Adding Attenuation Corrected Images with SPECT/CT and ECG-Gated in MPI is Usefull for Which Group of Patient?
Öz
Aim: There are large number of reasons which causes false positivity in myocardial perfusion imaging (MPI) as breast tissue and
diaphragm attenuation. In our study, we want to investigate that the factors which affect MPI rest recall, single photon emission
computerized tomography/computerized tomography (SPECT/CT) and electrocardiography ECG-Gated SPECT’s contribution.
Material and Methods: Between February 2012 and May 2013, 258 patient included the study who have done MPI SPECT/CT and
interpreted as normal study. The attenuation corrected (AC), non-attenuation-corrected (NAC) and ECG-Gated SPECT images were
analyzed separately and decided to rest MPI need or not. The relationship between body mass index (BMI), age and gender were
evaluated.
Results: When the NAC MPI images are evaluated alone, in 127 of 258 patient (49.2%) was found that they need rest MPI. When
we interpret AC images with SPECT/CT, this ratio fell down to 11.2%. When ECG-gated SPECT images added to AC with SPECT/
CT, this ratio decreases to 6.6% and these images provides the greatest contribution to the group of patients whose BMI <35kg/m².
Conclusion: We think that AC MPI with SPECT/CT and EKG -gated can be done especially for patients with BMI<35 kg/m².
Anahtar Kelimeler
Attenuation correction myocardial perfusion imaging SPECT/CT
Kaynakça
- 1. Sharma, Patel CD, Karunanithi S, Maharjan S, Malhotra A. Comparative accuracy of CT attenuation-corrected and non-attenuation-corrected SPECT myocardial perfusion imaging. Clinical Nuclear Medicine. 2012; 37(4): 332-8.
- 2. Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. Journal Of Nuclear Medicine Technology. 2006;34(4): 193-211.
- 3. DePuey EG. How to detect and avoid myocardial perfusion SPECT artifacts. Journal of Nuclear Medicine. 1994; 35(4): 699-702.
- 4. Berman DS, Kang X, Nishina H, Slomka PJ, Shaw LJ, Hayes SW et al. Diagnostic accuracy of gated Tc-99m sestamibi stress myocardial perfusion SPECT with combined supine and prone acquisitions to detect coronary artery disease in obese and nonobese patients. Journal of Nuclear Cardiology. 2006; 13(2): 191-201.
- 5. Links JM, DePuey EG, Taillefer R, Becker LC. Attenuation correction and gating synergistically improve the diagnostic accuracy of myocardial perfusion SPECT . Journal of Nuclear Cardiology. 2002; 9(2): 183-7.
- 6. Gaemperli O, Kaufmann PA, Alkadhi H. Cardiac hybrid imaging. European Journal of Nuclear Medicine and Molecular İmaging. 2014; 41(1): 91-103.
- 7. Ansheles AA. Specific features of interpretation of myocardial perfusion single-photon emission computed tomography with computed tomographic absorption correction. Vestnik Rentgenologii i Radiologii. 2014; (2): 5-20.
- 8. Bonow RO. Gated myocardial perfusion imaging for measuring left ventricular function. J Am Coll Cardiol. 1997; 30(7): 1649-50.
- 9. Gimelli A, Rossi G, Landi P, Marzullo P, Iervasi G, L’abbate A et al. Stress/Rest Myocardial Perfusion Abnormalities by Gated SPECT: Still the Best Predictor of Cardiac Events in Stable Ischemic Heart Disease. Journal of Nuclear Medicine. 2009; 50(4): 546-53.
- 10. Hedén B, Persson E, Carlsson M, Pahlm O, Arheden H. Disappearance of myocardial perfusion defects on prone SPECT imaging: comparison with cardiac magnetic resonance imaging in patients without established coronary artery disease. BMC Medical Imaging. 2009; 9: 1-9.
