Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis
Simultaneous dual-isotope solid-state detector SPECT for improved tracking of white blood cells in suspected endocarditis
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DOI：
10.1093/eurheartj/ehw231
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发表时间：
2017-02-07
影响因子：
39.3
通讯作者：
Bengel, Frank M.
中科院分区：
文献类型：
--
作者：
Caobelli, Federico;Wollenweber, Tim;Bengel, Frank M.
新型碲化镉锌（CZT）探测器配备SPECT系统的高能量分辨率和灵敏度有助于同时成像多种同位素，并可增强分子/细胞信号的检测。这可能会改善心内膜炎的检测。本研究的目的是确定的可行性和诊断准确性的同时成像的炎症与In-111标记的白色血细胞（白细胞）和心肌灌注与Tc-99 m-sestamibi，白细胞相对于瓣膜平面在可疑endocarditis.Methods和结果一个专用的心脏CZT相机（发现530 c，GE医疗）的本地化。对34例疑似自体瓣膜（n = 12）或植入物（n = 22）感染的患者进行了拟人胸部体模研究和临床研究。同时进行In-111-WBC/（99）mTc灌注显像，并与标准In-111-WBC平面动脉造影和SPECT-CT进行比较。体模研究排除了显著的放射性同位素串扰。对于高达2.5*Tc-99 m活性的In-111活性，未观察到Tc-99 m图像上的下散射。在患者中，CZT成像的图像质量上级常规SPECT-CT和平面血管造影（P < 0.01）。碲锌镉双同位素成像提高了读片者对炎症病灶检测的信心。随访期间基于手术或杜克标准的CZT成像诊断准确性最高（P < 0.001）。结论新型CZT SPECT技术提高了分子/细胞心脏成像的准确性。同时使用In-111和Tc-99 m进行多同位素成像是可行的，有助于可疑心内膜炎的检查。
Aims 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 In-111-labeled white blood cells (WBCs) and myocardial perfusion with Tc-99m-sestamibi, for localization of WBCs relative to the valve plane in suspected endocarditis.Methods and results 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 In-111-WBC/(99)mTc perfusion imaging was performed, and compared with standard In-111-WBC planar scintigraphy and SPECT-CT. Phantom studies ruled out significant radioisotope crosstalk. Downscatter on Tc-99m images was not observed for In-111 activity as high as 2.5*Tc-99m 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).Conclusion Novel CZT SPECT technology improves the accuracy of molecular/cellular cardiac imaging. Simultaneous multi-isotope imaging with In-111 and Tc-99m is feasible and aids in the workup of suspected endocarditis.