Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using czt-spect

Joris David van Dijk, J.D. van Dijk, A. Iskandrian (Editor), P.L. de Jager, M. Mouden, Cornelis H. Slump, J.P. Ottervanger, J. Boer, A.H.J. Oostdijk, J.A. van Dalen

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    Background: Guidelines for SPECT myocardial perfusion imaging (MPI) traditionally recommend a fixed tracer dose. Yet, clinical practice shows degraded image quality in heavier patients. The aim was to optimize and validate the tracer dose and scan time to obtain a constant image quality less dependent on patients’ physical characteristics. Methods: 125 patients underwent Cadmium Zinc Telluride (CZT)-SPECT stress MPI using a fixed Tc-99m-tetrofosmin tracer dose. Image quality was scored by three physicians on a 4-point grading scale and related to the number of photon counts normalized to tracer dose and scan time. Counts were correlated with various patient-specific parameters dealing with patient size and weight to find the best predicting parameter. From these data, a formula to provide constant image quality was derived, and subsequently tested in 92 new patients. Results: Degradation in image quality and photon counts was observed for heavier patients for all patients’ specific parameters (P < .01). We found body weight to be the best-predicting parameter for image quality and derived a new dose formula. After applying this new body weight-depended tracer dose and scan time in a new group, image quality was found to be constant (P > .19) in all patients. Conclusions: Also in CZT SPECT image quality decreases with weight. The use of a tracer dose and scan time that depends linearly on patient’s body weight corrected for the varying image quality in CZT-SPECT MPI. This leads to better radiation exposure justification.
    Original languageUndefined
    Pages (from-to)1158-1167
    Number of pages10
    JournalJournal of nuclear cardiology
    Issue number6
    Publication statusPublished - 9 Jul 2014


    • EWI-25396
    • SPECT
    • myocardial perfusion imaging
    • METIS-309708
    • IR-93067
    • CdZnTe
    • Activity
    • dose

    Cite this

    van Dijk, J. D., van Dijk, J. D., Iskandrian, A. (Ed.), de Jager, P. L., Mouden, M., Slump, C. H., ... van Dalen, J. A. (2014). Development and validation of a patient-tailored dose regime in myocardial perfusion imaging using czt-spect. Journal of nuclear cardiology, 21(6), 1158-1167.