Assessment of absolute myocardial blood blow with a dedicated CZT cardiac gamma camera: Methods and potential...

Non-invasive techniques for the evaluation of myocardial perfusion provide key functional information for the diagnosis of coronary disease and the stratification of risk in ischemic cardiopathy. Nonetheless, despite their adequate diagnostic performance, the myocardial perfusion images present limitations in the detection of balanced ischemia due to multivessel disease and in the assessment of microvascular pathology. Evaluation of the parameters of myocardial blood flow (MBF) and myocardial flow reserve may be useful in cases in which the technique is limited due to balanced coronary disease or in patients with healthy coronary arteries and suspicion of microvascular involvement. The greater spatial resolution and energy and greater sensitivity of the new generation cadmium-zinc-telluride gamma cameras compared to conventional equipment allow isotopic evaluation by single photon emission computed tomography of microvascular disease, which, previously, was mainly evaluated with the gold standard technique of positron emission tomography. The aim of this article of collaboration is to describe the protocol for the quantification of MBF developed by the Department of Nuclear Medicine of the Hospital Vall d'Hebron using a cardio-dedicated gamma camera (MyoSPECT™- GE HealthCare), highlighting the particularities of the acquisition of post-processing of the images as well as the possible artifacts.