68 y/o Male with Ischemic and Hypertensive Cardiomyopathy

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No contrast enhancement or “background subtraction” has been performed
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History: 68 y/o man with history of myocardial infarction x 2 and CABG x 2. Enlarged heart. Elevated cholesterol. No acute complaints.

Height: 6' 0”

Weight: 161 pounds (73 kg).

Tracer dose: 30.4 mCi at peak treadmill stress

Timing: Tracer was injected at peak treadmill exercise. After a 30 minute delay, SPECT images were obtained on a conventional, dual-detector, dedicated cardiac SPECT system. Approximately one hour later, images were obtained on the CardiArc® scanner. No additional tracer was administered between the two scans.

Scan Duration
Conventional
dual-detector w
LEHR collimation
15 min
CardiArc® 4.6 min


Scan findings: Markedly enlarged heart with dilated left and right ventricles. Right ventricular hypertrophy. Large regions of myocardial scar.

Even though it is hypertrophied, partial-volume effect causes the right ventricular wall (red arrowheads) to be poorly visuallized by the standard “high-resolution” sytem. The higher resolution of the CardiArc® system permits more accurate visualization of thinner structures. This marked reduction in partial volume effect results in images that most accurately reflect tissue uptake, not just tissue thickness.

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Conventional, dual-detector LEHR - 15 min acquisition
(click image for full screen comparison)

Click to see comparison in seprate window
CardiArc® - 4.6 min acquisition
Higher resolution gives better visualization of hypertrophied RV, even in only 1/3 the acquisition time.
(click image for full screen comparison)

Click to see comparison in seprate window
Conventional, dual-detector LEHR - 15 min acquisition
This patient's right atrium (blue arrowhead) is invisible with standard-type system, despite use of high-resolution collimators. It is easily seen on the CardiArc® images taken one hour later (below).
(click image for full screen comparison)


CardiArc® - 4.6 min acquisition
The right ventricle (red arrowheads) and right atrium (blue arrowhead) are clearly identifiable. The higher resolution CardiArc® images also more clearly demonstrate the true heterogeneity of left ventricular perfusion in this patient.
(click image for full screen comparison)

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