- 11. Heiba SI, Hayat NJ, Salman HS, Higazy E, Sayed ME, Saleh Z et al. Technetium-99m-MIBI myocardial SPECT: supine versus right lateral imaging and comparison with coronary arteriography. Journal of Nuclear Medicine. 1997; 38(10): 1510-4.
- 12. Notghi A, Low CS. Myocardial perfusion scintigraphy: past, present and future. Br J Radiol. 2011 ;84 Spec No 3(Spec Iss 3):229-36.
- 13. DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. Journal of Nuclear Medicine: official publication, Society of Nuclear Medicine. 1995; 36(6): 952-5.
- 14. Bateman TM, Cullom SJ. Attenuation correction single-photon emission computed tomography myocardial perfusion imaging. Semin Nucl Med. 2005;35(1):37-51.
- 15. Thompson RC, Heller GV, Johnson LL, Case JA, Cullom SJ, Garcia EV et al. Value of attenuation correction on ECG-gated SPECT myocardial perfusion imaging related to body mass index. Journal of Nuclear Cardiology. 2005; 12(2): 195-202.
- 16. Taillefer R, DePuey EG, Udelson JE, Beller GA, Latour Y, Reeves F. Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women. Journal of the American College of Cardiology. 1997; 29(1): 69-77.
- 17. Heller GV, Bateman TM, Johnson LL, Cullom SJ, Case JA, Galt JR, et al. Clinical value of attenuation correction in stress-only Tc-99m sestamibi SPECT imaging. J Nucl Cardiol. 2004; 11(3):273-81.
- 18. Huang R, Li F, Zhao Z, Liu B, Ou X, Tian R, Li L. Hybrid SPECT/ CT for attenuation correction of stress myocardial perfusion imaging. Clinical Nuclear Medicine. 2011; 36(5): 344-9.
- 19. Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology . Eur J Nucl Med Mol Imaging. 2005; 32: 855-97.
- 20. Rozanski A, Gransar H, Hayes SW, Min J, Friedman JD, Thomson LE et al.Temporal trends in the frequency of inducible myocardial ischemia during cardiac stress testing: 1991 to 2009. Journal of the American College of Cardiology. 2013; 61(10): 1054-65.
- 21. Bhavnani SP, Heller GV. Stress-only myocardial perfusion imaging. It is time for a change! Journal of Nuclear Cardiology. 2011; 18: 836-9.
- 22. Worsley DF1, Fung AY, Coupland DB, Rexworthy CG, Sexsmith GP, Lentle BC. Comparison of stress-only vs. stress/rest with technetium-99m methoxyisobutylisonitrile myocardial perfusion imaging. European Journal of Nuclear Medicine. 1992;19: 441-4.
- 23. Schroeder-Tanka JM, Tiel-van Buul MM, van der Wall EE, Roolker W, Lie KI, van Royen EA. Should imaging at stress always be followed by imaging at rest in Tc-99m MIBI SPECT? A proposal for a selective referral and imaging strategy. The International Journal of Cardiac Imaging. 1997; 13: 323-9.
- 24. Trägårdh E, Valind S, Edenbrandt L. Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study. BMC Medical Imaging. 2013; 13(1): 1-5.
MPS’de SPECT/BT ve EKG-Gated ile Atenüasyon Düzeltmeli̇ Görüntüleri̇n Eklenmesi̇ Hangi̇ Hasta Grubu İçi̇n Faydalıdır?
Öz
Amaç: Miyokard perfüzyon sintigrafisinde (MPS), meme dokusu atenüasyonu ve diyafragma atenüasyonu gibi yanlış pozitifliğe
neden olan çok sayıda neden vardır. Çalışmamızda MPS’de rest görüntülemeye çağırmada, Tek foton komputerize tomografi/Bilgisayarlı tomografi (SPECT/BT) ve elektrokardiyografi (EKG) gated Tek foton komputerize tomografi (SPECT)’yi etkileyen faktörlerin
katkısını araştırmak istedik.
