Qualitative and quantitative comparison of gated blood pool single photon emission computed tomography using low-energy high-resolution and SMARTZOOM collimation

Objective The aim of this study was to assess the feasibility of IQ-SPECT gated blood pool (MUGA) under conditions of decreased scan time (ST). Patients and methods Ten patients underwent routine 26-min, two-view planar, followed by LEHR and IQ-SPECT MUGA, on a Siemens dual-head Symbia scanner. Six 'back and forth' 4-min SPECT scans were summed into 4-, 8-, 12-, 16-, 20-, and 24-min equivalent scans, and reconstructed iteratively (IQ-SPECT and LEHR) and with FBP (LEHR). Uniformity, contrast, and wall motion were scored on a five-point scale. Linear regressions of left ventricular (LV) ejection fraction (EF) were performed between FBP, Flash 3D, and IQ-SPECT versus planar and Flash 3D and IQSPECT versus FBP. Agreement tables between Flash 3D and IQ-SPECT versus FBP LV EF were generated using a normal versus cardiotoxicity threshold of 50%. Results IQ-SPECT had the best scores for all STs, and 4, 8, and 16 min IQ-SPECT were judged to be similar to 24-min LEHR FBP, Flash 3D, and planar, respectively. The average LV EF correlation coefficients were 0.69, 0.71, and 0.63 between IQ-SPECT, Flash 3D, and FBP versus planar, respectively; 0.70 between IQ-SPECT and FBP; and 0.88 between Flash 3D and FBP, and all were statistically significant (P<0.05), except for 16-min FBP LEHR versus planar. Agreement tables showed diagnostic equivalence of IQ-SPECT, Flash 3D, and FBP. Conclusion These preliminary results suggest that IQSPECT is equivalent to LEHR Flash 3D and FBP for MUGA SPECT, and better at reduced ST. A larger patient population study is necessary for a more definitive assessment.