scholarly journals Inter- and Intraobserver Repeatability of Myocardial Flow Reserve Values Determined with SPECT Study Using a Discovery NM530c Camera and Corridor 4DM Software

2021 ◽  
Vol 11 (11) ◽  
pp. 1164
Author(s):  
Paweł Cichocki ◽  
Michał Błaszczyk ◽  
Kamila Cygulska ◽  
Krzysztof Filipczak ◽  
Zbigniew Adamczewski ◽  
...  
Keyword(s):  
Motion Correction ◽  
Gamma Camera ◽  
Vascular Territory ◽  
Multivessel Coronary Artery Disease ◽  
Flow Reserve ◽  
The Poor ◽  
Czt Spect ◽  
Artery Disease ◽  
99Mtc Mibi ◽  
Myocardial Flow

Background: Myocardial blood flow (MBF) and flow reserve (MFR) examination, especially useful in the diagnosis of multivessel coronary artery disease (CAD), can be assessed with a cadmium-zinc-telluride (CZT) SPECT gamma camera, as an alternative to the expensive and less available PET. However, study processing is not free from subjective factors. Therefore, this paper aims to evaluate intra- and interobserver repeatability of MBF and MFR values obtained by the same operator and two independent operators. Methods: This study included 57 adult patients. MBF and MFR were assessed using a Discovery NM530c camera in a two-day, rest/dipyridamople protocol, using 99mTc-MIBI. Data were processed using Corridor4DM software, twice by one operator and once by another operator. Results: The repeatability of the assessed values was quite good in the whole myocardium, LAD and LCX vascular territories, but was poor in the RCA territory. Conclusions: The poor repeatability of MBF and MFR in RCA vascular territory can be explained by poor automatic orientation of the heart axis during post-processing and a so-called “cardiac creep” phenomenon. Better automatic heart orientation and introduction of automatic motion correction is likely to drastically improve this repeatability. In the present state of the software, PET is better for patients requiring assessment of MFR in the RCA territory.

scholarly journals The usage CZT SPECT to assess myocardial blood flow and flow reserve in myocardial infarction with non-obstructive coronary arteries patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Maltseva ◽  
A Mochula ◽  
D Vorobyeva ◽  
M Gulya ◽  
V Ryabov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Blood Flow ◽  
Coronary Artery Stenosis ◽  
Flow Reserve ◽  
Czt Spect ◽  
Artery Disease ◽  
Myocardial Flow

Abstract Funding Acknowledgements Type of funding sources: None. Background. Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is currently of interest in terms of a small amount of data related to myocardial perfusion, myocardial blood flow (MBF) and myocardial flow reserve (MFR). Purpose. To assess the severity of myocardial perfusion, MBF and MFR impairment in MINOCA patients in comparison to those with MI with obstructive coronary artery disease (MICAD) and non-obstructive stable coronary artery disease (SCAD). Methods. The study group comprised 40 patients (29 men, mean age 62.9 ± 10.7 years). 28 patients were admitted to the hospital due to the acute coronary syndrome. At admission all patients underwent invasive coronary angiography (ICA) and cardiac biomarkers – Creatine phosphokinase-MB (CPK-MB) and Troponin I (TnI) measurement. Two groups of patients were created based on ICA results: 1) MINOCA: with coronary artery stenosis <50%, n = 11; 2) MICAD: with coronary artery stenosis ≥50%, n = 17. SCAD patients group without obstructive atherosclerosis was retrospectively selected from the hospital database. All patients underwent dynamic SPECT on Cadmium-Zinc-Telluride (CZT) gamma camera with the assessment of semi-quantitative indexes of myocardial perfusion (SSS, SRS, SDS) and quantitative parameters (rest MBF (rMBF), stress MBF (sMBF) and MFR). Results. After 24 hours cardiospecific biomarkers levels in MINOCA group were significantly (p < 0.05) lower compared to MICAD group: CPK-MB 21.5 (13.7;45.0) vs. 94.4 (53.1;217.0) U/L; TnI 0.5 (0.1;3.3) vs. 9.8 (2.0;23.0) ng/ml. Standard myocardial perfusion indexes differed significantly (p < 0.05) among all three groups (except SDS between the first and second groups): MINOCA: SSS 5.0 (3.0;6.0), SDS 2.0 (1.0;3.0); MICAD: SSS 9.0 (5.0;13.0), SDS 3.0 (2,0;5.0); SCAD: SSS 1.5 (0.5;2.0), SDS 0.0 (0.0;2.0). Moreover, sMBF and MFR differed significantly in all three groups of patients: MINOCA: sMBF 1.2 (0.8;1.7) ml/min/g, MFR 2.0 (1.2;2.4); MICAD: sMBF 0.7 (0.6;1.0) ml/min/g, MFR 1.2 (1.1;1.5); control group: sMBF 2.2 (2.1;2.3) ml/min/g, MFR 2.6 (2.5;2.8). In 7/11 (64%) of MINOCA patients the value of sMBF was ≤1.5 ml/min/g. In the MICAD group 16/17 (94%) had sMBF ≤1.5 ml/min/g and all SCAD patients had sMBF >1.5 ml/min/g. In 4/11 (36%) of MINOCA patients MFR values were less than 2; in MICAD group MFR < 2 was observed in 15/17 (88%) patients. Conclusion. MINOCA patients have more severe myocardial perfusion abnormalities, lower MBF and MFR compared to those with stable CAD. It means that MINOCA patients may have other reasons for reduced myocardial blood flow, such as endothelial dysfunction, thrombophilia, etc., despite the absence of obstructive coronary artery lesion. Further studies are needed to assess added diagnostic and prognostic value of CZT SPECT derived myocardial flow indexes in MINOCA patients.

Usefulness of Fractional Flow Reserve in Multivessel Coronary Artery Disease with Intermediate Lesions

2006 ◽  
Vol 19 (2) ◽  
pp. 148-152 ◽  
Author(s):  
MANUEL F. JIMENEZ-NAVARRO ◽  
JUAN ALONSO-BRIALES ◽  
JOSE MARIA HERNANDEZ-GARCIA ◽  
EMILIO CURIEL ◽  
BIRGIT KUHLMORGEN ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Fractional Flow Reserve ◽  
Multivessel Coronary Artery Disease ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Artery Disease
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