Comparison Between Ultrafast and Standard SPECT in Patients with Coronary Artery Disease: A Pilot Study

Background A novel technology has been developed for ultrafast (UF) singlephoton emission computed tomography (SPECT) myocardial perfusion imaging by employing a pin-hole collimation design and multiple cadmium zinc telluride crystal arrays. The purpose of this study was to compare myocardial perfusion imaging obtained by UF-SPECT with standard (S) SPECT in patients with known or suspected coronary artery disease. Methods and Results A total of 34 patients underwent single-day TcTetrofosmin stress/rest myocardial perfusion imaging. UF-SPECT was performed 10 min before S-SPECT. Images were qualitatively analyzed, the summed stress score (SSS) and summed rest score (SRS) were calculated. The segmental tracer uptake value (percentage of maximum myocardial uptake) was also quantified for both UFand S-SPECT. When only 29/34 patients with significant coronary lesions were analyzed, SSS was 10.1 ± 4.4 versus 6.4 ± 2.9, respectively for UFand S-SPECT (p=0.002). Qualitative and quantitative per-patient analysis showed similar results in detection of coronary artery disease for UFand S-SPECT. In contrast, per-vessel analysis demonstrated higher regional sensitivity of UFversus S-SPECT. UF-SPECT showed higher sensitivity in detecting multivessel disease (p = 0.003, versus SSPECT). Conclusions This pilot study confirms that UF-SPECT provides high quality fast myocardial perfusion imaging, and suggests that it may allow a more accurate evaluation of both extent and severity of myocardial ischemia in patients with coronary artery disease.