Value of attenuation correction in stress-only myocardial perfusion imaging using CZT-SPECT

J.D. van Dijk*, M. Mouden, J.P. Ottervanger, J.A. van Dalen, S. Knollema, C.H. Slump, P.L. Jager

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Background: Attenuation correction (AC) improves the diagnostic outcome of stress-only myocardial perfusion imaging (MPI) using conventional SPECT. Our aim was to determine the value of AC using a cadmium zinc telluride-based (CZT)-SPECT camera.

    Methods and results: We retrospectively included 107 consecutive patients who underwent stress-optional rest MPI CZT-SPECT/CT. Next, we created three types of images for each patient; (1) only displaying reconstructed data without the CT-based AC (NC), (2) only displaying AC, and (3) with both NC and AC (NC + AC). Next, two experienced physicians visually interpreted these 321 randomized images as normal, equivocal, or abnormal. Image outcome was compared with all hard events over a mean follow-up time of 47.7 ± 9.8 months. The percentage of images interpreted as normal increased from 45% using the NC images to 72% using AC and to 67% using NC + AC images (P < .001). Hard event hazard ratios for images interpreted as normal were not different between using NC and AC (1.01, P = .99), or NC and NC + AC images (0.97, P = .97).

    Conclusions: AC lowers the need for additional rest imaging in stress-first MPI using CZT-SPECT, while long-term patient outcome remained identical. Use of AC reduces the need for additional rest imaging, decreasing the mean effective dose by up to 1.2 mSv.

    Original languageEnglish
    Pages (from-to)395-401
    Number of pages7
    JournalJournal of nuclear cardiology
    Issue number2
    Publication statusPublished - 1 Apr 2017


    • Attenuation correction
    • CdZnTe
    • Myocardial perfusion imaging: SPECT
    • Stress-only


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