Key result
Application of CT attenuation correction during SPECT/CT imaging did not change the final result of myocardial perfusion imaging, indicating the CT component is not useful for TTS diagnosis.
Why the study?
Clinical symptoms and electrocardiographic changes in Takotsubo syndrome can resemble myocardial infarction, motivating an assessment of the impact of SPECT/CT imaging on diagnosis and management.
Does the addition of CT attenuation correction to SPECT imaging improve the diagnosis of Takotsubo syndrome?
Observational (n=27)
Does the addition of CT attenuation correction to SPECT imaging improve the diagnosis of Takotsubo syndrome?
The use of CT for attenuation correction in SPECT imaging does not alter myocardial perfusion results and is not useful for diagnosing Takotsubo syndrome.
Does not support routine SPECT/CT in Takotsubo; leaves open its diagnostic role in larger studies.
PURPOSE: Clinical symptoms and electrocardiographic changes in patients with Takotsubo syndrome can be similar to patients with myocardial infarction. The aim of the study was to assess the impact of SPECT/CT imaging on the diagnosis and management of Takotsubo syndrome (TTS). METHODS: Gated single photon emission computed tomography (SPECT)/CT after injection 99Tc-MIBI in resting conditions was performed in 27 patients with TTS using dual-head Symbia T6SPECT/CT hybrid device. CT data were used for attenuation correction of SPECT images and to assess the risk of coronary artery disease on the basis of coronary artery calcium score. RESULTS: Abnormal myocardial perfusion was found in 20/27 patients. The mean defect size was 9.8 cm, the extent 11.7%, mean total perfusion defect was 10.36%, mean summed rest score (SRS) 6.71.Left ventricle ejection fraction was lower in patients with SRS at least 4 than in patients with SRS less than 4. Perfusion defect size, total perfusion defect, number of akinetic segments in echocardiography and number of segments with perfusion defect in SPECT were higher in the group with SRS at least 4. The applied attenuation correction algorithms did not change the result of our SPECT study. CONCLUSION: In the majority of patients with TTS perfusion in SPECT was normal or only minor perfusion defect was observed. Application of CT attenuation correction did not change the final result of myocardial perfusion imaging; therefore, the CT component of the SPECT/CT study performed for attenuation correction is not useful for TTS diagnosis.
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Kobylecka et al. (2019) conducted an observational in Takotsubo syndrome (n=27). Hybrid SPECT/CT imaging with CT attenuation correction was evaluated on Abnormal myocardial perfusion. Application of CT attenuation correction during SPECT/CT imaging did not change the final result of myocardial perfusion imaging, indicating the CT component is not useful for TTS diagnosis.
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