Myocardial Perfusion Scintigraphy Dosimetry: Optimal Use of SPECT and SPECT/CT Technologies in Stress-first Imaging Protocol

Overview

Journal Clin Transl Imaging

Publisher Springer

Date 2016 Dec 10

PMID 27933282

Citations 6

Authors

M Lecchi

S Malaspina

C Scabbio

V Gaudieri

A Del Sole

Affiliations

Soon will be listed here.

Abstract

Purpose: Over the past decade, nuclear medicine experts have been seeking to minimize patient exposure to radiation in myocardial perfusion scintigraphy (MPS). This review describes the latest technological innovations in MPS, particularly with regard to dose reduction.

Methods: We searched in PubMed for original clinical papers in English, published after 2008, using the following research criteria: (dose) and ((reduction) or (reducing)) and ((myocardial) or (cardiac) or (heart)) and ((nuclear medicine) or (nuclear imaging) or (radionuclide) or (scintigraphy) or (SPET) or (SPECT)). Thereafter, recent reviews on the topic were considered and other relevant clinical papers were added to the results.

Results: Of 202 non-duplicate articles, 17 were included. To these, another eight papers cited in recent reviews were added. By optimizing the features of software, i.e., through algorithms for iterative reconstruction with resolution recovery (IRRs), and hardware, i.e., scanners and collimators, and by preferring, unless otherwise indicated, the use of stress-first imaging protocols, it has become possible to reduce the effective dose by at least 50% in stress/rest protocols, and by up to 89% in patients undergoing a diagnostic stress-only study with new technology. With today's SPECT/CT systems, the use of a stress-first protocol can conveniently be performed, resulting in an overall dose reduction of about 35% if two-thirds of stress-first examinations were considered definitively normal.

Conclusion: Using innovative gamma cameras, collimators and software, as well as, unless otherwise indicated, stress-first imaging protocols, it has become possible to reduce significantly the effective dose in a high percentage of patients, even when X-ray CT scanning is performed for attenuation correction.

Citing Articles

The Comparison of Quantitative Evaluation Results of the MPS SPECT/CT and Coronary Angiography: Determining the Most Valuable Quantitative Evaluation Score.

Karahan Sen N, Bekis R, Senturk B, Akdeniz B Mol Imaging Radionucl Ther. 2021; 30(3):169-176.

PMID: 34658498 PMC: 8522523. DOI: 10.4274/mirt.galenos.2021.26056.

Optimal Tc activity ratio in the single-day stress-rest myocardial perfusion imaging protocol: A multi-SPECT phantom study.

Zoccarato O, Matheoud R, Lecchi M, Scabbio C, Claudio M, Brambilla M J Nucl Cardiol. 2020; 28(1):338-349.

PMID: 32720060 PMC: 7384561. DOI: 10.1007/s12350-020-02290-2.

Radiation dose in nuclear medicine: the hybrid imaging.

Salvatori M, Rizzo A, Rovera G, Indovina L, Schillaci O Radiol Med. 2019; 124(8):768-776.

PMID: 30771217 DOI: 10.1007/s11547-019-00989-y.

Impact of non-specific normal databases on perfusion quantification of low-dose myocardial SPECT studies.

Scabbio C, Zoccarato O, Malaspina S, Lucignani G, Del Sole A, Lecchi M J Nucl Cardiol. 2017; 26(3):775-785.

PMID: 29043555 DOI: 10.1007/s12350-017-1079-5.

The long way to dose reduction in myocardial perfusion imaging.

Lecchi M, Del Sole A J Nucl Cardiol. 2017; 25(6):2129-2132.

PMID: 28667453 DOI: 10.1007/s12350-017-0967-z.

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