Diagnostic Performance of a Novel Cadmium-Zinc-Telluride Gamma Camera System Assessed Using Fractional Flow Reserve

作者：Tanaka Hirokazu^*; Chikamori Taishiro; Tanaka Nobuhiro; Hida Satoshi; Igarashi Yuko; Yamashita Jun; Ogawa Masashi; Shiba Chie; Usui Yasuhiro; Yamashina Akira

来源：Circulation Journal, 2014, 78(11): 2727-2734.

DOI：10.1253/circj.CJ-14-0612

• Cadmium-zinc-telluride camera
• Coronary artery disease
• Fractional flow reserve
• Single-photon emission computed tomography

Background: Although the novel cadmium-zinc-telluride (CZT) camera system provides excellent image quality, its diagnostic value using thallium-201 as assessed on coronary angiography (CAG) and fractional flow reserve (FFR) has not been validated. %26lt;br%26gt;Methods and Results; To evaluate the diagnostic accuracy of the CZT ultrafast camera system (Discovery NM 530c), 95 patients underwent stress thallium-201 single-photon emission computed tomography (SPECT) and then CAG within 3 months. Image acquisition was performed in the supine and prone positions after stress for 5 and 3 min, respectively, and in the supine position at rest for 10 min. Significant stenosis was defined as AO% diameter narrowing on visual estimation, or a lesion with %26lt;90% and %26gt;= 50% stenosis and FFR %26lt;= 0.75. To detect individual coronary stenosis, the respective sensitivity, specificity, and accuracy were 90%, 64%, and 78% for left anterior descending coronary artery stenosis, 78%, 84%, and 81% for left circumflex stenosis, and 83%, 47%, and 60% for right coronary artery (RCA) stenosis. The combination of prone and supine imaging had a higher specificity for RCA disease than supine imaging alone (65% vs. 47%), with an improvement in accuracy from 60% to 72%. %26lt;br%26gt;Conclusions: Using thallium-201 with short acquisition time, combined with prone imaging, CZT SPECT had a high diagnostic yield in detecting significant coronary stenosis as assessed using FFR.

• 出版日期2014-11