Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance

Background: Myocardial perfusion imaging (MPI) plays a crucial role in diagnosing coronary artery disease (CAD), with single-photon emission computed tomography (SPECT) being a widely accepted method. The accuracy of MPI relies on image quality and the expertise of physicians. While CZT-SPECT camera...

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Main Authors: Forough Kalantari, Nasibeh Mohseninia, Andreas Wetsch, Sara Harsini, Lukas Hehenwarter, Gregor Schweighofer-Zwink, Nazanin Zamani-Siahkali, Gundula Rendl, Mohsen Beheshti, Christian Pirich
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/13/9/1879
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author Forough Kalantari
Nasibeh Mohseninia
Andreas Wetsch
Sara Harsini
Lukas Hehenwarter
Gregor Schweighofer-Zwink
Nazanin Zamani-Siahkali
Gundula Rendl
Mohsen Beheshti
Christian Pirich
author_facet Forough Kalantari
Nasibeh Mohseninia
Andreas Wetsch
Sara Harsini
Lukas Hehenwarter
Gregor Schweighofer-Zwink
Nazanin Zamani-Siahkali
Gundula Rendl
Mohsen Beheshti
Christian Pirich
author_sort Forough Kalantari
collection DOAJ
description Background: Myocardial perfusion imaging (MPI) plays a crucial role in diagnosing coronary artery disease (CAD), with single-photon emission computed tomography (SPECT) being a widely accepted method. The accuracy of MPI relies on image quality and the expertise of physicians. While CZT-SPECT cameras offer advantages, they can be susceptible to attenuation artifacts. Therefore, our objective was to evaluate the diagnostic accuracy of CZT-SPECT and SPECT/CT in a clinical setting. Method: We conducted a prospective single-center study involving patients with known or suspected stable ischemic heart disease who underwent SPECT-MPI using CZT-SPECT and SPECT/CT scanners, and the latter was equipped with cardiofocal collimation. Experienced physicians performed analysis and reporting based on automated quantification and visual image interpretation. Results: A total of 77 patients (32 women (41.6%) and 45 men (58.4%) with an average age of 71.9 ± 8.9 years) were included. The agreement between readers regarding the final conclusion based on imaging reporting using both devices was very high (Kappa 0.87–0.93). Per-vessel analysis revealed a trend suggesting that CZT-SPECT was superior to conventional SPECT/CT in terms of sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, although the difference did not reach statistical significance. Conclusion: Our study demonstrated that CZT-SPECT imaging offers comparable diagnostic accuracy, improved patient comfort, and eliminates CT-induced radiation compared to SPECT/CT. These findings suggest that cardiac CZT-SPECT imaging has the potential to become a valuable imaging modality in clinical practice.
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spelling doaj.art-6113ec0b6b8745ce9f3efcdf429093042023-11-19T11:37:34ZengMDPI AGLife2075-17292023-09-01139187910.3390/life13091879Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic PerformanceForough Kalantari0Nasibeh Mohseninia1Andreas Wetsch2Sara Harsini3Lukas Hehenwarter4Gregor Schweighofer-Zwink5Nazanin Zamani-Siahkali6Gundula Rendl7Mohsen Beheshti8Christian Pirich9Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaBC Cancer Research Institute, Vancouver, BC V5Z 1L3, CanadaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDivision of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaBackground: Myocardial perfusion imaging (MPI) plays a crucial role in diagnosing coronary artery disease (CAD), with single-photon emission computed tomography (SPECT) being a widely accepted method. The accuracy of MPI relies on image quality and the expertise of physicians. While CZT-SPECT cameras offer advantages, they can be susceptible to attenuation artifacts. Therefore, our objective was to evaluate the diagnostic accuracy of CZT-SPECT and SPECT/CT in a clinical setting. Method: We conducted a prospective single-center study involving patients with known or suspected stable ischemic heart disease who underwent SPECT-MPI using CZT-SPECT and SPECT/CT scanners, and the latter was equipped with cardiofocal collimation. Experienced physicians performed analysis and reporting based on automated quantification and visual image interpretation. Results: A total of 77 patients (32 women (41.6%) and 45 men (58.4%) with an average age of 71.9 ± 8.9 years) were included. The agreement between readers regarding the final conclusion based on imaging reporting using both devices was very high (Kappa 0.87–0.93). Per-vessel analysis revealed a trend suggesting that CZT-SPECT was superior to conventional SPECT/CT in terms of sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, although the difference did not reach statistical significance. Conclusion: Our study demonstrated that CZT-SPECT imaging offers comparable diagnostic accuracy, improved patient comfort, and eliminates CT-induced radiation compared to SPECT/CT. These findings suggest that cardiac CZT-SPECT imaging has the potential to become a valuable imaging modality in clinical practice.https://www.mdpi.com/2075-1729/13/9/1879SPECTreproducibilitycoronary artery diseasemyocardial perfusion imaging
spellingShingle Forough Kalantari
Nasibeh Mohseninia
Andreas Wetsch
Sara Harsini
Lukas Hehenwarter
Gregor Schweighofer-Zwink
Nazanin Zamani-Siahkali
Gundula Rendl
Mohsen Beheshti
Christian Pirich
Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
Life
SPECT
reproducibility
coronary artery disease
myocardial perfusion imaging
title Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
title_full Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
title_fullStr Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
title_full_unstemmed Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
title_short Head-to-Head Comparison of CZT-SPECT and SPECT/CT Myocardial Perfusion Imaging: Interobserver and Intraobserver Agreement and Diagnostic Performance
title_sort head to head comparison of czt spect and spect ct myocardial perfusion imaging interobserver and intraobserver agreement and diagnostic performance
topic SPECT
reproducibility
coronary artery disease
myocardial perfusion imaging
url https://www.mdpi.com/2075-1729/13/9/1879
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