Validation of Myocardial Perfusion Imaging
Validation of Myocardial Perfusion Imaging
The new cadmium-zinc-telluride (CZT) technology is a powerful tool for cardiac nuclear
 medicine. The increased photon counting sensitivity of camera can be used to explore novel
 protocols like dual isotope (rapid stress Tl-201/rest Tc-99m protocol for use with high-speed
 SPECT MPI). The use of dual isotope imaging is very interesting because this imaging combines
 the use of thallium-201 with technetium-99m agents permitting optimal image resolution and
 simultaneous assessment of viability, all with an exam duration of approximately 20 minutes.
 However, no study compares stress thallium-201/rest technetium-99m sequential dual isotope
 high-speed myocardial perfusion imaging versus invasive coronary angiography. The
 investigators report here the first validation of high-speed protocol with dual isotope for
 myocardial perfusion imaging using invasive coronary angiography as the standard of
 reference.
The new cadmium-zinc-telluride (CZT) technology is a powerful tool for cardiac nuclear
 medicine. Indeed, recent clinical validation studies of CZT technology have documented a scan
 time reduction and low radiation dose without degradation of myocardial perfusion imaging in
 comparison with standard dual detector cameras. The increased photon counting sensitivity of
 camera can be used to explore novel protocols that may offer advantages over standard
 protocols used for Myocardial Perfusion Imaging. Berman et al. showed that rapid stress
 Tl-201/rest Tc-99m protocol for use with high-speed SPECT MPI has offered the superior
 qualities of Tl-201 for stress imaging and of the Tc-99m agents for rest imaging can be
 preserved. Nuclear medicine presents the most level of scientific validation for diagnosis
 and prognosis of coronary artery disease. A lot of studies have compared performance of
 standard dual detector cameras vs. Invasive Coronary Angiography. Fiechter et al. reported
 the first validation of ultrafast dedicated cardiac gamma camera with CZT versus invasive
 coronary angiography. But he used a novel hybrid SPECT /CT device and 99m-Tc-tetrofosmin
 pharmacological stress/rest examination. However, no study compares stress thallium-201/rest
 technetium-99m sequential dual isotope high-speed myocardial perfusion imaging versus
 invasive coronary angiography. Moreover, diagnosis performance of this high-speed protocol
 versus fractional flow reserve for stenosis evaluation is unknown.

 The investigators report here the first validation of high-speed protocol with dual isotope
 for myocardial perfusion imaging using invasive procedures (coronary angiography and
 fractional flow reserve) as the standard of reference.
Inclusion Criteria:

 -  Stable angina

 -  Cadmium-zinc-telluride gamma camera SPECT with dual isotope imaging

 -  Coronarography

 Exclusion Criteria:

 -  Pregnant woman

 -  Patient with terminal illness,

 -  Terminal Renal failure

 -  Allergy to iodine