Gereç ve Yöntemler: Şubat 2012 ve Mayıs 2013 tarihleri arasında MPS SPECT/BT yapılan ve normal çalışma olarak yorumlanan
258 hasta çalışmaya dahil edildi. Stres atenüasyon düzeltmeli (AD), atenüasyon düzeltmeli olmayan (NAD) ve EKG-gated SPECT
görüntüleri ayrı ayrı analiz edildi ve rest MPS gerekip gerekmediğine karar verildi. Ayrıca rest gerekliliği ile vücut kitle indeksi
(VKİ), yaş ve cinsiyet arasındaki ilişki değerlendirildi.
Bulgular: NAD MPS görüntüleri tek başına değerlendirildiğinde, 258 hastanın 127’sinde (%49.2) rest MPS ihtiyacı olduğu saptandı. MPS görüntüleri SPECT/BT ile yapılan AD ile yorumladığımızda bu oran %11.2’ye düştü. SPECT/BT’ye EKG-gated SPECT
görüntüleri eklendiğinde bu oranın %6.6’ya düşmekte olduğu ve bu görüntülerin VKİ<35kg/m² olan hasta grubunda en büyük katkıyı
sağladığı görüldü.
Sonuç: SPECT/BT ile yapılan AD ve EKG-Gated ile MPS’nin özellikle VKİ<35 kg/m² olan hastalar için faydalı olacağını düşünüyoruz.
Anahtar Kelimeler
Atenüasyon düzeltme Miyokard perfüzyon sintigrafisi SPECT/BT
Etik Beyan
Etik kurul onayı alınmıştır ve gerekli bölümde etik kurul onayı belgesi sisteme yüklenmiştir.
Destekleyen Kurum
Bu çalışmada herhangi bir kurum / kuruluştan destek alınmamıştır.
Kaynakça
- 1. Sharma, Patel CD, Karunanithi S, Maharjan S, Malhotra A. Comparative accuracy of CT attenuation-corrected and non-attenuation-corrected SPECT myocardial perfusion imaging. Clinical Nuclear Medicine. 2012; 37(4): 332-8.
- 2. Burrell S, MacDonald A. Artifacts and pitfalls in myocardial perfusion imaging. Journal Of Nuclear Medicine Technology. 2006;34(4): 193-211.
- 3. DePuey EG. How to detect and avoid myocardial perfusion SPECT artifacts. Journal of Nuclear Medicine. 1994; 35(4): 699-702.
- 4. Berman DS, Kang X, Nishina H, Slomka PJ, Shaw LJ, Hayes SW et al. Diagnostic accuracy of gated Tc-99m sestamibi stress myocardial perfusion SPECT with combined supine and prone acquisitions to detect coronary artery disease in obese and nonobese patients. Journal of Nuclear Cardiology. 2006; 13(2): 191-201.
- 5. Links JM, DePuey EG, Taillefer R, Becker LC. Attenuation correction and gating synergistically improve the diagnostic accuracy of myocardial perfusion SPECT . Journal of Nuclear Cardiology. 2002; 9(2): 183-7.
- 6. Gaemperli O, Kaufmann PA, Alkadhi H. Cardiac hybrid imaging. European Journal of Nuclear Medicine and Molecular İmaging. 2014; 41(1): 91-103.
- 7. Ansheles AA. Specific features of interpretation of myocardial perfusion single-photon emission computed tomography with computed tomographic absorption correction. Vestnik Rentgenologii i Radiologii. 2014; (2): 5-20.
- 8. Bonow RO. Gated myocardial perfusion imaging for measuring left ventricular function. J Am Coll Cardiol. 1997; 30(7): 1649-50.
- 9. Gimelli A, Rossi G, Landi P, Marzullo P, Iervasi G, L’abbate A et al. Stress/Rest Myocardial Perfusion Abnormalities by Gated SPECT: Still the Best Predictor of Cardiac Events in Stable Ischemic Heart Disease. Journal of Nuclear Medicine. 2009; 50(4): 546-53.
