Performance of Myocardial Perfusion Imaging Using Multi-focus Fan Beam Collimator with Resolution Recovery Reconstruction in a Comparison with Conventional SPECT

OBJECTIVE(S): IQ-SPECT is an advanced high-speed SPECT modality for myocardial perfusion imaging (MPI), which uses a multi-focus fan beam collimator with resolution recovery reconstruction. The aim of this study was to compare IQ-SPECT with conventional SPECT in terms of performance, based on standard clinical protocols. In addition, we examined the concordance between conventional and IQ_SPECT in patients with coronary artery disease (CAD). METHODS: Fifty-three patients, undergoing rest-gated MPI for the evaluation of known or suspected CAD, were enrolled in this study. In each patient, conventional SPECT ((99m)Tc-tetrofosmin, 9.6 min and (201)Tl, 12.9 min) was performed, immediately followed by IQ-SPECT, using a short acquisition time (4.3 min for (99m)Tc-tetrofosmin and 6.2 min for (201)Tl). 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 end-diastolic volume (EDV), end-systolic volume (ESV), 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 IQ-SPECT and conventional SPECT (P<0.05). The mean differences in (99m)Tc-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 (201)Tl-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 IQ-SPECT=68.3±12.1% for (99m)Tc-tetrofosmin; conventional SPECT= 56.0±11.7% and IQ-SPECT=61.5±12.2% for (201)Tl), quantitative parameters were not significantly different between IQ-SPECT and conventional SPECT. CONCLUSION: According to the (99m)Tc-tetrofosmin and (201)Tl 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.