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Federico Caobelli, Tim Wollenweber, Udo Bavendiek, Christian Kühn, Christian Schütze, Lilli Geworski, James T. Thackeray, Johann Bauersachs, Axel Haverich, Frank M. Bengel, Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis, European Heart Journal, Volume 38, Issue 6, 7 February 2017, Pages 436–443, https://doi.org/10.1093/eurheartj/ehw231
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High-energy resolution and sensitivity of novel cadmium-zinc-telluride (CZT) detector equipped SPECT systems facilitate simultaneous imaging of multiple isotopes and may enhance the detection of molecular/cellular signals. This may refine the detection of endocarditis. This study was designed to determine the feasibility and diagnostic accuracy of simultaneous imaging of inflammation with 111In-labeled white blood cells (WBCs) and myocardial perfusion with 99mTc-sestamibi, for localization of WBCs relative to the valve plane in suspected endocarditis.
A dedicated cardiac CZT camera (Discovery 530c, GE Healthcare) was employed. Anthropomorphic thorax phantom studies were followed by clinical studies in 34 patients with suspected infection of native valves (n = 12) or implants (n = 22). Simultaneous 111In-WBC/99mTc perfusion imaging was performed, and compared with standard 111In-WBC planar scintigraphy and SPECT-CT. Phantom studies ruled out significant radioisotope crosstalk. Downscatter on 99mTc images was not observed for 111In activity as high as 2.5*99mTc activity. In patients, image quality was superior for CZT imaging vs. conventional SPECT-CT and planar scintigraphy (P < 0.01). Cadmium-zinc-telluride dual isotope imaging improved reader confidence for detection of inflammatory foci. Diagnostic accuracy based on surgery or Duke Criteria during follow-up was highest for CZT imaging (P < 0.001).
Novel CZT SPECT technology improves the accuracy of molecular/cellular cardiac imaging. Simultaneous multi-isotope imaging with 111In and 99mTc is feasible and aids in the workup of suspected endocarditis.
- radionuclide imaging
- endocarditis
- duke endocarditis service criteria
- myocardial perfusion
- technetium tc 99m sestamibi
- inflammation
- single photon emission computed tomography
- scanning or imaging with vascular flow
- follow-up
- isotopes
- leukocytes
- radioisotopes
- surgical procedures, operative
- infections
- cadmium
- diagnosis
- diagnostic imaging
- heart
- surgery specialty
- chest
- zinc
- image quality
- implants
- solids
- spect ct scans