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The current status of CZT SPECT myocardial blood flow and reserve assessment: Tips and tricks

Konstantin V Zavadovsky1,2, Andrew V Mochula3, Alina N Maltseva3

  • 1Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya Str 111A, Tomsk, 634012, Russia. konstzav@gmail.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|May 3, 2021
PubMed

Insights

Cadmium zinc telluride (CZT) SPECT imaging offers a faster, lower-radiation alternative for assessing myocardial blood flow (MBF) and myocardial flow reserve (MFR) in coronary artery disease (CAD). This review explores CZT SPECT

Area of Science:

  • Nuclear Cardiology
  • Medical Imaging Technology
  • Cardiovascular Disease Diagnostics

Background:

  • Cardiac PET provides robust myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements for coronary artery disease (CAD) severity and prognosis.
  • High cost and limited availability of PET hinder widespread clinical use.
  • Advances in cadmium zinc telluride (CZT) SPECT technology offer potential for improved myocardial perfusion imaging.

Purpose of the Study:

  • To review the current status of MBF and MFR assessment using CZT SPECT.
  • To provide an overview of acquisition, processing, and interpretation challenges for quantitative CZT SPECT in CAD patients.

Main Methods:

  • Review of existing literature on CZT SPECT for MBF and MFR quantification.
  • Comparison of CZT SPECT systems (e.g., Discovery NM530c, D-SPECT) and their technical specifications.
  • Analysis of studies correlating CZT SPECT with cardiac PET and invasive fractional flow reserve (FFR).

Main Results:

  • CZT SPECT enables faster myocardial perfusion scintigraphy with reduced radiation exposure.
  • Dynamic CZT SPECT studies can achieve higher count rates, improving image quality.
  • Feasibility and correlation of CZT SPECT MBF/MFR with PET and invasive FFR have been demonstrated in multiple publications.

Conclusions:

  • CZT SPECT represents a significant technological advancement for quantitative myocardial perfusion imaging.
  • This technology holds promise for wider clinical implementation in the assessment of CAD.
  • Standardization of acquisition, processing, and interpretation protocols is crucial for reliable MBF and MFR assessment with CZT SPECT.

Keywords:
CADCZTMyocardial blood flowMyocardial flow reserveMyocardial ischemiaSPECT

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