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

J.D. van Dijk, P.L. Jager, M. Mouden, C.H. Slump, J.P. Ottervanger, J. de Boer, A.H.J. Oostdijk, J.A. van Dalen

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    22 Citations (Scopus)

    Abstract

    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 languageEnglish
    Pages (from-to)1158-1167
    Number of pages10
    JournalJournal of nuclear cardiology
    Volume21
    Issue number6
    DOIs
    Publication statusPublished - 9 Jul 2014

    Keywords

    • SPECT
    • Myocardial perfusion imaging (MPI)
    • 8
    • CdZnTe
    • Activity
    • Dose

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