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The radiation dose to overweighted patients undergoing myocardial perfusion SPECT can be significantly reduced : validation of a linear weight-adjusted activity administration protocol

Oddstig, Jenny LU ; Hindorf, Cecilia LU ; Hedeer, Fredrik LU ; Jögi, Jonas LU ; Arheden, Håkan LU ; Hansson, Magnus LU and Engblom, Henrik LU (2016) In Journal of Nuclear Cardiology
Abstract

Background: Large body size can cause a higher proportion of emitted photons being attenuated within the patient. Therefore, clinical myocardial perfusion SPECT (MPS) protocols often include unproportionally higher radioisotope activity to obese patients. The aim was to evaluate if a linear weight-adjusted low-dose protocol can be applied to obese patients and thereby decrease radiation exposure. Methods and result: Two hundred patients (>110 kg, BMI 18-41, [n = 69], ≤ 110 kg, BMI 31-58, [n = 131]) underwent 99mTc-tetrofosmin stress examination on a Cadmium Zinc Telluride or a conventional gamma camera using new generations of reconstruction algorithm (Resolution Recovery). Patients <110 kg were administered 2.5 MBq/kg,... (More)

Background: Large body size can cause a higher proportion of emitted photons being attenuated within the patient. Therefore, clinical myocardial perfusion SPECT (MPS) protocols often include unproportionally higher radioisotope activity to obese patients. The aim was to evaluate if a linear weight-adjusted low-dose protocol can be applied to obese patients and thereby decrease radiation exposure. Methods and result: Two hundred patients (>110 kg, BMI 18-41, [n = 69], ≤ 110 kg, BMI 31-58, [n = 131]) underwent 99mTc-tetrofosmin stress examination on a Cadmium Zinc Telluride or a conventional gamma camera using new generations of reconstruction algorithm (Resolution Recovery). Patients <110 kg were administered 2.5 MBq/kg, patients between 110 and 120 kg received 430 MBq and patients >120 kg received 570 MBq according to clinical routine. Patients >110 kg had 130% total number of counts in the images compared to patients <110 kg. Recalculating the counts to correspond to an administered activity of 2.5 MBq/kg resulted in similar number of counts across the groups. Image analyses in a subgroup with images corresponding to high activity and 2.5 MBq/kg showed no difference in image quality or ischemia quantification. Conclusion: Linear low-dose weight-adjusted protocol of 2.5 MBq/kg in MPS can be applied over a large weight span without loss of counts or image quality, resulting in a significant reduction in radiation exposure to obese patients.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
conventional gamma camera, CZT detector, image quality, Myocardial perfusion imaging: SPECT, radiation dose
in
Journal of Nuclear Cardiology
pages
10 pages
publisher
Springer
external identifiers
  • scopus:84981287297
ISSN
1071-3581
DOI
10.1007/s12350-016-0628-7
language
English
LU publication?
yes
id
f3f07ee5-35ff-4606-a7df-0808b1d2bba1
date added to LUP
2016-09-20 13:59:50
date last changed
2017-01-03 10:43:51
@article{f3f07ee5-35ff-4606-a7df-0808b1d2bba1,
  abstract     = {<p>Background: Large body size can cause a higher proportion of emitted photons being attenuated within the patient. Therefore, clinical myocardial perfusion SPECT (MPS) protocols often include unproportionally higher radioisotope activity to obese patients. The aim was to evaluate if a linear weight-adjusted low-dose protocol can be applied to obese patients and thereby decrease radiation exposure. Methods and result: Two hundred patients (&gt;110 kg, BMI 18-41, [n = 69], ≤ 110 kg, BMI 31-58, [n = 131]) underwent <sup>99m</sup>Tc-tetrofosmin stress examination on a Cadmium Zinc Telluride or a conventional gamma camera using new generations of reconstruction algorithm (Resolution Recovery). Patients &lt;110 kg were administered 2.5 MBq/kg, patients between 110 and 120 kg received 430 MBq and patients &gt;120 kg received 570 MBq according to clinical routine. Patients &gt;110 kg had 130% total number of counts in the images compared to patients &lt;110 kg. Recalculating the counts to correspond to an administered activity of 2.5 MBq/kg resulted in similar number of counts across the groups. Image analyses in a subgroup with images corresponding to high activity and 2.5 MBq/kg showed no difference in image quality or ischemia quantification. Conclusion: Linear low-dose weight-adjusted protocol of 2.5 MBq/kg in MPS can be applied over a large weight span without loss of counts or image quality, resulting in a significant reduction in radiation exposure to obese patients.</p>},
  author       = {Oddstig, Jenny and Hindorf, Cecilia and Hedeer, Fredrik and Jögi, Jonas and Arheden, Håkan and Hansson, Magnus and Engblom, Henrik},
  issn         = {1071-3581},
  keyword      = {conventional gamma camera,CZT detector,image quality,Myocardial perfusion imaging: SPECT,radiation dose},
  language     = {eng},
  month        = {08},
  pages        = {10},
  publisher    = {Springer},
  series       = {Journal of Nuclear Cardiology},
  title        = {The radiation dose to overweighted patients undergoing myocardial perfusion SPECT can be significantly reduced : validation of a linear weight-adjusted activity administration protocol},
  url          = {http://dx.doi.org/10.1007/s12350-016-0628-7},
  year         = {2016},
}