Available online 19 April 2023

Author links open overlay panelSection snippetsChallenges of myocardial blood flow quantification with CZT gamma cameras

In this issue of Diagnostic and Interventional Imaging, D'Antonio, et al. provide a comprehensive overview of the current state-of-the art in the quantification of MBF with SPECT and underscore the remaining challenges that will need to be overcome to integrate this approach into patient's management [7]. First, the prerequisite of accurate quantitative estimation of myocardial flow with compartment modeling is to obtain a reliable activity curve for the blood first-pass with a good separation

Added clinical value of MBF quantification with SPECT MPI

Dynamic cardiac SPECT acquisitions require patients to stay for a longer time under the camera and are more complex to perform than conventional MPI protocols. Accordingly, the implementation of these protocols will need to be justified by an improvement in the diagnostic and prognostic performance of SPECT-MPI. Based on the large clinical experience acquired with cardiac PET imaging, it may be assumed that SPECT-based quantification of global MBF might provide benefit for the interpretation of

Conclusion

In conclusion, MBF measurements with dynamic SPECT protocols might not reach the accuracy and robustness of PET imaging, but could offer access to estimates of stress MBF quantification to a larger number of sites and at lower costs. The analysis of global stress MBF values seems easier to integrate in the clinical interpretation of MPI than regional stress MBF because of the lower signal homogeneity of SPECT in comparison to PET acquisitions. This additional information, though not perfectly

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Disclosure of interest

F.H. is consultant or speaker for Curium, Bracco Imaging, GE Healthcare, Naogen Pharma, Pfizer.

Funding

The author declares that this work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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The author attests that he meets the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship.

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