Journal
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
Volume 17, Issue 9, Pages 1036-1043Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ehjci/jev312
Keywords
CZT SPECT; Coronary artery disease; Attenuation correction; Myocardial perfusion imaging
Funding
- Mallinckrodt
- Siemens
Ask authors/readers for more resources
Introduction Computed tomography (CT)-based attenuation correction (AC) improves the accuracy of standard myocardial perfusion SPECT. Most dedicated cadmium-zinc-telluride (CZT) SPECT cameras are not equipped with an integrated CT component. We aimed to determine the impact of AC on diagnostic performance of CZT SPECT using co-registration with an external low-dose CT. Methods Sixty patients underwent CZT SPECT (GE Discovery 530c) with Tc-99m-sestamibi at rest and following regadenoson stress. Using commercial software, SPECT images were co-registered with a low-dose CT acquired on a separate system (GE Discovery 670NMCT). Attenuation corrected and non-corrected (NC) images were reconstructed using an iterative algorithm. Accuracy was measured in 44 patients who had undergone invasive angiography within 6 months. Normalcy was compared in the remaining 16 patients who had a low pre-test likelihood (<5%) of coronary artery disease (CAD). Results Summed stress and rest scores were significantly lower in AC images (9 +/- 8 vs. 13 +/- 9 and 6 +/- 7 vs. 10 +/- 9, P = 0.01), while summed difference score did not differ. According to angiography, 38 patients had significant CAD in 71 vascular territories. Attenuation correction improved accuracy globally (P = 0.03) and in RCA territory (P = 0.008). Specificity improved both globally (100 vs. 40%, P < 0.05) and in each individual territory (LAD: 63 vs. 36%, LCX: 70 vs. 33%, RCA: 81 vs. 19%, P < 0.01). Normalcy was 100% for AC and 62.5% for NC images (P < 0.05). Conclusion Attenuation correction with a co-registered external CT is feasible using CZT cameras and improves diagnostic accuracy mostly by improving specificity over uncorrected images.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available