Yoshiko Nishiyama MD, Presenter: Nothing to Disclose

Masao Miyagawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Rami Yokoyama, Abstract Co-Author: Nothing to Disclose

Yuki Tanabe, Abstract Co-Author: Nothing to Disclose

Takuya Matsuda, Abstract Co-Author: Nothing to Disclose

Masashi Nakamura, Abstract Co-Author: Nothing to Disclose

Teruhito Kido MD, PhD, Abstract Co-Author: Nothing to Disclose

Teruhito Mochizuki MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to assess the feasibility of stress-only SPECT myocardial perfusion imaging (MPI) in the supine and prone position by using a novel cadmium-zinc telluride (CZT) camera.

A total of 290 consecutive patients with suspected/known coronary artery disease (CAD) underwent single-day stress-rest CZT SPECT—the Discovery NM530c (GE Healthcare, Haifa, Israel) — with technetium-99m (99mTc) radiopharmaceuticals and we have conducted retrospective cohort study. All patients underwent a 5-min scan in the supine and prone position, and the images were visually interpreted to obtain the supine and prone combined summed stress scores (SSS). An SSS < 4 and normal coronary angiography patients was considered normal. We compared the rate of stress-only exams for normal SPECT between combined supine-prone images and supine images alone. Follow-up data for 38.6 ± 1.3 months after SPECT imaging for the occurrence of cardiac events (death, non-fatal MI, unstable angina, heart failure, revascularization) for the group of stress-normal or stress-abnormal and for the evaluation of supine imaging or combined analysis.

In our protocol, the total acquisition time was a maximum of 15 min. The mean age was 68±10 years and mean body mass index was 24.9±3.0 kg/m2. The SSS for the supine, prone, and combined positions was 8±6, 6±5, and 6±5, respectively. Normal stress images were 126 cases for combined analysis. Among patients with abnormal stress images after supine images, nine cases considered normal for combined analysis. Thus, we were able to obtain a 65% isotope dose-reduction in the stress-only compared to the stress-rest protocol. Cardiac revascularization rates with stress-normal imaging were significant lower than those with stress-abnormal imaging (2 (1.5%) versus 25 (15.2%), p < 0.05). Survival curves shows stress-normal persons had a significantly higher rate than stress-abnormal. The incidence of all cause mortality was very low in patients with normal stress-only scans (1.0%).

The use of the CZT camera in the combined analysis increased the rate of stress-only SPECT MPI compared with the supine position, consequently reducing acquisition time and radiation exposure.

The CZT SPECT of the combined analysis increased the rate of stress-only SPECT MPI, consequently reducing acquisition time and radiation exposure.

Nishiyama, Y, Miyagawa, M, Yokoyama, R, Tanabe, Y, Matsuda, T, Nakamura, M, Kido, T, Mochizuki, T, Feasibility of Stress-only CZT Myocardial Perfusion SPECT with Combined Spine and Prone Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009720.html