gated spect myocardial perfusion imaging with cadmium-zinc-telluride detectors allows real-time assessment of dobutamine-stress-induced wall motion abnormalities

Left ventricular (lv) ejection fraction (ef) during high dobutamine stress (hd) by real-time gated-spect myocardial perfusion imaging (mpi) on a cadmium-zinc-telluride (czt) gamma camera was validated versus cardiac magnetic resonance imaging (cmr). after injecting 99mtc-tetrofosmin (320 mbq) in 50 patients (mean age 64 +/− 11 years), ef at rest and post-stress as well as relevant changes in ef at hd (δef ≥ 5%) were assessed. czt and cmr rest ef values yielded an excellent correlation and agreement (r = 0.96; p < 0.001; bland–altman limits of agreement (ba): + 0 to 14.8%). hd ef acquisition was feasible using czt and correlated better to hd cmr ef than did post-stress czt ef (r = 0.85 vs 0.76, respectively, all p < 0.001). agreement in δef detection between hd cmr and immediate post-stress czt (reflecting standard acquisition using conventional spect camera unable to scan during stress) was 45%, while this increased to 85% with real-time hd czt scan. real-time ultrafast dobutamine gated-spect mpi with a czt device is feasible and provides accurate measurements of hd lv performance.