Simultaneous dual-radionuclide myocardial perfusion imaging with a solid-state dedicated cardiac camera.

PURPOSE: We compared simultaneous dual-radionuclide (DR) stress and rest myocardial perfusion imaging (MPI) with a novel solid-state cardiac camera and a conventional SPECT camera with separate stress and rest acquisitions. METHODS: Of 27 consecutive patients recruited, 24 (64.5+/-11.8 years of age, 16 men) were injected with 74 MBq of (201)Tl (rest) and 250 MBq (99m)Tc-MIBI (stress). Conventional MPI acquisition times for stress and rest are 21 min and 16 min, respectively. Rest (201)Tl for 6 min and simultaneous DR 15-min list mode gated scans were performed on a D-SPECT cardiac scanner. In 11 patients DR D-SPECT was performed first and in 13 patients conventional stress (99m)Tc-MIBI SPECT imaging was performed followed by DR D-SPECT. The DR D-SPECT data were processed using a spill-over and scatter correction method. DR D-SPECT images were compared with rest (201)Tl D-SPECT and with conventional SPECT images by visual analysis employing the 17-segment model and a five-point scale (0 normal, 4 absent) to calculate the summed stress and rest scores. Image quality was assessed on a four-point scale (1 poor, 4 very good) and gut activity was assessed on a four-point scale (0 none, 3 high). RESULTS: Conventional MPI studies were abnormal at stress in 17 patients and at rest in 9 patients. In the 17 abnormal stress studies DR D-SPECT MPI showed 113 abnormal segments and conventional MPI showed 93 abnormal segments. In the nine abnormal rest studies DR D-SPECT showed 45 abnormal segments and conventional MPI showed 48 abnormal segments. The summed stress and rest scores on conventional SPECT and DR D-SPECT were highly correlated (r=0.9790 and 0.9694, respectively). The summed scores of rest (201)Tl D-SPECT and DR-DSPECT were also highly correlated (r=0.9968, p<0.0001 for all). In six patients stress perfusion defects were significantly larger on stress DR D-SPECT images, and five of these patients were imaged earlier by D-SPECT than by conventional SPECT. CONCLUSION: Fast and high-quality simultaneous DR MPI is feasible with D-SPECT in a single imaging session with comparable diagnostic performance and image quality to conventional SPECT and to a separate rest (201)Tl D-SPECT acquisition.

Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology.

D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it offers potential advantages over conventional systems. A series of measurements were made on a beta-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s(-1) MBq(-1) per head ((99m)Tc, 10 cm) (CS: 72 s(-1) MBq(-1)), and the tomographic sensitivity in the heart region was in the range 647-1107 s(-1) MBq(-1) (CS: 141 s(-1) MBq(-1)). The count rate increased linearly with increasing activity up to 1.44 M s(-1). The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.