Rest myocardial perfusion/metabolism imaging using simultaneous dual-isotope acquisition SPECT with technetium-99m-MIBI/fluorine-18-FDG

J Nucl Med. 1995 Nov;36(11):2110-9.

Abstract

The purpose of this study was to develop a dual-isotope simultaneous acquisition (DISA) protocol using a multihead SPECT camera equipped with an ultrahigh-energy (UHE) collimator to evaluate simultaneously rest cardiac perfusion and metabolism with 99mTc-MIBI/18FDG.

Methods: Physical measurements were first performed with phantoms to develop the acquisition protocol. Fifteen patients underwent DISA-SPECT with 99mTc-MIBI/18FDG to validate the protocol. To evaluate the quality of the 99mTc-MIBI images acquired with the UHE collimator, four patients underwent a resting 99mTc-MIBI scan acquired with a high-resolution, low-energy collimator prior to DISA-SPECT.

Results: With a window of 20% for both photopeaks and a 99mTc/18F concentration ratio of 3.2:1, the spillover from 18F into the 99mTc window is 6% of the counts in the window for normal subjects. Phantom images clearly demonstrated defects measuring 2 x 1 and 2 x 0.5 cm. Technetium-99m-MIBI images obtained with the UHE and high-resolution collimators provided similar diagnostic information. Using a stenosis of > 70% as criteria to diagnose coronary artery disease, DISA-SPECT had a sensitivity of 100% and a positive predictive value of 93%.

Conclusion: Simultaneous evaluation of rest myocardial perfusion/metabolism with a multihead SPECT camera equipped with an UHE collimator is possible using 99mTc-MIBI/18FDG with a dual-isotope simultaneous acquisition protocol.

MeSH terms

  • Deoxyglucose / analogs & derivatives*
  • Feasibility Studies
  • Female
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18
  • Heart / diagnostic imaging*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnostic imaging*
  • Myocardial Ischemia / metabolism
  • Myocardium / metabolism
  • Phantoms, Imaging
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*
  • Tomography, Emission-Computed, Single-Photon / instrumentation
  • Tomography, Emission-Computed, Single-Photon / methods*

Substances

  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Technetium Tc 99m Sestamibi
  • Deoxyglucose