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J Nucl Med. 2008; 49 (Supplement 1):126P
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Cardiovascular: Clinical Science

New' Applications and Findings for 'Old' Imaging Modalities

Very early post-stress (<6min) myocardial perfusion SPECT with Tc-99m-tetrofosmin

S. Cullom1, Bai Ling Hsu1, James Case1, Lyndy Volker1, Ryan Phillips1 and Timothy Bateman1

1 CVIT, Kansas City, Missouri

503

Objectives: Myocardial perfusion SPECT (MPS) acquired very early post-stress (VPS) holds promise to improve laboratory efficiency, diagnostic accuracy and sensitivity to high-grade lesions compared to delayed post-stress (DPS) imaging. We studied the feasibility of VPS SPECT using Tc99m-tetrofosmin (TETRO) compared with DPS.

Methods: 30 subjects (18M) were consented under IRB approval for rest/VPS/DPS TETRO MPS (15 adenosine/15 slow-walk). VPS imaging was started <6 min post injection using a Cardio-60TM SPECT system (Philips Medical Systems). VPS studies were acquired in listmode and rebinned to match the DPS image format. Patient motion and subdiaphragmatic activity were scored (0-none to 3-severe) for VPS and DPS images. Stress segmental perfusion scores and stress left ventricular ejection fraction (LVEF) were computed from QPS/QGSTM processing (Cedars-Sinai Med Cntr). Data was compared using Bland-Altman and regression analysis, expressed as mean±SD.

Results: Patient motion scores: VPS (1.1±0.76) vs. DPS (0.97±0.67), p=NS. Motion after correction: VPS (0.13±0.35) vs. DPS (0.03±0.18). Subdiaphragmatic activity scores (given as score:no. studies): VPS (0:24,1:3,2:3,3:0) vs. DPS (0:29,1:0,2:1,3:0). VPS and DPS segmental perfusion scores were statistically equivalent: VPS (70.0±15.5) vs. DPS (71.3±15.7), (p=0.016), mean diff=0.67±7.7. Stress LVEF values: VPS (55.4±15.2%) vs. DPS (58.0±15.3%) (p=0.26); mean difference=2.52±6.12%.

Conclusions: VPS TETRO SPECT starting <6 min post-stress tracer injection is feasible and provided equivalent stress perfusion scores to DPS SPECT without limitation from patent motion or subdiaphragmatic activity. VPS LVEF was equivalent to DPS in this limited population. Further powered studies are warranted to evaluate VPS SPECT in important populations and with exercise stress testing.





This Article
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Cullom, S.
Right arrow Articles by Bateman, T.
PubMed
Right arrow Articles by Cullom, S.
Right arrow Articles by Bateman, T.