Performance of myocardial perfusion imaging using multi-focus fan beam collimator with resolution recovery reconstruction in a comparison with conventional SPECT

Document Type : Original Article


1 Department of Radiology, Kurashiki Central Hospital/ Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University

2 Department of Radiology, Kurashiki Central Hospital

3 Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University


Objective: IQSPECT is an advanced high-speed SPECT modality for performing myocardial perfusion imaging (MPI), which uses a multi-focus fan beam collimator with resolution recovery reconstruction. The aim of this study was to compare IQSPECT compared with conventional SPECT interms of performance based on standard clinical protocols. In addition, we examined the concordance between conventional and IQSPECT in patients with coronary artery disease (CAD).
Methods: Fifty-three patients undergoing rest-gated MPI for the evaluation of known or suspected coronary artery disease were enrolled in this study. In each patient, conventional SPECT (99mTc-tetrofosmin, 9.6 min; 201Tl, 12.9 min) was performed, immediately followed by IQSPECT, using a short acquisition time (4.3 min for 99mTc-tetrofosmin and 6.2 min for 201Tl). A quantitative analysis was performed on an MPI polar map using a 20-segment model of the left ventricle. An automated analysis by gated SPECT was carried out to determine the left ventricular volume and function, including the end-diastolic volume, end-systolic volume and left ventricular ejection fraction (LVEF). The degree of concordance between conventional SPECT and IQ-SPECT images was evaluated according to linear regression and Bland-Altman analyses.
Results: The segmental percent uptake exhibited a significant correlation between IQSPECT and conventional SPECT (P<0.05). The mean differences in 99mTc‐tetrofosmin studies were 1.1±6.6% (apex), 2.8±5.7% (anterior wall), 2.9±6.2% (septal wall),4.9±6.7% (lateral wall), and 1.8±5.6% (inferior wall). Meanwhile, regarding the 201Tl‐SPECT studies, these values were 1.6±6.9%, 2.0±6.6%, 2.1±5.9%, 3.3±7.2%, and 2.4±5.8%, respectively. Although the mean LVEF in IQ‐SPECT tended to be higher than that observed in conventional SPECT (conventional SPECT=64.8±11.8% and IQSPECT=68.3±12.1% for 99mTc‐tetrofosmin; conventional SPECT= 56.0±11.7% and IQSPECT=61.5±12.2% for 201Tl), quantitative parameters were not significantly different between IQ‐SPECT and conventional SPECT.
Conclusion: According to the 99mTc‐tetrofosmin and 201Tl protocols, IQ‐SPECT images were comparable to and in agreement with conventional SPECT images. Our results suggest that IQ‐SPECT is a useful technology for MPI SPECT, and can lead to an increase in scan efficiency and patient comfort.


