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J Nucl Med. 2008; 49 (Supplement 1):199P
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Cardiovascular: Clinical Science

Clinical Science Posters

Comparison of very early post-stress Tc99m-tetrofosmin myocardial perfusion SPECT to delayed post-stress Tc99m-sestimibi

Bailing Hsu1, Ryan Phillips1, Kyle Robison1, James Case1, Timothy Bateman1 and James Cullom1

1 Physicis, Cardiovascular Imaging Technologies, Kansas City, Missouri

862

Objectives: Clinical Tc-99m SPECT requires a long delay (>30 min) for clearance of gut activity before scanning. Early post-stress SPECT (EPS) may improve laboratory efficiency and detection of cardiac disease. However, scatter from gut activity in EPS may limit its clinical usefulness. We evaluated an energy based scatter correction (IESD) on EPS-Tetrofosmin (EPS-TETRO) compared to delayed post-stress Sestamibi (CL-MIBI).

Methods: 30 patients (M=18) with one-day CL-MIBI had EPS-TETRO within a mean of 50 days. Using a Cardio-60TM SPECT system (Philips), listmode EPS-TETRO scans started <6.0 min post TETRO injection. Patient motion (PM) were scored (0=no, 3=severe). The distance of closest gut activity and ratio to myocardial counts (GMR) were measured for both studies. EPS-TETRO planar data was processed with IESD. All images had motion correction (MOCO) if PM score≥1. FWHM of normal wall (NW) and image contrast (IC) were measured. Segmental perfusion was calculated with QPSTM to determine normal (N) (scores>70) and defect segments (D) (<50).

Results: EPS-TETRO had an average 81% higher GMR with closer distance (d=2.1 cm) than CL-MIBI (>3 cm). PM scores were similar between EPS-TETRO (1.1±0.76) and CL-MIBI (1.05±0.64) (p=NS), reduced to (0.17±0.34) and (0.16±0.37) with MOCO. Mean IC of EPS-TETRO was (0.71±0.67) with a mean NW FWHM=3.3±0.48 cm, improved to 0.77±0.67, 3.0±0.32 cm with IESD compared to CL-MIBI (0.70±0.15, 3.0±0.33). IESD enhanced the scores in D ({Delta}mean=-3.38, {Delta}SD=0.67) while preserving the perfusion in N (2.07, 0.77).

Conclusions: Early post-stress Tetrofosmin SPECT had similar patient motion and gut activity. IESD may thus improve interpretation by enhancing cardiac perfusion and separability of gut activity.

Research Support: GE/Amersham Medical Systems research grant.





This Article
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Right arrow Email this article to a friend
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Right arrow Articles by Hsu, B.
Right arrow Articles by Cullom, J.
PubMed
Right arrow Articles by Hsu, B.
Right arrow Articles by Cullom, J.