Comparison: Conventional vs D-SPECT™

Patient 18 - Rest/Stress

Conventional camera vs. D-SPECT with Angiographic results

• Male, 56y, BMI 35
• DM; Hyperlipidemia; Obesity
• Atypical angina
• Bruce protocol 6:00 mins, MPHR 96%, stopped at stage 2 due to chest pain.
• Prescan likelihood of CAD: intermediate
• Tc-99m sestamibi stress/ rest gated SPECT
• Clinical response: ischemic
• ECG response: non-ischemic
  

Acquisition protocol:
10mCi MIBI/28 mCi MIBI

	Conventional Camera:
16 min. 20 min.

		Low dose 35 seconds per projection total of 20 minutes High dose 25 seconds per projection total of 16 minutes

	D-SPECT:
2 min. 4 min.

		Low dose 2 seconds per projection total of 4 minutes High dose 1 second per projection total of 2 minutes

Angiographic results:

• Normal coronary arteries
• A-SPECT: False positive reversible inferior wall defect
• D-SPECT: Normal perfusion
  
  

Images courtesy of Procardia Medical Center

Patient 17 - Rest/Stress

Conventional camera vs. D-SPECT with Angiographic results

• 63 year old male
• 5 feet nine inches tall
• 191.4lbs
• Atypical angina
• Risk factors: hypertension; family history of CAD

Acquisition protocol:
12mCi MIBI/35 mCi MIBI

	Conventional Camera:
16 min. 20 min.

		Low dose 35 seconds per projection total of 20 minutes High dose 25 seconds per projection total of 16 minutes

	D-SPECT:
2 min. 4 min.

		Low dose 2 seconds per projection total of 4 minutes High dose 1 second per projection total of 2 minutes

Angiographic results:

• Ischemia in inferior wall detected by D-SPECT and not by A-SPECT
• 95%-99% occlusion of the distal RCA 30-40% of the proximal LAD
  

Images courtesy of Miami Baptist Hospital

Patient 16 - Rest/Stress

Conventional camera vs. D-SPECT with Angiographic results

• 47 year old male
• BMI 25
• Family history of premature CAD
• Atypical chest pain

Acquisition protocol:
2.5 mCi Tl 201/20 mCi MIBI

	Conventional Camera:
16 min. 20 min.

		Low dose 35 seconds per projection total of 20 minutes High dose 25 seconds per projection total of 16 minutes

	D-SPECT:
2 min. 4 min.

		Low dose 2 seconds per projection total of 4 minutes High dose 1 second per projection total of 2 minutes

Angiographic results:

• First angio: ostium circumflex 80% and distal circumflex 80% stenosis; LAD: mid 70% stenosis; successful stent to both LCX lesions
• Second angio (2 days later): Successful stent to LAD
• Ischemia in LCX territory detected by D-SPECT and not by A-SPECT
  

Images courtesy of Cedars Sinai Medical Center