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Published in: BMC Medical Physics 1/2006

Open Access 01-12-2006 | Research article

Comparison of 18F SPECT with PET in myocardial imaging: A realistic thorax-cardiac phantom study

Authors: Karin Knešaurek, Josef Machac

Published in: BMC Medical Physics | Issue 1/2006

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Abstract

Background

Positron emission tomography (PET) imaging with fluorine-18 (18F) Fluorodeoxyglucose (FDG) and flow tracer such as Rubidium-82 (82Rb) is an established method for evaluating an ischemic but viable myocardium. However, the high cost of PET imaging restricts its wider clinical use. Therefore, less expensive 18F FDG single photon emission computed tomography (SPECT) imaging has been considered as an alternative to 18F FDG PET imaging. The purpose of the work is to compare SPECT with PET in myocardial perfusion/viability imaging.

Methods

A nonuniform RH-2 thorax-heart phantom was used in the SPECT and PET acquisitions. Three inserts, 3 cm, 2 cm and 1 cm in diameter, were placed in the left ventricular (LV) wall to simulate infarcts. The phantom acquisition was performed sequentially with 7.4 MBq of 18F and 22.2 MBq of Technetium-99m (99mTc) in the SPECT study and with 7.4 MBq of 18F and 370 MBq of 82Rb in the PET study. SPECT and PET data were processed using standard reconstruction software provided by vendors. Circumferential profiles of the short-axis slices, the contrast and viability of the inserts were used to evaluate the SPECT and PET images.

Results

The contrast for 3 cm, 2 cm and 1 cm inserts were for 18F PET data, 1.0 ± 0.01, 0.67 ± 0.02 and 0.25 ± 0.01, respectively. For 82Rb PET data, the corresponding contrast values were 0.61 ± 0.02, 0.37 ± 0.02 and 0.19 ± 0.01, respectively. For 18F SPECT the contrast values were, 0.31 ± 0.03 and 0.20 ± 0.05 for 3 cm and 2 cm inserts, respectively. For 99mTc SPECT the contrast values were, 0.63 ± 0.04 and 0.24 ± 0.05 for 3 cm and 2 cm inserts respectively. In SPECT, the 1 cm insert was not detectable. In the SPECT study, all three inserts were falsely diagnosed as "viable", while in the PET study, only the 1 cm insert was diagnosed falsely "viable".

