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01-04-2015 | Original Article

Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study

Authors: Ryo Nakazato, MD, PhD, Piotr J. Slomka, PhD, Mathews Fish, MD, Ronald G. Schwartz, MD, MS, Sean W. Hayes, MD, Louise E. J. Thomson, MD, John D. Friedman, MD, Mark Lemley Jr., BS, Maria L. Mackin, CNMT, RT(N), Benjamin Peterson, MD, Arielle M. Schwartz, BS, Jesse A. Doran, MD, Guido Germano, PhD, Daniel S. Berman, MD

Published in: Journal of Nuclear Cardiology | Issue 2/2015

Abstract

Background

Obesity is a common source of artifact on conventional SPECT myocardial perfusion imaging (MPI). We evaluated image quality and diagnostic performance of high-efficiency (HE) cadmium-zinc-telluride parallel-hole SPECT MPI for coronary artery disease (CAD) in obese patients.

Methods and Results

118 consecutive obese patients at three centers (BMI 43.6 ± 8.9 kg·m⁻², range 35-79.7 kg·m⁻²) had upright/supine HE-SPECT and invasive coronary angiography > 6 months (n = 67) or low likelihood of CAD (n = 51). Stress quantitative total perfusion deficit (TPD) for upright (U-TPD), supine (S-TPD), and combined acquisitions (C-TPD) was assessed. Image quality (IQ; 5 = excellent; < 3 nondiagnostic) was compared among BMI 35-39.9 (n = 58), 40-44.9 (n = 24) and ≥45 (n = 36) groups. ROC curve area for CAD detection (≥50% stenosis) for U-TPD, S-TPD, and C-TPD were 0.80, 0.80, and 0.87, respectively. Sensitivity/specificity was 82%/57% for U-TPD, 74%/71% for S-TPD, and 80%/82% for C-TPD. C-TPD had highest specificity (P = .02). C-TPD normalcy rate was higher than U-TPD (88% vs 75%, P = .02). Mean IQ was similar among BMI 35-39.9, 40-44.9 and ≥45 groups [4.6 vs 4.4 vs 4.5, respectively (P = .6)]. No patient had a nondiagnostic stress scan.

Conclusions

In obese patients, HE-SPECT MPI with dedicated parallel-hole collimation demonstrated high image quality, normalcy rate, and diagnostic accuracy for CAD by quantitative analysis of combined upright/supine acquisitions.

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Title: Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study
Authors: Ryo Nakazato, MD, PhD
Piotr J. Slomka, PhD
Mathews Fish, MD
Ronald G. Schwartz, MD, MS
Sean W. Hayes, MD
Louise E. J. Thomson, MD
John D. Friedman, MD
Mark Lemley Jr., BS
Maria L. Mackin, CNMT, RT(N)
Benjamin Peterson, MD
Arielle M. Schwartz, BS
Jesse A. Doran, MD
Guido Germano, PhD
Daniel S. Berman, MD
Publication date: 01-04-2015
Publisher: Springer US
Published in: Journal of Nuclear Cardiology / Issue 2/2015
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-014-9984-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative high-efficiency cadmium-zinc-telluride SPECT with dedicated parallel-hole collimation system in obese patients: Results of a multi-center study

Abstract

Background

Methods and Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and Results

Conclusions

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