Nuclear Cardiology: Single Photon Emission Computed Tomography. Chapter 2

Single photon emission computed tomography (SPECT) is the most widely applied nuclear medicine technique in cardiology. It is based on the use of single photon emitting radiopharmaceuticals that have the property of entering myocardial cells proportional to regional blood flow. This property allows the imaging of myocardial perfusion using detecting devices for either X rays or gamma rays. Indeed, the extraction of those radiopharmaceuticals increases proportionally in a myocardial territory perfused by a patent coronary artery than in a segment perfused by a stenosed vessel, enabling differentiation between the normal and the hypoperfused myocardium. Computer algorithms have been developed to automatically and objectively process and quantify these images. Myocardial perfusion imaging (MPI) has a widespread clinical use because of its well documented diagnostic accuracy for assessing coronary artery disease (CAD), as well as its prognostic value [2.1]. Recent advances in SPECT instrumentation have made it possible to improve image quality while reducing study time, radiation dose to the patient and overall cost. In addition, new software solutions have improved image resolution and helped to limit image noise. In this chapter, a general review of recent advances in this field is presented. The IAEA has published detailed guidance on SPECT MPI implementation