TY - JOUR
T1 - Technical aspects of myocardial spect imaging with technetium-99m sestamibi
AU - Garcia, Ernest V.
AU - Cooke, C. David
AU - Van Train, Kenneth F.
AU - Folks, Russell
AU - Peifer, John
AU - DePuey, E. Gordon
AU - Maddahi, Jamshid
AU - Alazraki, Naomi
AU - Galt, James
AU - Ezquerra, Norberto
AU - Ziffer, Jack
AU - Areeda, Joseph
AU - Berman, Daniel S.
N1 - Funding Information:
From Emory University School of Medicine, Atlanta, Georgia; Cedars-Sinai Medical Center, Los Angeles, California; Georgia Institute of Technology, Atlanta, Georgia; and St. Luke’s Medical Center, New York, New York. This study was supported in part by grants ROl-HL42052 and ROI-HL41628 from the National Institutes of Health, Bethesda, Maryland, as well as a grant from E. 1. du Pont de Nemours & Co., North Billerica, Massachusetts. Address for reprints: Ernest V. Garcia, PhD, Emory University Hospital, Division of Nuclear Medicine, 1364 Clifton Road, N.E., Atlanta, Georgia 30322.
PY - 1990/10/16
Y1 - 1990/10/16
N2 - Most reports to date using single photon emission computed tomography (SPECT) with technetium-99m (Tc-99m) sestamibi have used acquisition parameters that were optimized for thallium-201. To fully utilize the superior imaging characteristics of Tc-99m sestamibi, there is a need to optimize the technical aspects of SPECT imaging for this agent. Performance can be enhanced through the careful selection of optimal radiopharmaceutical doses, imaging sequences, acquisition parameters, reconstruction filters, perfusion quantification methods and multidimensional methods for visualizing perfusion distribution. The current report describes theoretical considerations, phantom studies and preliminary patient results that have led to optimized protocols, developed at Emory University and Cedars-Sinai Medical Center, for same-day reststress studies, given existing instrumentation and recommended dose limits. The optimizations were designed to fit a low-dose-high-dose rest-stress same-day imaging protocol. A principal change in the acquisition parameters compared with previous Tc-99m sestamibi protocols is the use of a highresolution collimator. The approach is being developed in both prone and supine positions. A new method for extracting a 3-dimensional myocardial count distribution has been developed that uses spherical coordinates to sample the apical region and cylindrical coordinates to sample the rest of the myocardium. New methods for visualizing the myocardial distribution in multiple dimensions are also described, with improved 2-dimensional, as well as 3- and 4-dimensional (3 dimensions plus time) displays. In the improved 2-dimensional display, distance-weighted and volume-weighted polar maps are used that appear to significantly improve the representation of defect location and defect extent, respectively. The protocols established and the methods developed for acquisition, quantification and display of Tc-99m sestamibi SPECT should provide improved image quality and accuracy, compared to current thallium-201 and Tc-99m sestamibi studies reported to date.
AB - Most reports to date using single photon emission computed tomography (SPECT) with technetium-99m (Tc-99m) sestamibi have used acquisition parameters that were optimized for thallium-201. To fully utilize the superior imaging characteristics of Tc-99m sestamibi, there is a need to optimize the technical aspects of SPECT imaging for this agent. Performance can be enhanced through the careful selection of optimal radiopharmaceutical doses, imaging sequences, acquisition parameters, reconstruction filters, perfusion quantification methods and multidimensional methods for visualizing perfusion distribution. The current report describes theoretical considerations, phantom studies and preliminary patient results that have led to optimized protocols, developed at Emory University and Cedars-Sinai Medical Center, for same-day reststress studies, given existing instrumentation and recommended dose limits. The optimizations were designed to fit a low-dose-high-dose rest-stress same-day imaging protocol. A principal change in the acquisition parameters compared with previous Tc-99m sestamibi protocols is the use of a highresolution collimator. The approach is being developed in both prone and supine positions. A new method for extracting a 3-dimensional myocardial count distribution has been developed that uses spherical coordinates to sample the apical region and cylindrical coordinates to sample the rest of the myocardium. New methods for visualizing the myocardial distribution in multiple dimensions are also described, with improved 2-dimensional, as well as 3- and 4-dimensional (3 dimensions plus time) displays. In the improved 2-dimensional display, distance-weighted and volume-weighted polar maps are used that appear to significantly improve the representation of defect location and defect extent, respectively. The protocols established and the methods developed for acquisition, quantification and display of Tc-99m sestamibi SPECT should provide improved image quality and accuracy, compared to current thallium-201 and Tc-99m sestamibi studies reported to date.
UR - http://www.scopus.com/inward/record.url?scp=0025027892&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(90)90608-4
DO - 10.1016/0002-9149(90)90608-4
M3 - Article
C2 - 2145742
AN - SCOPUS:0025027892
SN - 0002-9149
VL - 66
SP - E23-E31
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 13
ER -