期刊
JOURNAL OF NUCLEAR CARDIOLOGY
卷 30, 期 2, 页码 528-539出版社
SPRINGER
DOI: 10.1007/s12350-022-03054-w
关键词
cadmium-zinc-telluride; myocardial perfusion imaging; coronary artery disease; single-photon emission tomography
CZT-MPI has higher diagnostic sensitivity in detecting coronary artery disease compared to conventional Anger-MPI, but it has reduced specificity and diagnostic accuracy. Experienced readers show higher inter-rater agreement and special training is required for non-experienced readers.
Background Cadmium-zinc-telluride (CZT)-based detectors exhibit higher diagnostic sensitivity in myocardial perfusion imaging (MPI) than conventional Anger-MPI for detection of coronary artery disease (CAD); however, reduced specificity and diagnostic accuracy of CZT-MPI were observed. This study aims to compare these different camera systems and to examine the degree of inter-rater reproducibility among readers with varying experience in MPI. Methods 83 patients who underwent double stress/rest examinations using both a CZT and conventional SPECT cameras within one visit were included. Anonymized and randomized MPI-images were distributed to 15 international readers using a standardized questionnaire. Subsequent coronary angiography findings of ten patients served as a reference for analysis of sensitivity and specificity. Results Image quality was significantly better in CZT-MPI with significantly lower breast attenuation (P < 0.05). CZT-MPI exhibited higher sensitivity than Anger-MPI (87.5% vs. 62.5%) and significantly reduced specificity (40% vs. 100%). Readers experienced with both camera systems had the highest inter-rater agreement indicating higher reproducibility (CZT 0.54 vs. conv. 0.49, P < 0.05). Conclusions Higher diagnostic sensitivity of CZT-MPI offers advantages in detection of CAD yet potentially of at the cost of reduced specificity, therefore it requires special training and a differentiated evaluation approach, especially for non-experienced readers with such camera systems.
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