- 10. Hedén B, Persson E, Carlsson M, Pahlm O, Arheden H. Disappearance of myocardial perfusion defects on prone SPECT imaging: comparison with cardiac magnetic resonance imaging in patients without established coronary artery disease. BMC Medical Imaging. 2009; 9: 1-9.
- 11. Heiba SI, Hayat NJ, Salman HS, Higazy E, Sayed ME, Saleh Z et al. Technetium-99m-MIBI myocardial SPECT: supine versus right lateral imaging and comparison with coronary arteriography. Journal of Nuclear Medicine. 1997; 38(10): 1510-4.
- 12. Notghi A, Low CS. Myocardial perfusion scintigraphy: past, present and future. Br J Radiol. 2011 ;84 Spec No 3(Spec Iss 3):229-36.
- 13. DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. Journal of Nuclear Medicine: official publication, Society of Nuclear Medicine. 1995; 36(6): 952-5.
- 14. Bateman TM, Cullom SJ. Attenuation correction single-photon emission computed tomography myocardial perfusion imaging. Semin Nucl Med. 2005;35(1):37-51.
- 15. Thompson RC, Heller GV, Johnson LL, Case JA, Cullom SJ, Garcia EV et al. Value of attenuation correction on ECG-gated SPECT myocardial perfusion imaging related to body mass index. Journal of Nuclear Cardiology. 2005; 12(2): 195-202.
- 16. Taillefer R, DePuey EG, Udelson JE, Beller GA, Latour Y, Reeves F. Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women. Journal of the American College of Cardiology. 1997; 29(1): 69-77.
- 17. Heller GV, Bateman TM, Johnson LL, Cullom SJ, Case JA, Galt JR, et al. Clinical value of attenuation correction in stress-only Tc-99m sestamibi SPECT imaging. J Nucl Cardiol. 2004; 11(3):273-81.
- 18. Huang R, Li F, Zhao Z, Liu B, Ou X, Tian R, Li L. Hybrid SPECT/ CT for attenuation correction of stress myocardial perfusion imaging. Clinical Nuclear Medicine. 2011; 36(5): 344-9.
- 19. Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology . Eur J Nucl Med Mol Imaging. 2005; 32: 855-97.
- 20. Rozanski A, Gransar H, Hayes SW, Min J, Friedman JD, Thomson LE et al.Temporal trends in the frequency of inducible myocardial ischemia during cardiac stress testing: 1991 to 2009. Journal of the American College of Cardiology. 2013; 61(10): 1054-65.
- 21. Bhavnani SP, Heller GV. Stress-only myocardial perfusion imaging. It is time for a change! Journal of Nuclear Cardiology. 2011; 18: 836-9.
- 22. Worsley DF1, Fung AY, Coupland DB, Rexworthy CG, Sexsmith GP, Lentle BC. Comparison of stress-only vs. stress/rest with technetium-99m methoxyisobutylisonitrile myocardial perfusion imaging. European Journal of Nuclear Medicine. 1992;19: 441-4.
- 23. Schroeder-Tanka JM, Tiel-van Buul MM, van der Wall EE, Roolker W, Lie KI, van Royen EA. Should imaging at stress always be followed by imaging at rest in Tc-99m MIBI SPECT? A proposal for a selective referral and imaging strategy. The International Journal of Cardiac Imaging. 1997; 13: 323-9.
- 24. Trägårdh E, Valind S, Edenbrandt L. Adding attenuation corrected images in myocardial perfusion imaging reduces the need for a rest study. BMC Medical Imaging. 2013; 13(1): 1-5.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Kardiyoloji , Nükleer Tıp |
| Bölüm | Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 5 Aralık 2023 |
| Gönderilme Tarihi | 8 Kasım 2023 |
| Kabul Tarihi | 16 Kasım 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 8 Sayı: 4 |