Conclusion

For smaller defects the 99mTc/18F SPECT imaging cannot entirely replace the more expensive 82Rb/18F PET for myocardial perfusion/viability imaging, due to poorer image spatial resolution and poorer defect contrast.
Appendix
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Literature
1.
go back to reference Matsunari I, Yoneyama T, Kanayama S, Matsudaira M, Nakajima K, Taki J, Nekolla SG, Tonami N, Hisada K: Phantom Studies for Estimation of Defect Size on Cardiac 18F SPECT and PET: Implications for Myocardial Viability Assessment. J Nucl Med. 2001, 42: 1579-1585.PubMed Matsunari I, Yoneyama T, Kanayama S, Matsudaira M, Nakajima K, Taki J, Nekolla SG, Tonami N, Hisada K: Phantom Studies for Estimation of Defect Size on Cardiac 18F SPECT and PET: Implications for Myocardial Viability Assessment. J Nucl Med. 2001, 42: 1579-1585.PubMed
2.
go back to reference Patton JA, Sandler MP, Ohana I, Weinfeld Z: High-energy (511 keV) imaging with the scintillation camera. Radiographics. 1996, 16: 1183-1194.CrossRefPubMed Patton JA, Sandler MP, Ohana I, Weinfeld Z: High-energy (511 keV) imaging with the scintillation camera. Radiographics. 1996, 16: 1183-1194.CrossRefPubMed
3.
go back to reference Sandler MP, Bax JJ, Patton JA, Visser FC, Martin WH, Wijns W: Fluorine-18-florodeoxyglucosecardiac imaging using a modified scintillation camera. J Nucl Med. 1998, 39: 2035-2043.PubMed Sandler MP, Bax JJ, Patton JA, Visser FC, Martin WH, Wijns W: Fluorine-18-florodeoxyglucosecardiac imaging using a modified scintillation camera. J Nucl Med. 1998, 39: 2035-2043.PubMed
4.
go back to reference Matsunari I, Kanayama S, Yoneyama T, Matsudaira M, Nakajima K, Taki J, Nekolla SG, Tonami N, Hisada K: Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTC-sestamibi to assess myocardial viability and function in a single study. Eur J Nucl Med Mol Imaging. 2005, 32: 195-202. 10.1007/s00259-004-1668-9.CrossRefPubMed Matsunari I, Kanayama S, Yoneyama T, Matsudaira M, Nakajima K, Taki J, Nekolla SG, Tonami N, Hisada K: Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTC-sestamibi to assess myocardial viability and function in a single study. Eur J Nucl Med Mol Imaging. 2005, 32: 195-202. 10.1007/s00259-004-1668-9.CrossRefPubMed
5.
go back to reference Knešaurek K, Machac J: Improvement of the flourine-18 fluorodeoxyglucose images in simultaneous F-18 FDG/Tc-99m collimated SPECT imaging. Med Phys. 1999, 26: 917-923. 10.1118/1.598483.CrossRefPubMed Knešaurek K, Machac J: Improvement of the flourine-18 fluorodeoxyglucose images in simultaneous F-18 FDG/Tc-99m collimated SPECT imaging. Med Phys. 1999, 26: 917-923. 10.1118/1.598483.CrossRefPubMed
6.
go back to reference Mullani NA, Goldstein RA, Gould KL, Marani SK, Fisher DJ, O'Brien HA, Loberg MD: Myocardial perfusion with rubidium-82. I. Measurement of extraction fraction and flow with external detectors. J Nucl Med. 1983, 24: 898-906.PubMed Mullani NA, Goldstein RA, Gould KL, Marani SK, Fisher DJ, O'Brien HA, Loberg MD: Myocardial perfusion with rubidium-82. I. Measurement of extraction fraction and flow with external detectors. J Nucl Med. 1983, 24: 898-906.PubMed
7.
go back to reference Goldstein RA, Mullani NA, Marani SK, Fisher DJ, Gould KL, O'Brien HA: Myocardial perfusion with rubidium-82. II. Effects of metabolic and pharmacologic interventions. J Nucl Med. 1983, 24: 907-915.PubMed Goldstein RA, Mullani NA, Marani SK, Fisher DJ, Gould KL, O'Brien HA: Myocardial perfusion with rubidium-82. II. Effects of metabolic and pharmacologic interventions. J Nucl Med. 1983, 24: 907-915.PubMed
8.
go back to reference Goldstein RA, Mullani NA, Wong WH, Hartz RK, Hicks CH, Fuentes F, Smalling RW, Gould KL: Positron imaging of myocardial infarction with rubidium-82. J Nucl Med. 1986, 27: 1824-1829.PubMed Goldstein RA, Mullani NA, Wong WH, Hartz RK, Hicks CH, Fuentes F, Smalling RW, Gould KL: Positron imaging of myocardial infarction with rubidium-82. J Nucl Med. 1986, 27: 1824-1829.PubMed
9.
go back to reference Yoshida K, Mullani N, Gould KL: Coronary flow and flow reserve by PET simplified for clinical applications using rubidium-82 or nitrogen-13-ammonia. J Nucl Med. 1996, 37: 1701-1712.PubMed Yoshida K, Mullani N, Gould KL: Coronary flow and flow reserve by PET simplified for clinical applications using rubidium-82 or nitrogen-13-ammonia. J Nucl Med. 1996, 37: 1701-1712.PubMed
10.
