Upper reference limits of transient ischemic dilation ratio for different protocols on new-generation cadmium zinc telluride cameras: A report from REFINE SPECT registry.

Author(s) Hu, L.H.; Sharir, T.; Miller, R.J.H.; Einstein, A.J.; Fish, M.B.; Ruddy, T.D.; Dorbala, S.; Di Carli, M.; Kaufmann, P.A.; Sinusas, A.J.; Miller, E.J.; Bateman, T.M.; Betancur, J.; Germano, G.; Liang, J.X.; Commandeur, F.; Azadani, P.N.; Gransar, H.; Otaki, Y.; Tamarappoo, B.K.; Dey, D.; Berman, D.S.; Slomka, P.J.
Journal J Nucl Cardiol
Date Published 2019 May 13

BACKGROUND: Upper reference limits for transient ischemic dilation (TID) have not been rigorously established for cadmium-zinc-telluride (CZT) camera systems. We aimed to derive TID limits for common myocardial perfusion imaging protocols utilizing a large, multicenter registry (REFINE SPECT).

METHODS: One thousand six hundred and seventy-two patients with low likelihood of coronary artery disease with normal perfusion findings were identified. Images were processed with Quantitative Perfusion SPECT software (Cedars-Sinai Medical Center, Los Angeles, CA). Non-attenuation-corrected, camera-, radiotracer-, and stress protocol-specific TID limits in supine position were derived from 97.5th percentile and mean + 2 standard deviations (SD). Reference limits were compared for different solid-state cameras (D-SPECT vs. Discovery), radiotracers (technetium-99m-sestamibi vs. tetrofosmin), different types of stress (exercise vs. four different vasodilator-based protocols), and different vasodilator-based protocols.

RESULTS: TID measurements did not follow Gaussian distribution in six out of eight subgroups. TID limits ranged from 1.18 to 1.52 (97.5th percentile) and 1.18 to 1.39 (mean + 2SD). No difference was noted between D-SPECT and Discovery cameras (P = 0.71) while differences between exercise and vasodilator-based protocols (adenosine, regadenoson, or regadenoson-walk) were noted (all P < 0.05).

CONCLUSIONS: We used a multicenter registry to establish camera-, radiotracer-, and protocol-specific upper reference limits of TID for supine position on CZT camera systems. Reference limits did not differ between D-SPECT and Discovery camera.

DOI 10.1007/s12350-019-01730-y
ISSN 1532-6551
Citation J Nucl Cardiol. 2019.

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