Feasibility of simultaneous 99mTc-tetrofosmin and 123I-BMIPP dual-tracer imaging with cadmium-zinc-telluride detectors in patients undergoing primary coronary intervention for acute myocardial infarction
Simultaneous dual-tracer imaging using isotopes with close photo-peaks may benefit from improved properties of cadmium-zinc-telluride (CZT)-based scanners.
Thirty patients having undergone primary percutaneous coronary intervention for acute myocardial infarction underwent single-(99mTc-tetrofosmin (TF) or 123I-BMIPP first) followed by simultaneous 99mTc-TF /123I-BMIPP dual-tracer imaging using a Discovery NM/CT 670 CZT. The values for the quantitative gated-SPECT (QGS) and the quantitative perfusion SPECT (QPS) were assessed.
The intra-class correlation (ICC) coefficients between the single- and dual-tracer imaging were high in all the QGS and QPS data (Summed motion score: 0.95, summed thickening score: 0.94, ejection fraction: 0.98, SRS for 99mTc-TF: 0.97/ for 123I-BMIPP: 0.95). Wall motion, wall thickening and rest scores per coronary-territory-based regions were also comparable between the single- and dual imaging (ICC coefficient > 0.91). The interrater concordance in the visual analysis for the infarction and perfusion-metabolism mismatch was significant for the global and regional left ventricle (P < 0.001).
The quantitative/semi-quantitative values for global and regional left-ventricular function, perfusion, and fatty acid metabolism were closely comparable between the dual-tracer imaging and the single-tracer mode. These data suggests the feasibility of the novel CZT-based scanner for the simultaneous 99mTc-TF /123I-BMIPP dual-tracer acquisitions in clinical settings.
KeywordsPerfusion-metabolism mismatch CZT camera acute myocardial infarction dual imaging
The authors acknowledged to technical staffs in the Saitama Medical University Hospital and Mr. Hideyasu Hosono (GE Healthcare) for their technical support in performing imaging examination and analysis.
- 5.Dobbeleir AA, Hambye AS, Franken PR. Influence of methodology on the presence and extent of mismatching between 99 mTc-MIBI and 123I-BMIPP in myocardial viability studies. J Nucl Med 1999;40:707-14.Google Scholar
- 6.Tamaki N, Tadamura E, Kawamoto M, Magata Y, Yonekura Y, Fujibayashi Y, et al. Decreased uptake of iodinated branched fatty acid analog indicates metabolic alterations in ischemic myocardium. J Nucl Med 1995;36:1974-80.Google Scholar
- 8.Franken PR, Dendale P, De Geeter F, Demoor D, Bossuyt A, Block P. Prediction of functional outcome after myocardial infarction using BMIPP and sestamibi scintigraphy. J Nucl Med 1996;37:718-22.Google Scholar
- 15.Chowdhury FU, Vaidyanathan S, Bould M, Marsh J, Trickett C, Dodds K, et al. Rapid-acquisition myocardial perfusion scintigraphy (MPS) on a novel gamma camera using multipinhole collimation and miniaturized cadmium-zinc-telluride (CZT) detectors: Prognostic value and diagnostic accuracy in a ‘real-world’ nuclear cardiology service. Eur Heart J Cardiovasc Imaging 2014;15:275-83.CrossRefGoogle Scholar
- 18.Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002;105:539-42.CrossRefGoogle Scholar
- 19.Sharir T, Berman DS, Waechter PB, Areeda J, Kavanagh PB, Gerlach J, et al. Quantitative analysis of regional motion and thickening by gated myocardial perfusion SPECT: Normal heterogeneity and criteria for abnormality. J Nucl Med 2001;42:1630-8.Google Scholar
- 20.Germano G, Kavanagh PB, Waechter P, Areeda J, Van Kriekinge S, Sharir T, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. I: Technical principles and reproducibility. J Nucl Med 2000;41:712-9.Google Scholar
- 21.Agostini D, Marie PY, Ben-Haim S, Rouzet F, Songy B, Giordano A, et al. Performance of cardiac cadmium-zinc-telluride gamma camera imaging in coronary artery disease: A review from the cardiovascular committee of the European Association of Nuclear Medicine (EANM). Eur J Nucl Med Mol Imaging 2016;43:2423-32.CrossRefGoogle Scholar
- 28.Neill J, Prvulovich EM, Fish MB, Berman DS, Slomka PJ, Sharir T, et al. Initial multicentre experience of high-speed myocardial perfusion imaging: Comparison between high-speed and conventional single-photon emission computed tomography with angiographic validation. Eur J Nucl Med Mol Imaging 2013;40:1084-94.CrossRefGoogle Scholar
- 31.Matsunari I, Saga T, Taki J, Akashi Y, Hirai J, Wakasugi T, et al. Improved myocardial fatty acid utilization after percutaneous transluminal coronary angioplasty. J Nucl Med 1995;36:1605-7.Google Scholar
- 33.Taki J, Nakajima K, Matsunari I, Bunko H, Takata S, Kawasuji M, et al. Assessment of improvement of myocardial fatty acid uptake and function after revascularization using iodine-123-BMIPP. J Nucl Med 1997;38:1503-10.Google Scholar
- 35.Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999;33:2092-197.CrossRefGoogle Scholar
- 36.Iwado H, Iwado Y, Ohmori K, Mizushige K, Yukiiri K, Takagi Y, et al. Latent abnormal fatty acid metabolism in apparently normal perfusion during stress in patients with restenosis after coronary angioplasty: Assessment by exercise stress thallium-201 and iodine-123-labeled 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid-dual myocardial single-photon emission computed tomography. Am J Cardiol 2004;93:685-8.CrossRefGoogle Scholar