go back to reference Lin JW, Robert R, Sciacca RR, Chou R-L, Laine AF, Bergmann SR: Quantification of Myocardial Perfusion in Human Subjects Using 82Rb and Wavelet-Based Noise Reduction. J Nucl Med. 2001, 42: 201-208.PubMed Lin JW, Robert R, Sciacca RR, Chou R-L, Laine AF, Bergmann SR: Quantification of Myocardial Perfusion in Human Subjects Using 82Rb and Wavelet-Based Noise Reduction. J Nucl Med. 2001, 42: 201-208.PubMed
11.
go back to reference Knešaurek K, Machac J: Three-window transformation cross-talk correction for simultaneous dual-isotope imaging. J Nucl Med. 1997, 38: 1992-1998.PubMed Knešaurek K, Machac J: Three-window transformation cross-talk correction for simultaneous dual-isotope imaging. J Nucl Med. 1997, 38: 1992-1998.PubMed
12.
go back to reference Bergstrom M, Eriksson L, Bohm C, Blomqvist G, Litton J: Correction for scatter radiation in a ring detector positron camera by integral transformation of the projections. J Comput Assist Tomogr. 1983, 10: 845-850. Bergstrom M, Eriksson L, Bohm C, Blomqvist G, Litton J: Correction for scatter radiation in a ring detector positron camera by integral transformation of the projections. J Comput Assist Tomogr. 1983, 10: 845-850.
13.
go back to reference Gould KL, Yoshida K, Hess MJ, Haynie M, Mullani N, Smalling RW: Myocardial metabolism of fluorodeoxyglucose compared to cell membrane integrity for the potassium analogue rubidium-82 for assessing infarct size in man by PET. J Nucl Med. 1991, 32 (1): 1-9.PubMed Gould KL, Yoshida K, Hess MJ, Haynie M, Mullani N, Smalling RW: Myocardial metabolism of fluorodeoxyglucose compared to cell membrane integrity for the potassium analogue rubidium-82 for assessing infarct size in man by PET. J Nucl Med. 1991, 32 (1): 1-9.PubMed
14.
go back to reference Haas F, Haehnel CJ, Picker W, Nekolla S, Martinoff S, Meisner H, Schwaiger M: Preoperative positron emission tomographic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. J Am Coll Cardiol. 1997, 30 (7): 1693-1700. 10.1016/S0735-1097(97)00375-6.CrossRefPubMed Haas F, Haehnel CJ, Picker W, Nekolla S, Martinoff S, Meisner H, Schwaiger M: Preoperative positron emission tomographic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. J Am Coll Cardiol. 1997, 30 (7): 1693-1700. 10.1016/S0735-1097(97)00375-6.CrossRefPubMed
15.
go back to reference Schoder H, Campisi R, Ohtake T, Hoh CK, Moon DH, Czernin J, Schelbert HR: Blood flow-metabolism imaging with positron emission tomography in patients with diabetes mellitus for the assessment of reversible left ventricular contractile dysfunction. J Am Coll Cardiol. 1999, 33 (5): 1328-1337. 10.1016/S0735-1097(99)00010-8.CrossRefPubMed Schoder H, Campisi R, Ohtake T, Hoh CK, Moon DH, Czernin J, Schelbert HR: Blood flow-metabolism imaging with positron emission tomography in patients with diabetes mellitus for the assessment of reversible left ventricular contractile dysfunction. J Am Coll Cardiol. 1999, 33 (5): 1328-1337. 10.1016/S0735-1097(99)00010-8.CrossRefPubMed
16.
go back to reference Sand NP, Bottcher M, Madsen MM, Nielsen TT, Rehling M: Evaluation of regional myocardial perfusion in patients with severe left ventricular dysfunction: comparison of 13N-ammonia PET and 99mTc sestamibi SPECT. J Nucl Cardiol. 1998, 5 (1): 4-13. 10.1016/S1071-3581(98)80004-4.CrossRefPubMed Sand NP, Bottcher M, Madsen MM, Nielsen TT, Rehling M: Evaluation of regional myocardial perfusion in patients with severe left ventricular dysfunction: comparison of 13N-ammonia PET and 99mTc sestamibi SPECT. J Nucl Cardiol. 1998, 5 (1): 4-13. 10.1016/S1071-3581(98)80004-4.CrossRefPubMed
17.
go back to reference Beanlands RS, Hendry PJ, Masters RG, deKemp RA, Woodend K, Ruddy TD: Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fluorodeoxyglucose positron emission tomography imaging. Circulation. 1998, 98 (19 Suppl): II51-56.PubMed Beanlands RS, Hendry PJ, Masters RG, deKemp RA, Woodend K, Ruddy TD: Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fluorodeoxyglucose positron emission tomography imaging. Circulation. 1998, 98 (19 Suppl): II51-56.PubMed
18.
go back to reference Arrighi JA, Ng CK, Dey HM, Wackers FJ, Soufer R: Effect of left ventricular function on the assessment of myocardial viability by technectium-99m sestamibi and correlation with positron emission tomography in patients with healed myocardial infarcts or stable angina pectoris, or both. Am J Cardiol. 1997, 80 (8): 1007-1013. 10.1016/S0002-9149(97)00594-8.CrossRefPubMed Arrighi JA, Ng CK, Dey HM, Wackers FJ, Soufer R: Effect of left ventricular function on the assessment of myocardial viability by technectium-99m sestamibi and correlation with positron emission tomography in patients with healed myocardial infarcts or stable angina pectoris, or both. Am J Cardiol. 1997, 80 (8): 1007-1013. 10.1016/S0002-9149(97)00594-8.CrossRefPubMed
