Steele Peter P, Kirch Dennis L, Koss John E
Western Cardiology Associates, Westminster, Colorado 80031, USA.
J Nucl Med. 2008 Jul;49(7):1080-9. doi: 10.2967/jnumed.107.040915. Epub 2008 Jun 13.
A triple-detector, multipinhole SPECT system was optimally configured to perform simultaneous (201)Tl (stress)/(99m)Tc (rest) myocardial perfusion imaging (MPI) using a protocol that permitted direct diagnostic comparison of this multipinhole SPECT system with conventional rotational SPECT.
Both the rotational and the multipinhole SPECT systems used the same model gamma-detectors. The 2 systems were applied in tandem to study 26 patients with documented coronary status. Visual image evaluation of the MPI together with quantitative analysis using circumferential profile curves (CPC) were used for interpretation of stress/rest myocardial flow differences. A dual-peak attenuation compensation (DPAC) technique was applied to the stress (201)Tl multipinhole SPECT images by weighted combination of the images from the upper and lower peaks.
Detection of myocardial infarction by location and extent correlated closely, and correlation of differential flow changes between stress and rest indicated similar accuracy in terms of location and extent of myocardial blood flow differences as well. In addition, the application of DPAC clarified the multipinhole stress (201)Tl images through reduced background and increased statistics and also improved the relative superposition of the normalized CPC, especially for the inferior and more basal reconstructed regions.
The prototype 3-detector multipinhole SPECT system achieved diagnostic results comparable to those for rotational SPECT and required only a single image-acquisition session to generate stress/rest MPI and 16-segment poststress gated studies. This reduction in acquisition time significantly improves productivity without compromising diagnostic accuracy. In addition, DPAC is a useful adjunct to the multipinhole SPECT modality because it improves both the visual clarity of the stress images and the stress/rest quantitative comparability.
一个三探测器、多孔径单光子发射计算机断层显像（SPECT）系统经过优化配置，采用一种协议来同时进行（201）铊（负荷）/（99m）锝（静息）心肌灌注成像（MPI），该协议允许将此多孔径SPECT系统与传统旋转式SPECT进行直接诊断比较。
旋转式和多孔径SPECT系统均使用相同型号的γ探测器。这两种系统串联应用于研究26例有记录的冠状动脉状况患者。MPI的视觉图像评估以及使用圆周轮廓曲线（CPC）的定量分析用于解释负荷/静息心肌血流差异。通过对来自上下峰值图像的加权组合，将双峰衰减补偿（DPAC）技术应用于负荷（201）铊多孔径SPECT图像。
按位置和范围对心肌梗死的检测密切相关，负荷与静息之间的血流变化差异相关性在心肌血流差异的位置和范围方面也显示出相似的准确性。此外，DPAC的应用通过减少背景和增加统计量来清晰显示多孔径负荷（201）铊图像，还改善了归一化CPC的相对叠加，特别是对于下壁和更基底部的重建区域。
原型三探测器多孔径SPECT系统获得的诊断结果与旋转式SPECT相当，并且仅需一次图像采集即可生成负荷/静息MPI和负荷后门控16节段研究。采集时间的减少显著提高了工作效率，且不影响诊断准确性。此外，DPAC是多孔径SPECT模式的有用辅助手段，因为它既提高了负荷图像的视觉清晰度，又提高了负荷/静息定量可比性。
