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Cardiovascular: Clinical ScienceNew Software, Hardware and Tracer Development II |
1 Institute of Nuclear Medicine, University College Hospital, London, United Kingdom
283
Objectives: D-SPECT (Spectrum-Dynamics, Israel) is a novel cardiac camera designed to improve sensitivity and resolution of MPS. We compared fast D-SPECT with SPECT in patients with known or suspected coronary artery disease.
Methods: Sixty-nine consecutive patients (age 65±11 years, 39 men) had stress/rest gated MPS after the injection of 250+850 MBq of 99mTc-MIBI (55 pts) (Tc) or 120 MBq of 201Tl (Tl). Tl acquisition times were 6 min and 15 minutes for D-SPECT and SPECT, respectively. Tc stress/rest images were acquired for 6 and 4 minutes on D-SPECT and 15 and 17 min on SPECT, respectively. Images were visually interpreted by the consensus of 3 readers. Using a 17-segment model of the left ventricle and a 5-point scale (0=normal, 4=absent) the summed stress (SSS) and rest (SRS) scores were obtained (SSS>3 was deemed abnormal). Image quality was also graded (1=poor, 5=excellent).
Results: All 27 abnormal SPECT studies were abnormal on D-SPECT. SSS and SRS on SPECT and D-SPECT were strongly correlated (r=0.93 and r=0.97, respectively; p<0.0001 for both). Bland-Altman plots showed good agreement between SPECT and D-SPECT with a mean difference of 0.4 for SSS (95% CI: -0.03 - 0.2) and 0.96 (95% CI: 0.01 - 1.73) for SRS. Mean image quality score was 4.0 for D-SPECT vs. 3.2 for SPECT (p< 0.0001). There was no significant difference in the performance of Tl vs. Tc on D-SPECT compared to SPECT MPS.
Conclusions: D-SPECT and SPECT perfusion studies with either Tc or Tl show good correlation. D-SPECT improves image quality and reduces imaging time significantly.
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