Taishiro Chikamori1, Kenji Goto2, Satoshi Hida3, Masao Miyagawa4, Hayato Ishimura4, Kenji Uchida5, Takaya Fukuyama6, Teruhito Mochizuki4, Akira Yamashina3. 1. Department of Cardiology, Tokyo Medical University, Tokyo, Japan. Electronic address: chikamd@tokyo-med.ac.jp. 2. Department of Cardiology, Fukuyama Cardiovascular Hospital, Hiroshima, Japan. 3. Department of Cardiology, Tokyo Medical University, Tokyo, Japan. 4. Department of Radiology, Ehime University Graduate School of Medicine, Ehime, Japan. 5. Department of Radiology, Tokyo Medical University, Tokyo, Japan. 6. Department of Cardiology, Shin-Koga Hospital, Fukuoka, Japan.
Abstract
BACKGROUND: Despite the introduction of the novel cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) in Japan; its diagnostic value in clinical practice remains largely unknown. METHODS: The Semiconductor SPECT Study group is a multicenter Japanese registry which registered 1000 patients to evaluate the diagnostic utility of the CZT camera system (Discovery NM530c; GE Healthcare, Haifa, Israel). The patients underwent stress myocardial SPECT and coronary angiography within a 3-month interval. A significant stenosis was defined as ≥75% diameter narrowing based on the American Heart Association classification. RESULTS: Technetium (99mTc) radiotracer (555-1110MBq) was used in 71% and thallium-201 (201Tl) (74-148MBq) in 29%. The scan times with 99mTc-radiotracer were 5-10min for stress and 3-10min for rest, whereas those with 201Tl were 5-9min for stress and 8-10min for rest. To detect individual coronary stenosis, the respective sensitivities, specificities, and accuracies were 74%, 85%, and 81% for left anterior descending coronary artery (LAD) stenosis, 76%, 89%, and 85% for left circumflex stenosis, and 72%, 86%, and 82% for right coronary artery stenosis. However, 66% sensitivity and 91% specificity for LAD stenosis were observed with 99mTc-radiotracer, whereas 88% sensitivity and 63% specificity were found with 201Tl. CONCLUSIONS: The novel CZT SPECT system facilitated a short scan time with reduced radiotracer dose, yielding an acceptable diagnostic performance for angiographical coronary artery disease, although the low sensitivity for LAD detection with 99mTc-radiotracer needs to be refined.
BACKGROUND: Despite the introduction of the novel cadmium-zinc-telluride (CZT) single-photon emission computed tomography (SPECT) in Japan; its diagnostic value in clinical practice remains largely unknown. METHODS: The Semiconductor SPECT Study group is a multicenter Japanese registry which registered 1000 patients to evaluate the diagnostic utility of the CZT camera system (Discovery NM530c; GE Healthcare, Haifa, Israel). The patients underwent stress myocardial SPECT and coronary angiography within a 3-month interval. A significant stenosis was defined as ≥75% diameter narrowing based on the American Heart Association classification. RESULTS: Technetium (99mTc) radiotracer (555-1110MBq) was used in 71% and thallium-201 (201Tl) (74-148MBq) in 29%. The scan times with 99mTc-radiotracer were 5-10min for stress and 3-10min for rest, whereas those with 201Tl were 5-9min for stress and 8-10min for rest. To detect individual coronary stenosis, the respective sensitivities, specificities, and accuracies were 74%, 85%, and 81% for left anterior descending coronary artery (LAD) stenosis, 76%, 89%, and 85% for left circumflex stenosis, and 72%, 86%, and 82% for right coronary artery stenosis. However, 66% sensitivity and 91% specificity for LAD stenosis were observed with 99mTc-radiotracer, whereas 88% sensitivity and 63% specificity were found with 201Tl. CONCLUSIONS: The novel CZT SPECT system facilitated a short scan time with reduced radiotracer dose, yielding an acceptable diagnostic performance for angiographical coronary artery disease, although the low sensitivity for LAD detection with 99mTc-radiotracer needs to be refined.