Laetitia Imbert1,2,3,4, Véronique Roch5,6, Charles Merlin7,8, Wassila Djaballah5,6, Florent Cachin7,8, Mathieu Perrin5,6, Marine Claudin5,6, Antoine Verger5,6,9, Henri Boutley6,10, Gilles Karcher5,6,10, Pierre-Yves Marie5,6,11. 1. CHRU-Nancy, Université de Lorraine, Department of Nuclear Medicine, 54000, Nancy, France. l.imbert@chru-nancy.fr. 2. Nancyclotep Experimental Imaging Platform, 54000, Nancy, France. l.imbert@chru-nancy.fr. 3. INSERM, Université de Lorraine, UMR 947, IADI, 54000, Nancy, France. l.imbert@chru-nancy.fr. 4. Department of Radiotherapy, Lorraine Cancerology Institute, 54500, Vandoeuvre, France. l.imbert@chru-nancy.fr. 5. CHRU-Nancy, Université de Lorraine, Department of Nuclear Medicine, 54000, Nancy, France. 6. Nancyclotep Experimental Imaging Platform, 54000, Nancy, France. 7. Department of Nuclear Medicine, Jean Perrin Centre, Université d'Auvergne, 63011, Clermont-Ferrand, France. 8. INSERM, Université d'Auvergne, UMR 990, IMTV, 63000, Clermont-Ferrand, France. 9. INSERM, Université de Lorraine, UMR 947, IADI, 54000, Nancy, France. 10. University of Lorraine, Faculty of Medicine, 54000, Nancy, France. 11. INSERM, Université de Lorraine, UMR 1116, DCAC, 54000, Nancy, France.
Abstract
PURPOSE OF THE REPORT: This study aimed at assessing an original low-dose dual-isotope procedure in which the abnormal stress Tc-99m Sestamibi SPECT is followed by rest Tl-201 SPECT, along with a head-to-head comparison with a single-isotope procedure. METHODS AND RESULTS: One hundred two patients, referred for a low-dose stress-SPECT with Sestamibi (123 ± 20 MBq) on a CZT camera and for whom a rest Sestamibi SPECT was warranted, had an additional Tl-201 rest-SPECT (52 ± 5 MBq) between stress and rest Sestamibi SPECT recordings. Tl-201 images were processed for spill-over and scatter corrections, and uptake differences with stress Sestamibi SPECT were analyzed: (1) for rest acquisitions from Tl-201 (dual-isotope procedure) and from Sestamibi (single-isotope procedure) and (2) in segments for which a diagnosis of ischemia, infarct, or normal perfusion was achieved. Mean effective dose was 8.3 mSv for dual-isotope but would decrease to 5.7 mSv for an expected rate of 37% of patients for whom rest-SPECT is not warranted. After a further background correction of Tl-201 images, the rest-stress difference in myocardial uptake was equivalent between dual- and single-procedures for identifying ischemic segments (respective areas-under-curves: 0.83 ± 0.03 and 0.81 ± 0.03). CONCLUSION: This original dual-isotope procedure provides acceptable radiation doses and consistent results, as compared with conventional single-isotope.
PURPOSE OF THE REPORT: This study aimed at assessing an original low-dose dual-isotope procedure in which the abnormal stress Tc-99m Sestamibi SPECT is followed by rest Tl-201 SPECT, along with a head-to-head comparison with a single-isotope procedure. METHODS AND RESULTS: One hundred two patients, referred for a low-dose stress-SPECT with Sestamibi (123 ± 20 MBq) on a CZT camera and for whom a rest Sestamibi SPECT was warranted, had an additional Tl-201 rest-SPECT (52 ± 5 MBq) between stress and rest Sestamibi SPECT recordings. Tl-201 images were processed for spill-over and scatter corrections, and uptake differences with stress Sestamibi SPECT were analyzed: (1) for rest acquisitions from Tl-201 (dual-isotope procedure) and from Sestamibi (single-isotope procedure) and (2) in segments for which a diagnosis of ischemia, infarct, or normal perfusion was achieved. Mean effective dose was 8.3 mSv for dual-isotope but would decrease to 5.7 mSv for an expected rate of 37% of patients for whom rest-SPECT is not warranted. After a further background correction of Tl-201 images, the rest-stress difference in myocardial uptake was equivalent between dual- and single-procedures for identifying ischemic segments (respective areas-under-curves: 0.83 ± 0.03 and 0.81 ± 0.03). CONCLUSION: This original dual-isotope procedure provides acceptable radiation doses and consistent results, as compared with conventional single-isotope.
Authors: Manuel D Cerqueira; Neil J Weissman; Vasken Dilsizian; Alice K Jacobs; Sanjiv Kaul; Warren K Laskey; Dudley J Pennell; John A Rumberger; Thomas Ryan; Mario S Verani Journal: Circulation Date: 2002-01-29 Impact factor: 29.690
Authors: Sanjiv S Gambhir; Daniel S Berman; Jack Ziffer; Michael Nagler; Martin Sandler; Jim Patton; Brian Hutton; Tali Sharir; Shlomo Ben Haim; Simona Ben Haim Journal: J Nucl Med Date: 2009-04 Impact factor: 10.057
Authors: C Cousins; D L Miller; G Bernardi; M M Rehani; P Schofield; E Vañó; A J Einstein; B Geiger; P Heintz; R Padovani; K-H Sim Journal: Ann ICRP Date: 2013-02