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Dose-consistent dynamic SPECT.

A Krakovich1, E Gelbart2, I Moalem3

  • 1Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel. krakovich@mail.tau.ac.il.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|December 8, 2022
PubMed
Summary

Dynamic SPECT coronary flow reserve (CFR) measurements can vary significantly for individual patients. Optimizing region-of-interest positioning in dose-consistent dynamic SPECT may reduce this variability and improve accuracy.

Keywords:
CADSPECTcoronary flow reserve (CFR)myocardial blood flow (MBF)myocardial flow reserve

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Area of Science:

  • Nuclear cardiology
  • Cardiovascular imaging
  • Radiopharmaceutical dosimetry

Background:

  • Coronary flow reserve (CFR) measurements using dynamic SPECT often show patient-specific discrepancies compared to other modalities.
  • Arterial input function (AIF) region-of-interest (ROI) positioning is a potential source of variability in CFR.
  • Investigating ROI placement relative to injected radiotracer doses is crucial for accurate CFR assessment.

Purpose of the Study:

  • To introduce and demonstrate a dose-consistent dynamic SPECT methodology.
  • To evaluate the impact of different ROI positions on CFR measurements.
  • To assess the consistency of CFR with patient-specific injected radiotracer doses.

Main Methods:

  • A dose-consistent dynamic SPECT methodology was developed and applied.
  • A clinical study involving twenty patients was conducted.
  • The influence of various ROI placements on CFR was analyzed and compared to myocardial perfusion imaging.

Main Results:

  • Mean AIF ratios correlated well with injected dose ratios across all ROI positions.
  • Good agreement (>80%) was observed between total perfusion deficit and CFR for obstructive coronary artery disease (CAD) detection.
  • Individual patient CFR values varied significantly (typically 30%) based on ROI selection, while methodology uncertainty remained low (~7%).

Conclusions:

  • Dose-consistent dynamic SPECT offers a framework for quantifying CFR measurement uncertainty.
  • Improved ROI positioning within this framework may reduce individual patient variability in CFR.
  • This approach has the potential to enhance the reliability of CFR assessments in clinical practice.