Validation of early image acquisitions following
Tc-99 m sestamibi injection using
a semiconductors camera of cadmium-zinc-
Celine Meyer, MD,
and Pierre Weinmann, MD, PhD
European Hospital Georges Pompidou, AP-HP, Nuclear Medicine, Universite
Received Sep 28, 2015; accepted Mar 25, 2016
Background. Cadmium-zinc-telluride (CZT) cameras allow to decrease signiﬁcantly the
acquisition time of myocardial perfusion imaging (MPI), but the duration of the examination is
still long. Therefore, this study was performed to test the feasibility of early imaging following
injection of Tc-99 m sestamibi using a CZT camera.
Methods. Seventy patients underwent both an early and a delayed image acquisition after
exercise stress test (n 5 30), dipyridamole stress test (n 5 20), and at rest (n 5 20). After
injection of Tc-99 m sestamibi, the early image acquisition started on average within 5 minutes
for the exercise and rest groups, and 3 minutes 30 seconds for the dipyridamole group. Two
independent observers evaluated image quality and extracardiac uptake on four-point scales.
The difference between early and later images for each patient was scored on a ﬁve-point scale.
Results. The image quality and extracardiac uptake of early and delayed image acquisitions
were not different for the three groups (P > .05). There was no signiﬁcant difference between early
and delayed image acquisitions in the exercise, dipyridamole, and rest groups, respectively, in
63%, 40%, and 80% of cases. In the exercise group and rest group, a defect was only present in
early MPI, respectively, in 13% and 20% of cases. A defect was only present in delayed images in
10% of cases in the exercise group and in 45% of cases in the dipyridamole group.
Conclusions. There was no difference between early and later image acquisitions in terms of quality.
This protocol reduces the length of the procedure for the patient. Beginning with early image acquisitions
may help to overcome the artifacts that are observed at the delayed time. (J Nucl Cardiol 2017;24:1149–
Key Words: Sestamibi
Æ cadmium-zinc-telluride Æ myocardial perfusion imaging Æ SPECT Æ
LVEF Left ventricular ejection fraction
ASNC American Society of Nuclear Cardiology
CAD Coronary artery disease
SPECT Single photon emission computerized
MPI Myocardial perfusion imaging
MLEM Maximum-likelihood expectation
SD Standard deviation
Electronic supplementary material The online version of this
article (doi:10.1007/s12350-016-0499-y) contains supplementary
material, which is available to authorized users.
Reprint requests: Celine Meyer, European Hospital Georges Pompi-
dou, AP-HP, Nuclear Medicine, Universite
Paris Descartes, Paris,
Copyright Ó 2016 American Society of Nuclear Cardiology.