Main Subjects

1. DePuey EG, Ernest VG. Updated imaging guidelines for nuclear cardiology procedures. J
Nucl Cardiol. 2001; 8: G1‐G58.
2. Klocke FJ, Baird MG, Lorell BH, Batemon TM, Messer JV, Berman DS, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging—xecutive summarya report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC )Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging. J Am Coll Cardiol. 2003; 42: 1318‐33.
3. DePasquale EE, Nody AC, DePuey EG, Garcia EV, Pilcher G, Bredlau C, et al. Quantitative rotational thallium‐201 tomography for identifying and localizing coronary artery disease. Circulation. 1988; 77: 316‐27.
4. Thomas GS, Miyamoto MI, Morello AP, Majmundar H, Thomas JJ, Sampson CH, et al. Technetium99m sestamibi myocardial perfusion imaging predicts clinical outcome in the community outpatient setting􀀀The Nuclear Utility in the Community (NUC) Study. J Am Coll  Cardiol. 2004; 43: 213‐23.
 5. Nishimura T, Nakajima K, Kusuoka H, Yamashina A, Nishimura S. Prognostic study of risk stratification among apanese patients with ischemic heart disease using gated myocardial perfusion SPECT: J‐ACCESS study. Eur J Nucl Med Mol Imaging. 2008; 35: 319‐28.
 6. Asao K, Takaki A, Tominaga M, Sasaki M. The interpolated projection data estimation method improves the image quality of myocardial perfusion SPECT with a short acquisition time. Ann Nucl Med. 2012; 26:123‐30.
 7. Borges‐Neto S, Pagnanelli RA, Shaw LK, Honeycutt E, Shwartz SC, Adams GL, et al. Clinical results of a novel wide beam reconstruction method for shortening scan time of Tc‐99m cardiac SPECT perfusion studies. J Nucl Cardiol.2007; 14: 555‐65. 
8. Sun XX, Tian YQ, Wang DY, He ZX. Shortened acquisition time or reduced‐activity dose for gated myocardial perfusion SPECT with new reconstruction algorithm. Int J Cardiovasc Imaging. 2013; 29:1287‐93. 
9. Venero CV, Heller GV, Bateman TM, McGhie A, Ahlberg AW, Katten D, et al. A multicenter evaluation of a new post‐processing method with depth‐dependent collimator resolution applied to full‐time and half‐time acquisitions without and with simultaneously acquired attenuation correction. J Nucl Cardiol. 2009; 16: 714‐25. 
10. DePuey EG. Advances in SPECT camera software and hardware: Currently available and new on the horizon. J Nucl Cardiol. 2012; 19: 551‐81. 
11. Onishi H, Matsutomo N, Kangai Y, Saho T, Amijima H. Differential impact of multi‐focus fan beam collimation with L‐mode and conventional systems on the accuracy of myocardial perfusion imaging: Quantitative evaluation using phantoms. Asia Oceania J Nucl Med. 2013; 1: 28‐34. 
12. Germano G, Erel J, Lewin H, Kavanagh PB, Berman DS. Automatic quantitation of regional myocardial wall motion and thickening from gated technetium‐99m sestamibi myocardial perfusion single‐photon emission computed tomography. J Am Coll Cardiol. 1997; 30: 1360‐7. 
13. Bax JJ, Visser FC, van Lingen A, Sloof GW, Cornel JH, Visser CA. Comparison between 360 and 180 data sampling in thallium‐201 rest‐redistribution single‐photon emission tomography to predict functional recovery after revascularization. Eur J Nucl Med. 1997; 24: 516‐22. 
14. Go RT, MacIntyre WJ, Houser TS, Pantoja M, O’DENNEL JK, Feiglin DH, et al. Clinical evaluation of 360 and 180 data sampling techniques for transaxial SPECT thallium‐201myocardial perfusion imaging. J Nucl Med. 1985; 26: 695‐706. 
15. Liu YH, Lam PT, Sinusas AJ, Frans JT. Differential effect of 180 and 360 acquisition orbits on the accuracy of SPECT imaging: quantitative evaluation in phantoms. J Nucl Med. 2002; 43:1115‐24. 
16. Hughes T, Celler A. A multivendor phantom study comparing the image quality produced from three state‐of‐the‐art SPECT‐CT systems. Nucl Med Commun. 2012; 33: 663‐70. 
17. Onishi H, Motomura N, Fujino K, Natsume T, Haramoto Y. Quantitative performance of advanced resolution recovery strategies on SPECT images: evaluation with use of digital phantom models. Radiol Phys Technol. 2013; 6: 42‐53. 
18. Imbert L, Poussier S, Franken PR, Songy B, Verger A, Morel O, et al. Compared performance of high‐sensitivity cameras dedicated to myocardial perfusion SPECT: a comprehensive analysis of phantom and human images. J Nucl Med. 2012; 53: 1897‐903.
19. Ali I, Ruddy TD, Almgrahi A, Anstett FG, Wells RG. Half‐time SPECT myocardial perfusion imaging with attenuation correction. J Nucl Med. 2009; 50: 554‐62. 
20. Hendel RC, Berman DS, Cullom SJ, Follansbee W,Heller GV, Kiat H, et al. Multicenter clinical trial to evaluate the efficacy of correction for photon attenuation and scatter in SPECT myocardial perfusion imaging. Circulation. 1999; 99: 2742‐9.
21. Vija AH, Malmin R, Yahil A, Zeintl J, Bhattacharya M, Rempel TD, et al. A method for improving the efficiency of myocardial perfusion imaging using conventional SPECT and SPECT/CT imaging systems. Paper represented at IEEE Nuclear Science Symposium conference. 2010; 6: 3433‐7.
22. Germano G. Technical Aspects of Myocardial SPECT Imaging. J Nucl Med. 2001; 42: 1499‐1507.