Myocardial blood flow quantitation in patients with congestive heart failure: head-to-head comparison between rapid-rotating gantry SPECT and CZT SPECT

Abstract

Purpose: Recently, the feasibility of myocardial blood flow (MBF) quantitation using rapid-rotating gantry (RRG) and cadmium-zinc-telluride (CZT) SPECT cameras has been demonstrated. We compared MBF quantitation using these two camera systems.

Methods: Twenty patients with congestive heart failure (CHF) and 20 patients without CHF (non-CHF) were included. On two consecutive days, dynamic SPECT imaging was performed after a bolus injection of 20 mCi of ^99mTc-Sestamibi (MIBI) with RRG-SPECT and list-mode acquisition with CZT-SPECT. All dynamic SPECT images were reconstructed with full physical corrections, corrections for ventricular spillover and partial volume effect, using one-tissue kinetic modeling. Resting MBF converted from K1 was then corrected for MIBI extraction fraction and adjusted for rate-pressure product.

Results: In both patient groups, there was no significant difference between resting MBF values measured with RRG-SPECT and CZT-SPECT systems (P = 0.06, P = 0.2 respectively). For CHF patients, linear regression (LR) was y(RRG) = 1.0412x (CZT) (r = 0.97) with a small systemic difference (Δ = 0.03 mL·min^-1·g^-1, 95% CI - 0.11 to 0.20) by Bland-Altman analysis. For non-CHF patients, LR was y(RRG) = 1.025x (CZT) (r = 0.89) with also small systemic difference (ΔT= 0.02 mL·min^-1·g^-1, 95% CI - 0.14 to 0.19) in BA analysis.

Conclusion: Physical corrections along with other image corrections can provide comparable MBF quantitations in both CHF and non-CHF patients, regardless of the type of SPECT systems used.

Keywords: CZT SPECT; SPECT myocardial blood flow quantitation; congestive heart failure; correction of 99mTc-Sestamibi extraction fraction; corrections of left and right ventricle spillovers; physical corrections; rapid-rotating SPECT.