Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322, USA.
J Nucl Cardiol. 2009 Nov-Dec;16(6):927-34. doi: 10.1007/s12350-009-9137-2. Epub 2009 Aug 18.
To compare the diagnostic performance of a new dedicated ultrafast solid-state cardiac camera (Discovery NM 530c [DNM]) with standard dual detector cameras (S-SPECT) in myocardial perfusion imaging. The primary goal was a per-patient analysis of diagnostic performance of the DNM using S-SPECT as the reference standard.
In total, 168 patients underwent one-day Tc-99m tetrofosmin rest/stress myocardial perfusion SPECT. DNM and S-SPECT images were obtained with the same injected doses. The DNM camera uses an array of cadmium zinc telluride pixilated detectors and a multipinhole collimator simultaneously imaging all cardiac views with no moving parts. Rest and stress acquisition times were 4 and 2 minutes for DNM and 14 and 12 minutes for S-SPECT. Two blinded readers independently interpreted all scans on a patient level and on a vascular territory level using a standard five-point scale. Interobserver differences were resolved by a third observer. Agreement between DNM and S-SPECT for presence or absence of myocardial perfusion defects on a per-patient analysis was 91.9% and 92.5%, respectively. Correlation coefficients of rest and stress left ventricular ejection fractions were 0.87 (P < .01) and 0.90 (P < .01).
The diagnostic performance of DNM is comparable to that of S-SPECT on a per-patient basis. However, superior image quality can be achieved with significantly shorter acquisition times with DNM because of improved count sensitivity and image contrast over S-SPECT.
比较新型专用超快速固态心脏相机(Discovery NM 530c [DNM])与标准双探测器相机(S-SPECT)在心肌灌注成像中的诊断性能。主要目标是使用 S-SPECT 作为参考标准,对 DNM 的每位患者的诊断性能进行分析。
共有 168 例患者在一天内进行了 Tc-99m 四氮茂静息/负荷心肌灌注 SPECT。使用相同的注射剂量获取 DNM 和 S-SPECT 图像。DNM 相机使用碲化镉锌像素化探测器阵列和多针孔准直器,无需移动部件即可同时对所有心脏视图进行成像。DNM 的静息和负荷采集时间分别为 4 分钟和 2 分钟,S-SPECT 为 14 分钟和 12 分钟。两名盲法读者独立地以患者水平和血管区域水平对所有扫描进行解读,使用标准的五分制。观察者间差异由第三位观察者解决。DNM 和 S-SPECT 在每位患者的基础上评估心肌灌注缺损的存在与否的一致性分别为 91.9%和 92.5%。静息和负荷左心室射血分数的相关系数分别为 0.87(P<0.01)和 0.90(P<0.01)。
DNM 的诊断性能与 S-SPECT 在每位患者的基础上相当。然而,由于 DNM 在计数灵敏度和图像对比度方面优于 S-SPECT,因此可以通过显著缩短采集时间来获得更好的图像质量。