Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France
Signalisation, Électrophysiologie et Imagerie des Lésions d'Ischémie-Reperfusion Myocardique, UNICAEN, Normandie Université, Caen, France.
J Nucl Med. 2018 Feb;59(2):251-258. doi: 10.2967/jnumed.117.194373. Epub 2017 Jun 23.
The aim of this retrospective study was to compare the heart-to-mediastinum ratio (HMR) of I-metaiodobenzylguanidine (I-MIBG) uptake obtained using a multipinhole cadmium-zinc-telluride (CZT) camera with that obtained using conventional planar imaging. Forty consecutive heart failure patients underwent planar acquisition 4 h after I-MIBG injection (191 ± 41 [mean ± SD] MBq). To localize the heart using the CZT camera, Tc-tetrofosmin (358 ± 177 MBq) was administered and dual-isotope acquisition was performed. The HMRs were calculated with conventional planar imaging (HMR), with anterior reprojection images using the CZT camera (HMR), and with transaxial reconstructed images using the CZT camera (HMR). In a phantom study, we estimated a linear model fitting the CZT camera data to the planar data, and we applied it to provide corrected CZT camera-determined HMRs in patients (cHMR and cHMR). Thirty-four men and 6 women (71 ± 9 y old) with ischemic (22 patients) and nonischemic (18 patients) heart failure completed the study. For 22 of the 40 patients (55%), the New York Heart Association classification was class II and the ejection fraction was 35% ± 9%. HMR (1.12 ± 0.19) and HMR (1.35 ± 0.34) were lower than HMR (1.44 ± 0.14) ( < 0.0001 and < 0.01, respectively). cHMR (1.54 ± 0.09) and cHMR (1.45 ± 0.14) were significantly different ( < 0.0001). Lin concordance correlation and Bland-Altman analysis demonstrated an almost perfect concordance and a high agreement between HMR and cHMR ( was not significant) but not between HMR and cHMR ( < 0.0001). This study demonstrated that determination of the late HMR of cardiac I-MIBG uptake using dual-isotope (I and Tc) acquisition on a multipinhole CZT camera was feasible in patients with heart failure. However, this determination should be performed using transaxial reconstructed images and linear correction based on phantom data acquisitions.
这项回顾性研究的目的是比较使用多针孔碲锌镉（CZT）相机获得的碘-间位碘苄胍（I-MIBG）摄取的心脏-纵隔比（HMR）与使用传统平面成像获得的 HMR。40 例连续心力衰竭患者在 I-MIBG 注射后 4 小时进行平面采集（191±41[均值±标准差]MBq）。为了使用 CZT 相机定位心脏，给予 Tc-四氮茂（358±177MBq）并进行双同位素采集。使用传统平面成像（HMR）、使用 CZT 相机进行前向重投影图像（HMR）和使用 CZT 相机进行横断重建图像（HMR）计算 HMR。在一项体模研究中，我们估计了一个线性模型，将 CZT 相机数据拟合到平面数据中，并将其应用于为患者提供校正后的 CZT 相机确定的 HMR（cHMR 和 cHMR）。34 名男性和 6 名女性（71±9 岁）患有缺血性（22 例）和非缺血性（18 例）心力衰竭，完成了该研究。对于 40 例患者中的 22 例（55%），纽约心脏协会（NYHA）分级为 II 级，射血分数为 35%±9%。HMR（1.12±0.19）和 HMR（1.35±0.34）均低于 HMR（1.44±0.14）（<0.0001 和 <0.01，分别）。cHMR（1.54±0.09）和 cHMR（1.45±0.14）也有显著差异（<0.0001）。Lin 一致性相关和 Bland-Altman 分析表明，HMR 和 cHMR 之间具有几乎完美的一致性和高度的一致性（无统计学意义），但 HMR 和 cHMR 之间没有（<0.0001）。这项研究表明，使用多针孔 CZT 相机进行双同位素（I 和 Tc）采集，可以在心力衰竭患者中确定心脏 I-MIBG 摄取的晚期 HMR。然而，这种测定应该使用横断重建图像和基于体模数据采集的线性校正来进行。
