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Factors affecting the myocardial activity acquired during exercise SPECT with a high-sensitivity cardiac CZT camera as compared with conventional Anger camera

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Injected doses are difficult to optimize for exercise SPECT since they depend on the myocardial fraction of injected activity (MFI) that is detected by the camera. The aim of this study was to analyse the factors affecting MFI determined using a cardiac CZT camera as compared with those determined using conventional Anger cameras.

Methods

Factors affecting MFI were determined and compared in patients who had consecutive exercise SPECT acquisitions with 201Tl (84 patients) or 99mTc-sestamibi (87 patients) with an Anger or a CZT camera. A predictive model was validated in a group of patients routinely referred for 201Tl (78 patients) or 99mTc-sestamibi (80 patients) exercise CZT SPECT.

Results

The predictive model involved: (1) camera type, adjusted mean MFI being ninefold higher for CZT than for Anger SPECT, (2) tracer type, adjusted mean MFI being twofold higher for 201Tl than for 99mTc-sestamibi, and (3) logarithm of body weight. The CZT SPECT model led to a +1 ± 26 % error in the prediction of the actual MFI from the validation group. The mean MFI values estimated for CZT SPECT were more than twofold higher in patients with a body weight of 60 kg than in patients with a body weight of 120 kg (15.9 and 6.8 ppm for 99mTc-sestamibi and 30.5 and 13.1ppm for 201Tl, respectively), and for a 14-min acquisition of up to one million myocardial counts, the corresponding injected activities were only 80 and 186 MBq for 99mTc-sestamibi and 39 and 91 MBq for 201Tl, respectively.

Conclusion

Myocardial activities acquired during exercise CZT SPECT are strongly influenced by body weight and tracer type, and are dramatically higher than those obtained using an Anger camera, allowing very low-dose protocols to be planned, especially for 99mTc-sestamibi and in non-obese subjects.

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Acknowledgments

The authors thank Henri Boutley for his help in image analysis, Pierre Pothier for critical review of the manuscript, and the Nancy University Hospital for financial and organizational support.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Nuclear Medicine, CHU-Nancy, Nancy, 54000, France

    Antoine Verger, Laetitia Imbert, Yalcine Yagdigul, Wassila Djaballah, Véronique Roch, Gilles Karcher & Pierre-Yves Marie

  2. INSERM U947 and Université de Lorraine, Nancy, 54000, France

    Antoine Verger, Wassila Djaballah, Sylvain Poussier & Gilles Karcher

  3. Nancyclotep experimental imaging platform, Nancy, 54000, France

    Antoine Verger, Laetitia Imbert, Yalcine Yagdigul, Sylvain Poussier, Véronique Roch, Gilles Karcher & Pierre-Yves Marie

  4. Department of Radiotherapy, Centre Alexis Vautrin, Vandœuvre, 54500, France

    Laetitia Imbert

  5. Department of Nuclear Medicine, AP-HP, Hôpital Bichat, Paris, 75018, France

    François Rouzet & Dominique Le Guludec

  6. INSERM U 773 and Denis Diderot University, Paris, 75018, France

    François Rouzet & Dominique Le Guludec

  7. Clinique Pasteur, Toulouse, 31000, France

    Nicolas Fourquet

  8. INSERM, Centre d’Investigation Clinique CIC-P 9501, Nancy, 54000, France

    Renaud Fay

  9. INSERM U1116 and Université de Lorraine, Nancy, 54000, France

    Pierre-Yves Marie

  10. Médecine Nucléaire, Hôpital de Brabois, CHU-Nancy, Allée du Morvan, 54500, Vandoeuvre-les-Nancy, France

    Pierre-Yves Marie

Authors
  1. Antoine Verger
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  2. Laetitia Imbert
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  3. Yalcine Yagdigul
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  5. Wassila Djaballah
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  6. François Rouzet
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  7. Nicolas Fourquet
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  8. Sylvain Poussier
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  9. Véronique Roch
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  10. Dominique Le Guludec
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  11. Gilles Karcher
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  12. Pierre-Yves Marie
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Correspondence to Pierre-Yves Marie.

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Verger, A., Imbert, L., Yagdigul, Y. et al. Factors affecting the myocardial activity acquired during exercise SPECT with a high-sensitivity cardiac CZT camera as compared with conventional Anger camera. Eur J Nucl Med Mol Imaging 41, 522–528 (2014). https://doi.org/10.1007/s00259-013-2617-2

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  • DOI: https://doi.org/10.1007/s00259-013-2617-2

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