Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles. California; and
Department of Imaging, Medicine, and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles. California; and.
J Nucl Med. 2019 Sep;60(9):1194-1204. doi: 10.2967/jnumed.118.220657. Epub 2019 Aug 2.
There has been an evolutionary leap in SPECT imaging with the advent of camera systems that use solid-state crystals and novel collimator designs configured specifically for cardiac imaging. Solid-state SPECT camera systems have facilitated dramatic reductions in both imaging time and radiation dose while maintaining high diagnostic accuracy. These advances are related to simultaneous improvement in photon sensitivity due to the collimator and imaging geometry, as well as image resolution due to the improved energy resolution of the new crystals. Improved photon sensitivity has facilitated fast or low-dose myocardial perfusion imaging (MPI), and early dynamic imaging has emerged as a technique for assessing myocardial blood flow with SPECT. Lastly, general-purpose solid-state camera systems and hybrid SPECT/CT systems have also been developed that may have important clinical roles in cardiac imaging. This review summarizes state-of-the-art solid-state SPECT MPI technology and clinical applications, including emerging techniques for SPECT MPI flow estimation. We also discuss imaging protocols used with the new cameras, potential imaging pitfalls, and the latest data providing large-scale validation of the diagnostic and prognostic value of this new technology.
随着使用固态晶体和专为心脏成像设计的新型准直器的相机系统的出现，SPECT 成像技术取得了重大飞跃。固态 SPECT 相机系统极大地缩短了成像时间和辐射剂量，同时保持了高诊断准确性。这些进展与由于准直器和成像几何形状而导致的光子灵敏度的同时提高以及由于新晶体的改进的能量分辨率而导致的图像分辨率有关。提高的光子灵敏度促进了快速或低剂量的心肌灌注成像（MPI），早期动态成像已成为一种使用 SPECT 评估心肌血流的技术。最后，还开发了通用的固态相机系统和 SPECT/CT 混合系统，它们在心脏成像中可能具有重要的临床作用。这篇综述总结了最先进的固态 SPECT MPI 技术和临床应用，包括 SPECT MPI 流量估计的新兴技术。我们还讨论了新相机使用的成像方案、潜在的成像陷阱以及提供新技术诊断和预后价值的最新数据。
