Husmann, L

Kaufmann, P A

Pazhenkottil, A P

ZORA

Cardiac hybrid imaging with high-speedsingle-photon emission computedtomography/CT camera to detectischaemia and coronary arteryobstructionA 48-year-old female patient (body mass index 33 kg/m2)without known coronary artery disease was treated over severalweeks for prolonged episodes of back pain unrelated to physicalactivity. Due to the persistence and progression of symptomsthe patient was evaluated for suspected coronary artery disease.Blood test (cardiac enzymes) as well as physical exercise test wasnegative but ECG at rest revealed signs of anterior non-Q-waveinfarction. Therefore, the patient was referred for further non-invasive comprehensive cardiac evaluation by contrast enhancedlow-dose (prospective ECG-triggering) computed tomographycoronary angiography (CTCA) combined with rest/stressmyocardial perfusion single-photon emission computed tomog-raphy (SPECT). This was performed on a new dedicated cardiacSPECT/CT hybrid scanner (Discovery NM/CT 570c; GE Health-care, Milwaukee, Wisconsin, USA) integrating the latest genera-tion gamma camera using ultrafast semiconducting cadmiumzinc telluride pinhole detectors with a 64-slice CT device.The hybrid images revealed a partially reversible anteroapicalperfusion defect (figure 1, panels A and B), caused by totalocclusions of the proximal left anterior descending coronaryartery and of a diagonal branch (figure 1, panel C). Coronaryangiography confirmed these findings (figure 1, panel D), and thepatient was re-canalised in the same session.This case illustrates the advantages of using a high-speedcadmium zinc telluride SPECT/CT hybrid scanner that allowsa combined morphological and functional assessment in onesession with minimised effective radiation dose (3 mSv for CTCAand 2/6 mSv for stress/rest SPECT) and shortened scan time (totalSPECT/CTCA acquisition time below 15 min), demonstrating theimportance and the ease of performing comprehensive non-inva-sive tests in low to moderate pretest probability patients.Aju P Pazhenkottil, Lars Husmann, Philipp A KaufmannCorrespondence to Philipp A Kaufmann; pak@usz.chCompeting interests None to declare.Patient consent Obtained.Ethics approval This study was conducted with the approval of the local ethicscommittee University Hospital Zurich.Provenance and peer review Not commissioned; not externally peer reviewed.Heart 2010;-:1. doi:10.1136/hrt.2010.201996Figure 1Pazhenkottil AP, Husmann L, Kaufmann PA. Heart (2010). doi:10.1136/hrt.2010.201996 1 of 1Images in cardiology Heart Online First, published on September 20, 2010 as 10.1136/hrt.2010.201996Copyright Article author (or their employer) 2010. Produced by BMJ Publishing Group Ltd (& BCS) under licence.  group.bmj.com on March 15, 2011 - Published by heart.bmj.comDownloaded from doi: 10.1136/hrt.2010.201996 published online September 20, 2010Heart Aju P Pazhenkottil, Lars Husmann and Philipp A Kaufmann and coronary artery obstructiontomography/CT camera to detect ischaemiasingle-photon emission computed Cardiac hybrid imaging with high-speed http://heart.bmj.com/content/early/2010/09/20/hrt.2010.201996.full.htmlUpdated information and services can be found at: These include:References http://heart.bmj.com/content/early/2010/09/20/hrt.2010.201996.full.html#related-urlsArticle cited in: P<P Published online September 20, 2010 in advance of the print journal.serviceEmail alertingthe box at the top right corner of the online article.Receive free email alerts when new articles cite this article. Sign up inNotespublication. Advance online articles must include the digital object identifier (DOIs) and date of initialpublication priority; they are indexed by PubMed from initial publication. Citations to available prior to final publication). Advance online articles are citable and establishnot yet appeared in the paper journal (edited, typeset versions may be posted when Advance online articles have been peer reviewed and accepted for publication but have http://group.bmj.com/group/rights-licensing/permissionsTo request permissions go to: http://journals.bmj.com/cgi/reprintformTo order reprints go to: http://group.bmj.com/subscribe/To subscribe to BMJ go to: group.bmj.com on March 15, 2011 - Published by heart.bmj.comDownloaded from 

Cardiac hybrid imaging with high-speed single-photon emission computed tomography/CT camera to detect ischaemia and coronary artery obstruction

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Cardiac hybrid imaging with high-speed single-photon emission computed tomography/CT camera to detect ischaemia and coronary artery obstruction

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