Mallet Florian, Poitrasson-Rivière Alexis, Mariano-Goulart Denis, Agostini Denis, Manrique Alain
Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Univ, UNICAEN UR 4650 PSIR, 14000, Caen, France.
Department of Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand, France.
J Nucl Cardiol. 2023 Oct;30(5):2006-2017. doi: 10.1007/s12350-022-03165-4. Epub 2023 Jan 4.
Dynamic acquisition allows absolute quantification of myocardial perfusion and flow reserve, offering an alternative to overcome the potential limits of relative quantification, especially in patients with balanced multivessel coronary artery disease. SPECT myocardial perfusion is widely available, at lower cost than PET. Dynamic cardiac SPECT is now feasible and has the potential to be the next step of comprehensive perfusion imaging. In order to help nuclear cardiologists potentially interested in using dynamic perfusion SPECT, we sought to review the different steps of acquisition, processing, and reporting of dynamic SPECT studies in order to enlighten the potentially critical pitfalls and artifacts. Both patient-related and technical artifacts are discussed. Key parameters of the acquisition include pharmacological stress, radiopharmaceuticals, and injection device. When it comes to image processing, attention must be paid to image-derived input function, patient motion, and extra-cardiac activity. This review also mentions compartment models, cameras, and attenuation correction. Finally, published data enlighten some facets of dynamic cardiac SPECT while several issues remain. Harmonizing acquisition and quality control procedures will likely improve its performance and clinical strength.
动态采集可实现心肌灌注和血流储备的绝对定量，为克服相对定量的潜在局限性提供了一种替代方法，特别是在患有均衡多支冠状动脉疾病的患者中。单光子发射计算机断层扫描（SPECT）心肌灌注检查广泛可用，成本低于正电子发射断层扫描（PET）。动态心脏SPECT现在是可行的，有可能成为全面灌注成像的下一步。为了帮助可能对使用动态灌注SPECT感兴趣的核心脏病专家，我们试图回顾动态SPECT研究的采集、处理和报告的不同步骤，以揭示潜在的关键陷阱和伪影。本文讨论了与患者相关的和技术方面的伪影。采集的关键参数包括药物负荷、放射性药物和注射装置。在图像处理方面，必须注意图像衍生的输入函数、患者运动和心脏外活动。本综述还提到了房室模型、相机和衰减校正。最后，已发表的数据揭示了动态心脏SPECT的一些方面，但仍存在几个问题。统一采集和质量控制程序可能会提高其性能和临床优势。