19.
go back to reference Gunning MG, Anagnostopoulos C, Knight CJ, Pepper J, Burman ED, Davies G, Fox KM, Pennell DJ, Ell PJ, Underwood SR: Comparison of 201Tl, 99mTc-tetrofosmin, and dobutamine magnetic resonance imaging for identifying hibernating myocardium. Circulation. 1998, 98 (18): 1869-1874.CrossRefPubMed Gunning MG, Anagnostopoulos C, Knight CJ, Pepper J, Burman ED, Davies G, Fox KM, Pennell DJ, Ell PJ, Underwood SR: Comparison of 201Tl, 99mTc-tetrofosmin, and dobutamine magnetic resonance imaging for identifying hibernating myocardium. Circulation. 1998, 98 (18): 1869-1874.CrossRefPubMed
20.
go back to reference Huitink JM, Visser FC, Bax JJ, van Lingen A, Groenveld AB, Teule GJ, Visser CA: Predictive value of planar 18F-fluorodeoxyglucose imaging for cardiac events in patients after acute myocardial infarction. Am J Cardiol. 1998, 81 (9): 1072-1077. 10.1016/S0002-9149(98)00143-X.CrossRefPubMed Huitink JM, Visser FC, Bax JJ, van Lingen A, Groenveld AB, Teule GJ, Visser CA: Predictive value of planar 18F-fluorodeoxyglucose imaging for cardiac events in patients after acute myocardial infarction. Am J Cardiol. 1998, 81 (9): 1072-1077. 10.1016/S0002-9149(98)00143-X.CrossRefPubMed
21.
go back to reference Levine MG, McGill CC, Ahlberg AW, White MP, Giri S, Shareef B, Waters D, Heller GV: Functional assessment with electrocardiographic gated single-photon emission computed tomography improves the ability of technetium-99m sestamibi myocardial perfusion imaging to predict myocardial viability in patients undergoing revascularization. Am J Cardiol. 1999, 83 (1): 1-5. 10.1016/S0002-9149(98)00772-3.CrossRefPubMed Levine MG, McGill CC, Ahlberg AW, White MP, Giri S, Shareef B, Waters D, Heller GV: Functional assessment with electrocardiographic gated single-photon emission computed tomography improves the ability of technetium-99m sestamibi myocardial perfusion imaging to predict myocardial viability in patients undergoing revascularization. Am J Cardiol. 1999, 83 (1): 1-5. 10.1016/S0002-9149(98)00772-3.CrossRefPubMed
22.
go back to reference Skoufis E, McGhie AI: Radionuclide techniques for the assessment of myocardial viability. Tex Heart Inst J. 1998, 25 (4): 272-279.PubMedPubMedCentral Skoufis E, McGhie AI: Radionuclide techniques for the assessment of myocardial viability. Tex Heart Inst J. 1998, 25 (4): 272-279.PubMedPubMedCentral
23.
go back to reference Melon PG, de Landsheere CM, Degueldre C, Peters JL, Kulbertus HE, Pierard LA: Relation between contractile reserve and positron emission tomographic patterns of perfusion and glucose utilization in chronic ischemic left ventricular dysfunction: implications for identification of myocardial viability. J Am Coll Cardiol. 1997, 30 (7): 1651-1659. 10.1016/S0735-1097(97)00373-2.CrossRefPubMed Melon PG, de Landsheere CM, Degueldre C, Peters JL, Kulbertus HE, Pierard LA: Relation between contractile reserve and positron emission tomographic patterns of perfusion and glucose utilization in chronic ischemic left ventricular dysfunction: implications for identification of myocardial viability. J Am Coll Cardiol. 1997, 30 (7): 1651-1659. 10.1016/S0735-1097(97)00373-2.CrossRefPubMed
24.
go back to reference Siebelink HM, Blanksma PK, Crijns HJ, Bax JJ, van Boven AJ, Kingma T, Piers DA, Pruim J, Jager PL, Vaalburg W, van der Wall EE: No difference in cardiac event-free survival between positron emission tomography-guided and single-photon emission computed tomography-guided patient management: a prospective, randomized comparison of patients with suspicion of jeopardized myocardium. J Am Coll Cardiol. 2001, 37 (1): 81-88. 10.1016/S0735-1097(00)01087-1.CrossRefPubMed Siebelink HM, Blanksma PK, Crijns HJ, Bax JJ, van Boven AJ, Kingma T, Piers DA, Pruim J, Jager PL, Vaalburg W, van der Wall EE: No difference in cardiac event-free survival between positron emission tomography-guided and single-photon emission computed tomography-guided patient management: a prospective, randomized comparison of patients with suspicion of jeopardized myocardium. J Am Coll Cardiol. 2001, 37 (1): 81-88. 10.1016/S0735-1097(00)01087-1.CrossRefPubMed
Metadata
Title
Comparison of 18F SPECT with PET in myocardial imaging: A realistic thorax-cardiac phantom study
Authors
Karin Knešaurek
Josef Machac
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Medical Physics / Issue 1/2006
Electronic ISSN: 1756-6649
DOI
https://doi.org/10.1186/1471-2385-6-5

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