Single photon emission computed tomography (SPECT) has become an important tool in the diagnosis of heart disease, primarily because it has demonstrated an important clinical role in evaluating myocardial ischemia and more recently in evaluating myocardial viability. Over the last several years, (201)Tl has been the primary radiopharmaceutical used for cardiac SPECT. More recently, agents like sestamibi and teboroxime labelled with (99m)Tc have been developed to replace (201)Tl. The isotope(99m)Tc is more desirable than (201)Tl because of its better photon energy and radiation absorbed dose properties. However, these agents have not totally replaced (201)Tl due in part to their physiological characteristics. In particular, teboroxime has a fast wash-in and wash-out from the heart which requires rapid tomographic acquisitions which previously has not been feasible. However, with the advancement of multi- detector SPECT systems, we have demonstrated that dynamic cardiac SPECT imaging of teboroxime is possible. The development of dynamic cardiac SPECT has the potential to offer a more sensitive measure of ischemia than the present static SPECT techniques using (201)Tl. The goal of this proposal is to prescribe clinical protocols for dynamic SPECT imaging of the heart that are able to acquire complete projection sets every 5-10 seconds of a full three-dimensional tissue distribution of a short biological half-life radiopharmaceutical and to develop mathematical tools to extract from the dynamically acquired data a three- dimensional spatial distribution of kinetic parameters in the left ventricular myocardial tissue of blood volume fraction and wash-in (k21) and wash-out (k12) rate constants. The proposal will develop the applied mathematical tools to accurately and precisely quantify kinetic parameters and systematically evaluate these methods with computer simulations, canine experiments and clinical studies. At the completion of this proposal equipment requirements will also be specified. This proposal draws upon the physiological modeling development in PET. At present, PET is much further advanced than SPECT in utilizing dynamic imaging to extract kinetic parameters of organ systems. It is the intent of this proposal to develop methods that would be able to use existing multi-detector SPECT systems; and, in so doing, to provide improved health care to the general public through better detectability of myocardial infarcts, better diagnosis of ischemic heart disease, and better evaluation of tissue viability without adding additional cost to the SPECT procedure. Many of the methods developed will also be applicable to other organ systems such as the kidney and the brain.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL050663-03
Application #
2028954
Study Section
Diagnostic Radiology Study Section (RNM)
Project Start
1995-01-01
Project End
1998-12-31
Budget Start
1997-01-01
Budget End
1997-12-31
Support Year
3
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Utah
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
Mitra, Debasis; Abdalah, Mahmoud; Boutchko, Rostyslav et al. (2018) Comparison of sparse domain approaches for 4D SPECT dynamic image reconstruction. Med Phys 45:4493-4509
Sciammarella, Maria; Shrestha, Uttam M; Seo, Youngho et al. (2017) A combined static-dynamic single-dose imaging protocol to compare quantitative dynamic SPECT with static conventional SPECT. J Nucl Cardiol :
Pan, Hui; Chang, Haoran; Mitra, Debasis et al. (2017) Sparse domain approaches in dynamic SPECT imaging with high-performance computing. Am J Nucl Med Mol Imaging 7:283-294
Pampaloni, Miguel Hernandez; Shrestha, Uttam M; Sciammarella, Maria et al. (2017) Noninvasive PET quantitative myocardial blood flow with regadenoson for assessing cardiac allograft vasculopathy in orthotopic heart transplantation patients. J Nucl Cardiol 24:1134-1144
Shrestha, Uttam; Sciammarella, Maria; Alhassen, Fares et al. (2017) Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation. J Nucl Cardiol 24:268-277
Boutchko, Rostyslav; Mitra, Debasis; Baker, Suzanne L et al. (2015) Clustering-initiated factor analysis application for tissue classification in dynamic brain positron emission tomography. J Cereb Blood Flow Metab 35:1104-11
Shrestha, Uttam M; Seo, Youngho; Botvinick, Elias H et al. (2015) Image reconstruction in higher dimensions: myocardial perfusion imaging of tracer dynamics with cardiac motion due to deformation and respiration. Phys Med Biol 60:8275-301
Abdalah, Mahmoud; Boutchko, Rostyslav; Mitra, Debasis et al. (2015) Reconstruction of 4-D dynamic SPECT images from inconsistent projections using a Spline initialized FADS algorithm (SIFADS). IEEE Trans Med Imaging 34:216-28
Veress, Alexander I; Fung, George S K; Lee, Taek-Soo et al. (2015) The direct incorporation of perfusion defect information to define ischemia and infarction in a finite element model of the left ventricle. J Biomech Eng 137:051004
Shrestha, Uttam; Botvinick, Elias H; Yeghiazarians, Yerem et al. (2014) Quantitative Signature of Coronary Steal in a Patient with Occluded Coronary Arteries Supported by Collateral Circulation Using Dynamic SPECT. IEEE Nucl Sci Symp Conf Rec (1997) 2014:

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