Zavadovsky Konstantin V, Mochula Andrew V, Maltseva Alina N, Shipulin Vladimir V, Sazonova Svetlana I, Gulya Marina O, Liga Ricardo, Gimelli Alessia
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya Str 111A, Tomsk, 634012, Russia.
Siberian State Medical University, Tomsk, Russia.
J Nucl Cardiol. 2022 Dec;29(6):3137-3151. doi: 10.1007/s12350-021-02620-y. Epub 2021 Apr 30.
Cardiac PET-derived measurements of myocardial blood flow (MBF) and myocardial flow reserve (MFR) are proven robust indexes of the severity of coronary artery disease (CAD). They facilitate the diagnosis of diffuse epicardial and microvascular disease and are also of prognostic significance. However, low availability and high cost have limited their wide clinical implementation. Over the last 15 years, cadmium zinc telluride (CZT)-based detectors have been implemented into SPECT imaging devices. Myocardial perfusion scintigraphy can be performed faster and with less radiation exposure as compared with standard gamma cameras. Rapid dynamic SPECT studies with higher count rates can be performed. This technological breakthrough has renewed the interest in SPECT MBF assessment in patients with CAD. Currently, two cardiac-centered CZT gamma cameras are available commercially-Discovery NM530c and D-SPECT. They differ in parameters such as collimator design, number of detectors, sensitivity, spatial resolution and image reconstruction. A number of publications have focused on the feasibility of dynamic CZT SPECT and on the correlation with cardiac PET and invasive coronary angiography measurements of fractional flow reserve. Current study reviews the present status of MBF and MFR assessment with CZT SPECT. It also aims to provide an overview of specific issues related to acquisition, processing and interpretation of quantitative studies in patients with CAD.
心脏正电子发射断层扫描(PET)所测量的心肌血流量(MBF)和心肌血流储备(MFR)是已被证实的冠状动脉疾病(CAD)严重程度的可靠指标。它们有助于诊断弥漫性心外膜和微血管疾病,并且具有预后意义。然而,可用性低和成本高限制了它们在临床上的广泛应用。在过去15年中,基于碲化镉锌(CZT)的探测器已应用于单光子发射计算机断层扫描(SPECT)成像设备。与标准伽马相机相比,心肌灌注闪烁扫描可以更快地进行,且辐射暴露更少。可以进行更高计数率的快速动态SPECT研究。这一技术突破重新激发了人们对CAD患者SPECT评估MBF的兴趣。目前,有两款以心脏为中心的CZT伽马相机在市场上销售——Discovery NM530c和D-SPECT。它们在准直器设计、探测器数量、灵敏度、空间分辨率和图像重建等参数方面存在差异。许多出版物关注动态CZT SPECT的可行性以及与心脏PET和有创冠状动脉造影测量的血流储备分数的相关性。本研究回顾了CZT SPECT评估MBF和MFR的现状。它还旨在概述与CAD患者定量研究的采集、处理和解释相关的具体问题。