Preliminary clinical results of photon energy recovery in simultaneous rest Tl-201/stress Tc-99m sestamibi myocardial SPECT.

ABSTRACT

BACKGROUND: The purpose of this study is to report the first clinical results obtained with the spectral deconvolution technique photon energy recovery (PER) for crosstalk correction in simultaneous rest thallium 201/stress technetium 99m sestamibi myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: Thirty-four patients with suspected coronary artery disease received Tl-201 (111-130 MBq) at rest, followed by single SPECT. Tc-99m sestamibi (444-518 MBq) was then injected at stress, followed by dual SPECT. Single SPECT data were processed to obtain the following data sets single raw (conventional) Tl-201 and single PER (scatter-corrected) Tl-201. Dual SPECT data were processed to obtain the following data sets dual raw Tl-201, dual PER (scatter- and crosstalk-corrected) Tl-201, dual raw Tc-99m, and dual PER (scatter-corrected) Tc-99m. All data sets were automatically analyzed with Cedars-Sinai Quantitative Perfusion SPECT software to derive the relative segmental uptake, the summed score, and the summed difference score. The relative segmental uptake, the summed score, and the number of patients with significant reversibility (summed difference score >2) were 74.84% +/- 12.79%, 3.44 +/- 3.07, and 13, respectively, for single raw Tl-201; 80.5% +/- 10.18%, 1.97 +/- 2.25, and 20, respectively, for dual raw Tl-201; 69.47% +/- 14.08%, 6.41 +/- 3.68, and 17, respectively, for single PER Tl-201; and 69.99% +/- 13.39%, 6.58 +/- 3.63, and 17, respectively, for dual PER Tl-201. The differences between single and dual raw Tl-201 data sets were highly significant, whereas there was no significant difference between PER-corrected Tl-201 data sets. CONCLUSIONS: PER is quantitatively efficient to correct for crosstalk in patients investigated with simultaneous rest Tl-201/stress Tc-99m sestamibi myocardial SPECT.