Journal of Nuclear Cardiology

, Volume 24, Issue 1, pp 245–251 | Cite as

Comparison of the prognostic value of myocardial perfusion imaging using a CZT-SPECT camera with a conventional anger camera

  • Ronaldo Lima
  • Thais Peclat
  • Thalita Soares
  • Caio Ferreira
  • Ana Carolina Souza
  • Gabriel Camargo
Original Article



Recent studies have shown that myocardial perfusion imaging (MPI) in cadmium-zinc-telluride (CZT) cameras allow faster exams with less radiation dose but there are little data comparing its prognosis information with that of dedicated cardiac Na-I SPECT cameras


The objective of this study is to compare the prognostic value of MPI using an ultrafast protocol with low radiation dose in a CZT-SPECT and a traditional one.


Group 1 was submitted to a two-day MIBI protocol in a conventional camera, and group 2 was submitted to a 1-day MIBI protocol in CZT camera. MPI were classified as normal or abnormal, and perfusion scores were calculated. Propensity score matching methods were performed


3554 patients were followed during 33±8 months. Groups 1 and 2 had similar distribution of age, gender, body mass index, risk factors, previous revascularization, and use of pharmacological stress. Group 1 had more abnormal scans, higher scores than group 2. Annualized hard events rate was higher in group 1 with normal scans but frequency of revascularization was similar to normal group 2. Patients with abnormal scans had similar event rates in both groups


New protocol of MPI in CZT-SPECT showed similar prognostic results to those obtained in dedicated cardiac Na-I SPECT camera, with lower prevalence of hard events in patients with normal scan.


myocardial perfusion imaging coronary artery disease SPECT 



Myocardial perfusion imaging


Coronary artery disease


Single-photon emission computed tomography




Body mass index


Percutaneous coronary intervention


Coronary artery bypass surgery



The authors had no financial support for this research. The authors would like to thanks Dr. Ilan Gottlieb for his review and valuable suggestions.

Compliance with Ethical Standards


The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

12350_2016_618_MOESM1_ESM.pptx (610 kb)
Supplementary material 1 (PPTX 610 kb)


  1. 1.
    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. J Nucl Med. 2009;50(4):546–53.CrossRefPubMedGoogle Scholar
  2. 2.
    Underwood SR, Godman B, Salyani S, Ogle JR, Ell PJ. Economics of myocardial perfusion imaging in Europe—the EMPIRE Study. Eur Heart J. 1999;20(2):157–66.CrossRefPubMedGoogle Scholar
  3. 3.
    De Puey EG. Advances in SPECT camera software and hardware: Currently available and new on the horizon. J Nucl Cardiol. 2012;19(3):551–81.CrossRefGoogle Scholar
  4. 4.
    Duvall WL, Croft LB, Ginsberg ES, Einstein AJ, Guma KA, George T, et al. Reduced isotope dose and imaging time with a high-efficiency CZT SPECT camera. J Nucl Cardiol. 2011;18(5):847–57.CrossRefPubMedGoogle Scholar
  5. 5.
    Herzog BA, Buechel RR, Katz R, Brueckner M, Husmann L, Burger IA, et al. Nuclear myocardial perfusion imaging with a cadmium-zinc-telluride detector technique: optimized protocol for scan time reduction. J Nucl Med. 2010;51(1):46–51.CrossRefPubMedGoogle Scholar
  6. 6.
    Slomka PJ, Patton JA, Berman DS, Germano G. Advances in technical aspects of myocardial perfusion SPECT imaging. J Nucl Cardiol. 2009;16(2):255–76.CrossRefPubMedGoogle Scholar
  7. 7.
    De Lorenzo A, Peclat T, Amaral AC, Lima RSL. Prognostic evaluation in obese patients using a dedicated multipinhole cadmium-zinc telluride SPECT camera. Int J Cardiovasc Imaging. 2015;2015:1–7.Google Scholar
  8. 8.
    Diamond GA, Forrester JS, Hirsch M, Staniloff HM, Vas R, Berman DS, et al. Application of conditional probability analysis to the clinical diagnosis of coronary artery disease. J Clin Investig. 1980;65(5):1210–21.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Lima R, De Lorenzo A, Camargo G, Oliveira G, Reis T, Peclat T, et al. Prognostic value of myocardium perfusion imaging with a new reconstruction algorithm. J Nucl Cardiol. 2014;21(1):149–57.CrossRefPubMedGoogle Scholar
  10. 10.
    Henzlova MJ, Cerqueira MD, Hansen CL, Taillefer R, Yao S-S. ASNC imaging guidelines for nuclear cardiology procedures: stress protocols and tracers. J Nucl Cardiol. 2009. doi: 10.1007/s12350-009-9062-4.Google Scholar
  11. 11.
    Lima R, Peclat T, Amaral AC, Nakamoto A, Lavagnoli D, De Lorenzo A. Preliminary data on the prognostic value of a new protocol of ultra-fast myocardial scintigraphy with less radiation in CZT gamma camera. Arq Bras Cardiol: Im Cardiov. 2016;29(1):11–6.Google Scholar
  12. 12.
    Thygesen K, Alpert JS, White HD. Universal definitions of myocardial infarction. J Am Coll Cardiol. 2007;50:2173–95.CrossRefPubMedGoogle Scholar
  13. 13.
    Douglas PS, Hendel RC, Cummings JE, Dent JM, Hodgson JM, Hoffmann U, et al. ACCF/ACR/AHA/ASE/ASNC/HRS/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR 2008 Health Policy Statement on Structured Reporting in Cardiovascular Imaging. J Am Coll Cardiol. 2009;53:76–90.CrossRefPubMedGoogle Scholar
  14. 14.
    Sharir T, Pinskiy M, Pardes A, Rochman A, Prokhorov V, Kovalski G, et al. Comparison of the diagnostic accuracies of very low stress-dose with standard-dose myocardial perfusion imaging: Automated quantification of one-day, stress-first SPECT using a CZT camera. J Nucl Card. 2016;23(1):11–20.CrossRefGoogle Scholar
  15. 15.
    Gimelli A, Bottai M, Giorgetti A, Genovesi D, Kusch A, Ripoli A, et al. Comparison between ultrafast and standard single-photon emission CT in patients with coronary artery disease: a pilot study. Circ Cardiovasc Imaging. 2011;4(1):51–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Oldan JD, Shaw LK, Hofmann P, Phelan M, Nelson J, Pagnanelli R, et al. Prognostic value of the cadmium-zinc-telluride camera: A comparison with a conventional (Anger) camera. J Nucl Cardiol. 2015. doi: 10.1007/s12350-015-0224-2.PubMedCentralGoogle Scholar
  17. 17.
    Yokota S, Mouden M, Ottervanger JP, Engbers E, Knollema S, Timmer JR, et al. Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT. Eur J Nucl Med Mol Imaging. 2016;43(2):296–301.CrossRefPubMedGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  • Ronaldo Lima
    • 1
    • 2
  • Thais Peclat
    • 3
  • Thalita Soares
    • 3
  • Caio Ferreira
    • 3
  • Ana Carolina Souza
    • 3
  • Gabriel Camargo
    • 1
  1. 1.Department of CardiologyUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
  2. 2.Nuclear MedicineClínica de Diagnóstico por ImagemRio de JaneiroBrazil
  3. 3.Universidade Federal do Rio de JaneiroRio de JaneiroBrazil

Personalised recommendations