FDG gamma camera PET equipped with one inch crystal and XCT

Summary

Metabolic imaging with 2-[fluorine-18]-fluoro- 2-deoxy-D-glucose (FDG) is actually considered as the best method to detect and quantitatively assess myocardial tissue viability. The aim of this study was to investigate the accuracy of FDG gamma camera positron emission tomography (GCPET) imaging equipped with one inch NaI crystals in comparison to FDG dedicated PET (dPET) imaging as a „gold standard“ in phantom and clinical studies. Patients, methods: Nineteen patients with coronary artery disease (CAD) underwent both imaging modalities. Phantom and clinical GCPET imaging were performed with a dual-headed, coincidence based gamma camera equipped with 1 inch thick NaI crystals and an x-ray tube (XCT) for attenuation correction (AC), as well as with a dedicated PET scanner with AC. ^99mTc tetrofosmin single-photon emission tomography (SPET) studies were performed for assessment of myocardial perfusion, with AC. Results: Phantom studies showed a significant relation in segmental activity between FDG imaging with AC using GCPET and dPET (r = 0.91, p <0.001). In clinical studies with AC correlation coefficients of mean segmental FDG uptake and regional defect size were r = 0.87 (p <0.0001) and r = 0.83 (p <0.0001), respectively. In regional analysis close agreement was even found in the most attenuated regions of the heart if AC was used in GCPET imaging. The overall agreement for detection of viable myocardium was 81% between FDG-dPET (AC) and FDG-GCPET (AC) and 74% between FDG-dPET (AC) and FDG-GCPET (NC). Conclusion: This study suggests that the assessment of myocardial metabolism by means of FDG is feasible with a coincidence based gamma camera equipped with 1 inch thick NaI crystals if AC is performed. The results reveal a close concordance and agreement between FDG-dPET (AC) and FDG-GCPET (AC) as compared to FDG-GCPET (NC).

Zusammenfassung

Die Bildgebung mit 2-[Fluor-18]-Fluor-2-deoxy-D-glukose (FDG) ist die genaueste szintigraphische Methode zur Erfassung und Quantifizierung der myokardialen Vitalität. Ziel dieser Studie war es, die Genauigkeit der Positronenemissionstomographie mit einer mit 1-Zoll Kristallen ausgerüsteten Gammakamera (GCPET) mit jener der dezidierten PET (dPET) als Goldstandard zu vergleichen. Patienten, Methodik: Neunzehn Patienten mit koronarer Herzerkrankung wurden mit beiden Verfahren untersucht. Phantom- und klinische Studien wurden an einer mit 1-Zoll Natriumiodidkristallen ausgerüsteten GCPET mit und ohne Röntgen-Abschwächungskorrektur und an einem dezidierten PET-Scanner mit Abschwächungskorrektur durchgeführt. ^99mTc-Tetrofosmin Single-Photonen-Emissionstomographie( SPET)-Untersuchungen mit Abschwächungskorrektur wurden zur Beurteilung der myokardialen Perfusion herangezogen. Ergebnisse: Die Phantomstudien zeigten eine signifikante Beziehung zwischen der segmentalen FDG Aktivität in schwächungskorrigierten GCPET und dPET Untersuchungen (r = 0,91, p <0,001). In den klinischen Untersuchungen betrugen die Korrelationskoeffizienten für die mittlere segmentale FDG Aufnahme und die regionale Defektgröße r = 0,87 (p <0,0001) und r = 0,83 (p <0,0001). Die Übereinstimmungsrate zwischen FDGdPET und FDG-GCPET für die Erfassung von vitalen Myokardsegmenten betrug 81% unter Verwendung der Schwächungskorrektur, jedoch nur 74%, wenn diese bei der GCPET nicht eingesetzt worden war. Schlussfolgerung: Phantom- und klinische Studien zeigen die Machbarkeit der Beurteilung des myokardialen Glukosemetabolismus mit FDG unter Verwendung einer Gammakamera mit 1-Zoll-NaJ-Kristallen, falls die Schwächungskorrektur eingesetzt wird. Die Ergebnisse zeigen hohe Konkordanz zwischen dPET und GCPET mit Schwächungskorrektur.

Keywords

Myocardial viability - ¹⁸F-FDG - dedicated PET - gamma camera PET - attenuation correction

Schlüsselwörter

Myokardiale Vitalität - ¹⁸F-FDG - Gammakamera-PET - Abschwächungskorrektur

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