Rapid-acquisition myocardial perfusion scintigraphy (MPS) on a novel gamma camera using multipinhole collimation and miniaturized cadmiumzinctelluride (CZT) detectors: prognostic value and diagnostic accuracy in a real-world nuclear cardiology service

To study the prognostic value of rapid-acquisition adenosine stressrest myocardial perfusion scintigraphy (MPS) on a gamma camera using multipinhole collimation and cadmiumzinctelluride (CZT) detectors. The secondary aim was to assess the diagnostic accuracy of the technique compared with invasive coronary angiography. Retrospective analysis of 1109 consecutive patients undergoing MPS in a routine clinical setting on a high-efficiency multipinhole gamma camera. MPS acquisition, performed with a standard injection of 550 MBq of Tc-99m-tetrofosmin, required a mean (SD) scanning time of 322 51 s. The hard cardiac event rate at a median (inter-quartile range) follow-up of 624 (552699) days was 0.4 (95 CI 0.11.1) in patients with no significant perfusion abnormality versus 6.8 (95 CI 4.310.7, P 0.001) in those with an abnormal scan. In a sub-group of 165 patients, comparison with obstructive coronary artery disease on X-ray angiography gave a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for rapid-acquisition MPS of 84 (95 CI 7491), 79 (95 CI 6887), 82 (95 CI 7289), 81 (95 CI 7089), and 82 (95 CI 7389), respectively. MPS performed on a CZT solid-state detector camera with multipinhole collimation is an evolutionary development that provides reliable prognostic and diagnostic information, while significantly reducing image acquisition time.