Feasibility of simultaneous dual isotope acquisition for myocardial perfusion imaging with a cadmium zinc telluride camera.

Author(s) Songy, B.; Guernou, M.; Lussato, D.; Queneau, M.; Bonardel, G.; Grellier, J.F.; Flahaut, L.; Nguyen, D.
Journal J Nucl Cardiol
Date Published 2018 Nov 26

BACKGROUND: We studied the impact of technetium-99m (Tc) in the thallium-201 (Tl) energy window (70 keV) to determine if CZT cardiac cameras allow us to perform simultaneous dual-isotope acquisition for myocardial perfusion imaging.

METHODS: We included 117 consecutive patients. We injected 0.7 MBq/kg of Tl at stress, performed the first scan (image T1), then injected at rest 2 MBq/kg of Tc-tetrofosmin and immediately acquired a second scan with reconstruction in the energy window of thallium (image T2). A corrected thallium image was created by the subtraction of Tc downscattered photons (image TS). We compared spectra, image quality, and semiquantitative scores on T1, T2, and TS images.

RESULTS: Though T2 images were of worse quality, TS images were of equal quality compared to T1 images in most cases. Scores show an underestimation of abnormalities in 20% of patients on T2 images and in 10% on TS images.

CONCLUSIONS: Despite the improved energy resolution of CZT cameras, downscatter of technetium in the Tl window leads to an underestimation of the pathological territory in 10% to 20% of cases. It does not allow us to use simultaneous dual-isotope acquisition in clinical practice without additional tools for scatter correction.

DOI 10.1007/s12350-018-1452-z
ISSN 1532-6551
Citation J Nucl Cardiol. 2018.

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