Quantification of myocardial blood flow by CZT-SPECT with motion correction and comparison with 15O-water PET

J Nucl Cardiol. 2021 Aug;28(4):1477-1486. doi: 10.1007/s12350-019-01854-1. Epub 2019 Aug 26.

Abstract

Background: We compared quantification of MBF and myocardial flow reserve (MFR) with a 99mTc-sestamibi CZT-SPECT to 15O-water PET.

Methods: SPECT MBF for thirty patients in the WATERDAY study was re-analyzed by QPET software with motion correction and optimal placement of the arterial input function. 15O-water PET MBF was re-quantified using dedicated software. Inter-operator variability was assessed using repeatability coefficients (RPC).

Results: Significant correlations were observed between global (r = 0.91, P < 0.001) and regional MBF (r = 0.86, P < 0.001) with SPECT compared to PET. Global MBF (rest 0.95 vs 1.05 ml/min/g, P = 0.07; stress 2.62 vs 2.68 mL/min/g, P = 0.17) and MFR (2.65 vs 2.75, P = 0.86) were similar between SPECT and PET. Rest (0.81 vs 0.98 mL/min/g, P = 0.03) and stress MBF (1.98 vs 2.61 mL/min/g, P = 0.01) in right coronary artery (RCA) were lower with SPECT compared to PET. However, MFR in the RCA territory was similar (2.54 vs 2.77, P = 0.21). The SPECT-PET RPC for global MBFs and MFR were 0.95 mL/min/g and 0.94, with inter-observer RPC of 0.59 mL/min/g and 0.74, respectively.

Conclusions: MBF and MFR derived from CZT-SPECT with motion correction and optimal placement of the arterial input function showed good agreement with 15O-water PET, as well as low inter-operator variability.

Keywords: Myocardial blood flow; positron emission tomography; single-photon emission computed tomography.

MeSH terms

  • Aged
  • Algorithms
  • Cadmium*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / physiopathology*
  • Female
  • Fractional Flow Reserve, Myocardial / physiology*
  • Humans
  • Male
  • Middle Aged
  • Motion
  • Myocardial Perfusion Imaging*
  • Observer Variation
  • Oxygen Radioisotopes
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Technetium Tc 99m Sestamibi
  • Tellurium*
  • Tomography, Emission-Computed, Single-Photon*
  • Water
  • Zinc*

Substances

  • CdZnTe
  • Oxygen Radioisotopes
  • Radiopharmaceuticals
  • Cadmium
  • Water
  • Technetium Tc 99m Sestamibi
  • Zinc
  • Tellurium