameters have
Filtering
Image filtering is a very complex topic that encompasses techniques for image enhancement, reconstruction, and feature extraction.46,47 The main area of concern for an interpreter of SPECT studies is image enhancement via noise reduction. All forms of imaging are plagued by statistical variation in the acquired image counts commonly referred to as noise. The quality of an image can be described the signal-to-noise ratio, which describes the relative strength of the signal component (what is
General Comments
The interpretation of myocardial perfusion SPECT images should be performed in a systematic fashion to include: (1) evaluation of the raw images in cine mode to determine the presence of potential sources of image artifact and the distribution of extracardiac tracer activity; (2) interpretation of images with respect to the location, size, severity, and reversibility of perfusion defects as well as cardiac chamber sizes, and, especially for Tl-201, presence or absence of increased pulmonary
Acknowledgments
Dr. Robert Hendel receives grant support from GE Healthcare, is on the Speakers’ Bureau for Astellas Pharma US, and serves on the Advisory Boards for PGx Health, Astellas Pharma US, UnitedHealthcare, and GE Healthcare. Dr. Donna Polk serves on the Data Safety Monitoring Board for Lantheus. Dr. Dennis Calnon serves on the Research Steering Committee for PGx Health. Dr. Christopher Hansen receives grant support from Digirad and is a stock shareholder of General Electric. The authors have no
References (87)
- et al.
A new solid state, ultra fast cardiac multi-detector SPECT system [abstract]
J Nucl Cardiol
(2008) - et al.
Collimator integrity
J Nucl Cardiol
(2006) Instrument- and computer-related problems and artifacts in nuclear medicine
Semin Nucl Med
(1996)- et al.
High-speed myocardial perfusion imaging initial clinical comparison with conventional dual detector anger camera imaging
J Am Coll Cardiol Imaging
(2008) - et al.
SPECT myocardial perfusion imaging with prone-only acquisitions: Correlation with coronary angiography
J Nucl Cardiol
(2009) - et al.
Normal stress-only versus standard stress/rest myocardial perfusion imaging: Similar patient mortality with reduced radiation exposure
J Am Coll Cardiol
(2010) - et al.
Combined quantitative supine-prone myocardial perfusion SPECT improves detection of coronary artery disease and normalcy rates in women
J Nucl Cardiol
(2007) - et al.
American Society of Nuclear Cardiology position statement on electrocardiographic gating of myocardial perfusion SPECT scintigrams
J Nucl Cardiol
(1999) - et al.
Value of gating of technetium-99m sestamibi single-photon emission computed tomographic imaging
J Am Coll Cardiol
(1997) Digital image processing for clinicians, part II: Filtering
J Nucl Cardiol
(2002)
Lower accuracy of Tl-201 SPECT in women is not improved by size-based normal databases or Wiener filtering
J Nucl Cardiol
Digital image processing for clinicians, part III: SPECT reconstruction
J Nucl Cardiol
Clinical results of a novel wide beam reconstruction methods for shortening scan time of Tc-99m cardiac SPECT perfusion studies
J Nucl Cardiol
Ordered subset expectation maximization and wide beam reconstruction “half-time” gated myocardial perfusion SPECT functional imaging: A comparison to “full-time” filtered backprojection
J Nucl Cardiol
Wide beam reconstruction “quarter-time” gated myocardial perfusion SPECT functional imaging: A comparison to “full-time” ordered subset expectation maximum
J Nucl Cardiol
The role of the translation table in cardiac image display
J Nucl Cardiol
Digital image processing for clinicians, Part I: Basics of image formation
J Nucl Cardiol
Transient ischemic dilation: A powerful diagnostic and prognostic finding of stress myocardial perfusion imaging
J Nucl Cardiol
Comparison of pulmonary uptake with transient cavity dilation after exercise thallium-201 perfusion imaging
J Am Coll Cardiol
Comparison of pulmonary uptake with transient cavity dilation after dipyridamole Tl-201 perfusion imaging
J Nucl Cardiol
Significance of dipyridamole-induced transient dilation of the left ventricle during thallium-201 scintigraphy in suspected coronary artery disease
Am J Cardiol
On the bright side
J Nucl Cardiol
Increased stress right ventricular activity on dual isotope perfusion SPECT: A sign of multivessel and/or left main coronary artery disease
J Am Coll Cardiol
Noncardiac findings on dual-isotope myocardial perfusion SPECT
J Nucl Cardiol
Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association
J Nucl Cardiol
ASNC imaging guidelines for nuclear cardiology procedures: Standardized reporting of myocardial perfusion images
J Nucl Cardiol
Comparative prognostic value of automatic quantitative analysis versus semiquantitative visual analysis of exercise myocardial perfusion single-photon emission computed tomography
J Am Coll Cardiol
Quantitative assessment of myocardial perfusion abnormality on SPECT myocardial perfusion imaging is more reproducible than expert visual analysis
J Nucl Cardiol
Automated assessment of serial SPECT myocardial perfusion images
J Nucl Cardiol
Regadenoson induces comparable left ventricular perfusion defects as adenosine: A quantitative analysis from the ADVANCE MPI 2 Trial
J Am Coll Cardiol Img
Reverse redistribution of thallium-201: A sign of nontransmural myocardial infarction with patency of the infarct-related coronary artery
J Am Coll Cardiol
Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: Gender-related differences in normal limits and outcomes
J Nucl Cardiol
ACC/AHA/ACR/ASE/ASNC/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR/SIR key data elements and definitions for cardiac imaging
J Am Coll Cardiol
ACC/ACR/AHA/ASE/ASNC/HRS/MITA/NASCI/RSNA/SAIP/SCCT/SCMR health policy statement on structured reporting in cardiovascular imaging
J Am Coll Cardiol
Timeliness of reporting results of nuclear cardiology procedures
J Nucl Cardiol
3D spatial resolution map and sensitivity characterization of a dedicated cardiac CZT SPECT camera [abstract]
J Nucl Med
A novel high-sensitivity rapid-acquisition single-photon cardiac imaging camera
J Nucl Med
The essential physics of medical imaging
The essential physics of medical imaging
Physics in nuclear medicine
Physics in nuclear medicine
Principles of cardiac SPECT imaging
Cardiac SPECT
Maximum likelihood reconstruction for emission tomography
IEEE Trans Med Imaging
Accelerated image reconstruction using ordered subsets of projection data
IEEE Trans Med Imaging
Treatment of Compton scattering in maximum likelihood, expectation-maximization reconstructions of SPECT images
J Nucl Med
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Unless reaffirmed, retired, or amended by express action of the Board of Directors of the American Society of Nuclear Cardiology, this Imaging Guideline shall expire as of May 2015.