Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: results of a multi-center study.

Abstract

BACKGROUND:

Obesity is a common source of artifact on conventional SPECT myocardial perfusion imaging (MPI). We evaluated image quality and diagnostic performance of high-efficiency (HE) cadmium-zinc-telluride parallel-hole SPECT MPI for coronary artery disease (CAD) in obese patients.

METHODS AND RESULTS:

118 consecutive obese patients at three centers (BMI 43.6 ± 8.9 kg·m(-2), range 35-79.7 kg·m(-2)) had upright/supine HE-SPECT and invasive coronary angiography > 6 months (n = 67) or low likelihood of CAD (n = 51). Stress quantitative total perfusion deficit (TPD) for upright (U-TPD), supine (S-TPD), and combined acquisitions (C-TPD) was assessed. Image quality (IQ; 5 = excellent; < 3 nondiagnostic) was compared among BMI 35-39.9 (n = 58), 40-44.9 (n = 24) and ≥45 (n = 36) groups. ROC curve area for CAD detection (≥50% stenosis) for U-TPD, S-TPD, and C-TPD were 0.80, 0.80, and 0.87, respectively. Sensitivity/specificity was 82%/57% for U-TPD, 74%/71% for S-TPD, and 80%/82% for C-TPD. C-TPD had highest specificity (P = .02). C-TPD normalcy rate was higher than U-TPD (88% vs 75%, P = .02). Mean IQ was similar among BMI 35-39.9, 40-44.9 and ≥45 groups [4.6 vs 4.4 vs 4.5, respectively (P = .6)]. No patient had a nondiagnostic stress scan.

CONCLUSIONS:

In obese patients, HE-SPECT MPI with dedicated parallel-hole collimation demonstrated high image quality, normalcy rate, and diagnostic accuracy for CAD by quantitative analysis of combined upright/supine acquisitions.

• Authors: Ryo Nakazato, Piotr J Slomka, Mathews Fish, Ronald G Schwartz, Sean W Hayes, Louise E J Thomson, John D Friedman, Mark Lemley Jr, Maria L Mackin, Benjamin Peterson, Arielle M Schwartz, Jesse A Doran, Guido Germano, Daniel S Berman
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 22 Issue 2 Pg. 266-75 (Apr 2015) ISSN: 1532-6551 [Electronic] United States
• PMID: 25388380 (Publication Type: Evaluation Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Cadmium Compounds
• Selenium Compounds
• Zinc Compounds
• cadmium selenide
• zinc selenide

Topics

• Artifacts
• Cadmium Compounds
• California
• Coronary Artery Disease (complications, diagnostic imaging)
• Equipment Design
• Equipment Failure Analysis
• Female
• Humans
• Image Enhancement (methods)
• Male
• Middle Aged
• Myocardial Perfusion Imaging (methods)
• Obesity (complications)
• Reproducibility of Results
• Selenium Compounds
• Sensitivity and Specificity
• Tomography, Emission-Computed, Single-Photon (instrumentation)
• Transducers
• Zinc Compounds