Diagnostic accuracy for CZT gamma camera compared to conventional gamma camera technique with myocardial perfusion single-photon emission computed tomography: Assessment of myocardial infarction and function,Journal of Nuclear Cardiology

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Diagnostic accuracy for CZT gamma camera compared to conventional gamma camera technique with myocardial perfusion single-photon emission computed tomography: Assessment of myocardial infarction and function
Journal of Nuclear Cardiology ( IF 3.0 ) Pub Date : 2023-03-13 , DOI: 10.1007/s12350-022-03185-0
Fredrik Hedeer ₁ , Shahnaz Akil ₁ , Jenny Oddstig ₂ , Cecilia Hindorf ₂ , Håkan Arheden ₁ , Marcus Carlsson ₁ , Henrik Engblom ₁

Affiliation

Background

The solid-state cadmium-zinc-telluride (CZT) gamma camera for myocardial perfusion single-photon emission computed tomography (MPS) has theoretical advantages compared to the conventional gamma camera technique. This includes more sensitive detectors and better energy resolution. We aimed to explore the diagnostic performance of gated MPS with a CZT gamma camera compared to a conventional gamma camera for detection of myocardial infarct (MI) and assessment of left ventricular (LV) volumes and ejection fraction (LVEF), using cardiac magnetic resonance (CMR) as the reference method.

Methods

Seventy-three patients (26% female) with known or suspected chronic coronary syndrome were examined with gated MPS using both a CZT gamma camera and a conventional gamma camera as well as with CMR. Presence and extent of MI on MPS and late gadolinium enhancement (LGE) CMR was evaluated. For LV volumes, LVEF and LV mass, gated MPS images and cine CMR images were evaluated.

Results

MI was found in 42 patients on CMR. The overall sensitivity, specificity, positive and negative predictive values for the CZT and the conventional gamma camera were the same (67%, 100%, 100% and 69%). For infarct size > 3% on CMR, the sensitivity was 82% for the CZT and 73% for the conventional gamma camera, respectively. LV volumes were significantly underestimated by MPS compared to CMR (P ≤ .002 for all measures). The underestimation was slightly less pronounced for the CZT compared to the conventional gamma camera (2-10 mL, P ≤ .03 for all measures). For LVEF, however, accuracy was high for both gamma cameras.

Conclusion

Differences between a CZT and a conventional gamma camera for detection of MI and assessment of LV volumes and LVEF are small and do not appear to be clinically significant.

中文翻译：

与心肌灌注单光子发射计算机断层扫描的传统伽马相机技术相比，CZT 伽马相机的诊断准确性：心肌梗死和功能的评估

背景

用于心肌灌注单光子发射计算机断层扫描（MPS）的固态碲化镉锌（CZT）伽马相机与传统伽马相机技术相比具有理论上的优势。这包括更灵敏的探测器和更好的能量分辨率。我们的目的是探索使用 CZT 伽马相机与传统伽马相机相比，门控 MPS 的诊断性能，以使用心脏磁共振检测心肌梗死 (MI) 并评估左心室 (LV) 容积和射血分数 (LVEF)。 CMR）作为参考方法。

方法

使用 CZT 伽马相机和传统伽马相机以及 CMR 对 73 名已知或疑似慢性冠状动脉综合征的患者（26% 女性）进行了门控 MPS 检查。对 MPS 和晚期钆增强 (LGE) CMR 上 MI 的存在和程度进行了评估。对于 LV 体积、LVEF 和 LV 质量、门控 MPS 图像和电影 CMR 图像进行了评估。

结果

42 名 CMR 患者发现心肌梗死。 CZT 和传统伽玛相机的总体灵敏度、特异性、阳性和阴性预测值相同（67%、100%、100% 和 69%）。对于 CMR 上梗塞面积 > 3% 的情况，CZT 的灵敏度为 82%，传统伽玛相机的灵敏度为 73%。与 CMR 相比，MPS 显着低估了 LV 体积（所有测量值P ≤ .002）。与传统伽玛相机相比，CZT 的低估程度稍微不那么明显（2-10 mL，所有测量值P ≤ .03）。然而，对于 LVEF，两台伽玛相机的准确度都很高。