Myocardial blood flow quantitation in patients with congestive heart failure: head-to-head comparison between rapid-rotating gantry SPECT and CZT SPECT

PurposeRecently, the feasibility of myocardial blood flow (MBF) quantitation using rapid-rotating gantry (RRG) and cadmium–zinc–telluride (CZT) SPECT cameras has been demonstrated. We compared MBF quantitation using these two camera systems.MethodsTwenty patients with congestive heart failure (CHF) and 20 patients without CHF (non-CHF) were included. On two consecutive days, dynamic SPECT imaging was performed after a bolus injection of 20 mCi of 99mTc-Sestamibi (MIBI) with RRG-SPECT and list-mode acquisition with CZT-SPECT. All dynamic SPECT images were reconstructed with full physical corrections, corrections for ventricular spillover and partial volume effect, using one-tissue kinetic modeling. Resting MBF converted from K1 was then corrected for MIBI extraction fraction and adjusted for rate-pressure product.ResultsIn both patient groups, there was no significant difference between resting MBF values measured with RRG-SPECT and CZT-SPECT systems (P = 0.06, P = 0.2 respectively). For CHF patients, linear regression (LR) was y(RRG) = 1.0412x (CZT) (r = 0.97) with a small systemic difference (Δ = 0.03 mL·min−1·g−1, 95% CI − 0.11 to 0.20) by Bland–Altman analysis. For non-CHF patients, LR was y(RRG) = 1.025x (CZT) (r = 0.89) with also small systemic difference (ΔT= 0.02 mL·min−1·g−1, 95% CI − 0.14 to 0.19) in BA analysis.ConclusionPhysical corrections along with other image corrections can provide comparable MBF quantitations in both CHF and non-CHF patients, regardless of the type of SPECT systems used.