Assessment of sestamibi CZT-SPECT reconstructed using deep-learning-based virtual attenuation correction maps according to coronary artery territory and with comparison to rubidium-PET.

Nathaniel Roth, Matthieu Doyen, Fabien Hyafil, Laetitia Imbert, Véronique Roch, Mathieu Perrin, Marine Claudin, Pierre-Yves Marie, François Rouzet, Telma Sprauel, Kaya Doyeux, Yechiel Lamash, Renata Chequer

Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 2025;49():102226

PMID: 40258438

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Attenuation artifacts affect the analysis of single-photon emission computed tomography (SPECT) myocardial perfusion imaging, especially in the right coronary artery (RCA) territory, although computed tomography (CT)-based attenuation corrections minimize this issue. This study aims to assess stress-rest [Tc]sestamibi cadmium zinc telluride (CZT)-SPECT reconstructed using deep-learning-based attenuation correction (DLAC) maps according to coronary artery territory and with comparison to [Rb]rubidium-positron emission tomography (Rb-PET) conventionally reconstructed with CT-based attenuation correction.

METHODS

We compared stress-rest [Tc]sestamibi CZT-SPECT reconstructed without (i.e., standard (SD-SPECT)) and with DLAC (DLAC-SPECT) in 84 patients at risk of attenuation artifacts (overweight individuals and women) with no previous history of coronary artery disease (CAD), and who also had Rb-PET and, when indicated, coronary angiography.

RESULTS

In 74 very low CAD-risk patients: (i) the stress segmental activity values were homogeneous between the three coronary artery territories with DLAC-SPECT and Rb-PET but exhibited a marked reduction in the RCA territory with SD-SPECT (69.1% ± 8.2% vs 81.2% ± 7.1% and 77.7% ± 8.5% for DLAC-SPECT and Rb-PET, respectively, both P < .001), and (ii) the absolute value of the difference between the rest and stress segmental activities was higher in the RCA territory with SD-SPECT (5.13% ± 4.04%) than with DLAC-SPECT (4.21% ± 3.24%) and Rb-PET (3.92% ± 3.08%, both P < .001).

CONCLUSIONS

When utilizing DLAC maps for reconstruction of [Tc]sestamibi CZT-SPECT, there is no more drop in the RCA territory uptake with lower fluctuations in stress-to-rest activity, aligning closely with the results observed using Rb-PET in the same patients.

TRIAL REGISTRATION NUMBER

NCT01679886 on clinicaltrials.gov.

Address: Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000, Nancy, France.; Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000, Nancy, France; Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France.; Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), F-75000, Paris, France.; Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France.; Spectrum Dynamics Medical, Caesarea, Israel.; Department of Nuclear Medicine, Bichat University Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), F-75000, Paris, France; Université Paris Cité, INSERM U 1148, F-75000, Paris, France.; Department of Nuclear Medicine, DMU IMAGINA, European Hospital Georges-Pompidou, Assistance Publique-Hopitaux de Paris (AP-HP), F-75015, Paris, France; INSERM U 970, University Paris-City, F-75015, Paris, France.; Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000, Nancy, France; Université de Lorraine, IADI, INSERM U1254, F-54000, Nancy, France. Electronic address: [email protected].

DOI: 10.1016/j.nuclcard.2025.102226

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MeSH Terms: Aged, Female, Humans, Male, Middle Aged, Artifacts, Cadmium, Coronary Artery Disease, Coronary Vessels, Deep Learning, Image Processing, Computer-Assisted, Myocardial Perfusion Imaging, Positron-Emission Tomography, Radiopharmaceuticals, Rubidium Radioisotopes, Technetium Tc 99m Sestamibi, Tellurium, Tomography, Emission-Computed, Single-Photon, Zinc