Dynamic SPECT and quantification of coronary flow reserve using a CZT camera

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Authors: Milan Kamínek; Iva Metelková; Lenka Henzlová
Authors‘ workplace: Klinika nukleární medicíny, LF UP a FN Olomouc, ČR
Published in: NuklMed 2021;10:58-62
Category: Review Article

Overview

Conventional SPECT on dual-head camera allows relative estimation of myocardial perfusion. However, it can underestimate the extent of disease in patients with multivessel coronary artery disease. Dynamic positron emission tomography (PET) is the standard for quantification of coronary flow reserve (CFR) and it can assist in the identification of multivessel disease. CFR is calculated as a ratio between myocardial blood flow during stress vasodilator hyperaemia and flow at rest. The normal value of CFR is usually ≥ 2. However, perfusion PET tracers are costly, and not widely available. Recently, quantification of CFR has been validated for dynamic SPECT on Cadmium Zinc Telluride (CZT) cameras. Department of nuclear medicine of University Hospital Olomouc is the first laboratory with the licence for CFR SPECT software in the Czech Republic. The aim is to present our first experience with the new technology of dynamic SPECT on CZT camera.

Keywords:

coronary flow reserve – CFR – dynamic SPECT – CZT camera

Sources

Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40:87-165
Havel M, Koranda P, Kincl V, et al. Additional Value of the Coronary Artery Calcium Score in Patients for whom Myocardial Perfusion Imaging is Challenging. Kardiol Pol 2019;11;77:458-464
Johnson NP, Gould KL, Di Carli MF, et al. Invasive FFR and Noninvasive CFR in the Evaluation of Ischemia: What Is the Future? J Am Coll Cardiol. 2016;67:2772-2788
Schindler TH, Schelbert HR, Quercioli A, et al. Cardiac PET paging for the detection and monitoring of coronary artery disease and microvascular health. JACC Cardiovasc Imaging 2010;3:623-640
Kincl V, Drozdová A, Vašina J, et al. Cadmium-zinc-telluride SPECT scanners - new perspectives in nuclear kardiology. Cor Vasa 2015;57:e214-e218
Kincl V, Kamínek M, Vašina J, et al. Feasibility of ultra low-dose thallium stress-redistribution protocol including prone imaging in obese patients using CZT camera. International Journal of Cardiovascular Imaging 2016;32:1463-1469
Hyafil F, Gimelli A, Slart R, et al. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. Eur J Hybrid Imaging. 2019;3:11
Agostini D, Roule V, Nganoa C, et al. First validation of myocardial flow reserve assessed by dynamic 99mTc-sestamibi CZT-SPECT camera: head to head comparison with 15O-water PET and fractional flow reserve in patients with suspected coronary artery disease. The WATERDAY study. Eur J Nucl Med Mol Imaging. 2018;45:1079-1090
Nkoulou R, Fuchs TA, Pazhenkottil AP, et al. Absolute Myocardial Blood Flow and Flow Reserve Assessed by Gated SPECT with Cadmium-Zinc-Telluride Detectors Using 99mTc-Tetrofosmin: Head-to-Head Comparison with 13N-Ammonia PET. J Nucl Med. 2016;57:1887-1892
Giubbini R, Bertoli M, Durmo R, et al. Comparison between N13NH3-PET and 99mTc-Tetrofosmin-CZT SPECT in the evaluation of absolute myocardial blood flow and flow reserve. J Nucl Cardiol 2019 Nov 14. doi: 10.1007/s12350-019-01939-x. Online ahead of print