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      EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras

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          Abstract

          An increasing number of Nuclear Medicine sites in Europe are using cardiac-centered gamma cameras for myocardial perfusion scintigraphy (MPS). Three cardiac-centered gamma cameras are currently the most frequently used in Europe: the D-SPECT (Spectrum Dynamics), the Alcyone (Discovery NM 530c and Discovery NM/CT 570c; General Electric Medical Systems), and the IQ-SPECT (Siemens Healthcare). The increased myocardial count sensitivity of these three cardiac-centered systems has allowed for a decrease in the activities of radiopharmaceuticals injected to patients for myocardial perfusion imaging and, consequently, radiation exposure of patients. When setting up protocols for MPS, the overall objective should be to maintain high diagnostic accuracy of MPS, while injecting the lowest activities reasonably achievable to reduce the level of radiation exposure of patient and staff. These guidelines aim at providing recommendations for acquisition protocols and image interpretation using cardiac-centered cameras. As each imaging system has specific design and features for image acquisition and analysis, these guidelines have been separated into three sections for each gamma camera system. These recommendations have been written by the members of the Cardiovascular Committee of EANM and were based on their own experience with each of these systems and on the existing literature.

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          Accelerated image reconstruction using ordered subsets of projection data.

          The authors define ordered subset processing for standard algorithms (such as expectation maximization, EM) for image restoration from projections. Ordered subsets methods group projection data into an ordered sequence of subsets (or blocks). An iteration of ordered subsets EM is defined as a single pass through all the subsets, in each subset using the current estimate to initialize application of EM with that data subset. This approach is similar in concept to block-Kaczmarz methods introduced by Eggermont et al. (1981) for iterative reconstruction. Simultaneous iterative reconstruction (SIRT) and multiplicative algebraic reconstruction (MART) techniques are well known special cases. Ordered subsets EM (OS-EM) provides a restoration imposing a natural positivity condition and with close links to the EM algorithm. OS-EM is applicable in both single photon (SPECT) and positron emission tomography (PET). In simulation studies in SPECT, the OS-EM algorithm provides an order-of-magnitude acceleration over EM, with restoration quality maintained.
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            Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.

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              EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology.

              The European procedural guidelines for radionuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radiopharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation-scatter compensation, data analysis, reports and image display, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocardial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocardial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness.
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                Author and article information

                Contributors
                (+33) 140 25 64 75 , fabien.hyafil@aphp.fr
                Journal
                Eur J Hybrid Imaging
                Eur J Hybrid Imaging
                European Journal of Hybrid Imaging
                Springer International Publishing (Cham )
                2510-3636
                2 July 2019
                2 July 2019
                December 2019
                : 3
                : 11
                Affiliations
                [1 ]ISNI 0000 0001 2217 0017, GRID grid.7452.4, Department of Nuclear Medicine; Bichat University Hospital, Assistance Publique - Hôpitaux de Paris; Inserm UMR 1148, , Paris Diderot-Paris 7 University, ; 46 rue Henri Huchard, 75018 Paris, France
                [2 ]Fondazione Toscana/CNR Gabriele Monasterio, Pisa, Italy
                [3 ]ISNI 0000 0000 9558 4598, GRID grid.4494.d, Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, , University Medical Center Groningen, ; Groningen, The Netherlands
                [4 ]ISNI 0000 0004 0399 8953, GRID grid.6214.1, TechMed Centre, Department of Biomedical Photonic Imaging, , University of Twente, ; Enschede, The Netherlands
                [5 ]GRID grid.411299.6, Department of Nuclear Medicine, , University of Thessaly, University Hospital of Larissa, ; Larissa, Greece
                [6 ]ISNI 0000 0001 2187 5445, GRID grid.5718.b, Department of Nuclear Medicine, University Hospital Essen, , University of Duisburg-Essen, ; Essen, Germany
                [7 ]ISNI 0000 0001 2351 3333, GRID grid.412354.5, Department of Medical Physics and PET Centre, , Uppsala University Hospital, ; Uppsala, Sweden
                [8 ]ISNI 0000 0004 1757 2304, GRID grid.8404.8, Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences, , University of Florence, ; Florence, Italy
                [9 ]ISNI 0000 0004 0480 1382, GRID grid.412966.e, Department of Nuclear Medicine, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht (CARIM), , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [10 ]ISNI 0000 0000 8653 1507, GRID grid.412301.5, Department of Nuclear Medicine, , University Hospital RWTH Aachen, ; Aachen, Germany
                [11 ]ISNI 0000 0004 0472 0160, GRID grid.411149.8, Department of Nuclear Medicine, , CHU Caen Normandy University, ; Caen, France
                [12 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Radiology and Nuclear Medicine, Amsterdam UMC, , University of Amsterdam, ; Amsterdam, The Netherlands
                Author information
                http://orcid.org/0000-0002-9600-0376
                Article
                58
                10.1186/s41824-019-0058-2
                8218102
                34191169
                e70bf721-6120-405a-aa77-bb3dc2a706a2
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 1 May 2019
                : 10 June 2019
                Categories
                Guideline
                Custom metadata
                © The Author(s) 2019

                myocardial perfusion scintigraphy,cardiac spect,czt gamma camera,procedural guidelines

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