Single photon emission computed tomography imaging method

• US 9,173,625 B2
• Filed: 03/11/2013
• Issued: 11/03/2015
• Est. Priority Date: 04/30/2012
• Status: Active Grant

• Current Assignee: Elazar A. Bienenstock
• Original Assignee: Elazar A. Bienenstock
• Inventors: Bienenstock, Elazar A.
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US13/792,632
• Publication Number:
  US 20130289397A1
• Time in Patent Office: 967 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/4884 inducing physiological or psychological stress, e.g. applications for stress testing
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/486 involving generating temporal series of image data
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/507 for determination of haemodynamic parameters, e.g. perfusion CT
• CPC Class Codes: A61B 6/5217 extracting a diagnostic or physiological parameter from medical diagnostic data
• CPC Class Codes: A61B 6/5235 combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
• CPC Class Codes: A61B 6/5264 due to motion
• CPC Class Codes: A61K 51/02 characterised by the carrier , i.e. characterised by the agent or material covalently linked or complexing the radioactive nucleus
• CPC Class Codes: A61K 51/025 inorganic Tc complexes or compounds

Abstract

A SPECT diagnostic method of performing myocardial perfusion imaging on a patient by administering a rest radiotracer to the patient while the patient is at rest; then when the rest radiotracer is fixed in a heart of the patient, scanning the heart to obtain rest heart pumping ability information; scanning the heart of the patient to obtain a rest perfusion image; administering a stressing agent to the patient to place the patient'"'"'s heart under stress; scanning the heart of the patient to obtain stress heart pumping ability information; then administering a stress radiotracer while the heart of the patient is under stress; then when the stress radiotracer is fixed in the heart, scanning the heart to obtain a stress perfusion image.

Claims

1. A SPECT diagnostic method of performing myocardial perfusion imaging on a patient, the method comprising the steps of:

(A) administering a rest radiotracer to the patient while the patient is at rest;

then (B) when the rest radiotracer is fixed in a heart of the patient, scanning the heart to obtain rest heart pumping ability information;

(C) scanning the heart of the patient to obtain a rest perfusion image;

(D) administering a stressing agent to the patient to place the patient'"'"'s heart under stress;

(E) scanning the heart of the patient to obtain stress heart pumping ability information;

then

(F) administering a stress radiotracer while the heart of the patient is under stress;

then

(G) when the stress radiotracer is fixed in the heart, scanning the heart to obtain a stress perfusion image.

2. A SPECT diagnostic method as claimed in claim 1, wherein step (D) is performed after step (B) is complete, but while step (C) is still being performed.

3. A SPECT diagnostic method as claimed in claim 1, wherein step (D) is commenced only after step (C) is finished.

4. A SPECT diagnostic method as claimed in claim 1, wherein step (C) continues to be executed during execution of steps (D), (F), (F) and (G).

5. A SPECT diagnostic method as claimed in claim 1, wherein step (C) continues to be executed during the execution of steps (D) and (E).

6. A SPECT diagnostic method as claimed in claim 1, wherein the rest radiotracer comprises a Technetium-based radiopharmaceutical.

7. A SPECT diagnostic method as claimed in claim 6, wherein the stress radiotracer comprises a Technetium-based radiopharmaceutical.

8. A SPECT diagnostic method as claimed in claim 6, wherein the stress radiotracer comprises Thallium, and wherein the method further comprises the steps of (1) prior to step (E), taking a pre-stress-scan image in Thallium'"'"'s energy window, and (2) after step (G), subtracting the pre-stress-scan image from the stress perfusion image to obtain a refined stress perfusion image;

whereby an effect of Technetium crosstalk in the Thallium energy window is minimized.

9. A SPECT diagnostic method as claimed in claim 1, wherein the stress radiotracer comprises Thallium.

10. A SPECT diagnostic method as claimed in claim 9, wherein the rest radiotracer comprises Thallium.

11. A SPECT diagnostic method as claimed in claim 9, wherein said step (A) comprises administering 5 mCi or less of technetium to the patient while the patient is at rest.

12. A SPECT diagnostic method as claimed in claim 1, wherein the rest radiotracer comprises Thallium, and the stress radiotracer comprises a Technetium-based radiopharmaceutical.

13. A SPECT diagnostic method as claimed in claim 12, wherein the stress pharmceutical comprises dipyridamole.

14. A SPECT diagnostic method as claimed in claim 1, wherein the rest heart pumping ability information comprises at least one of rest wall motion information and rest left ventricle ejection fraction information.

15. A SPECT diagnostic method as claimed in claim 1, wherein the stress heart pumping ability information comprises at least one of stress wall motion information and stress left ventricle ejection fraction information.

16. A SPECT diagnostic method as claimed in claim 1, wherein the stress heart pumping ability information includes end systolic volume and end diastolic volume.

17. A SPECT diagnostic method as claimed in claim 1, wherein the stressing agent comprises a stress pharmaceutical which is selected from a group consisting of dipyridamole, dobutamine adenosine and regadenosone.

18. A SPECT diagnostic method as claimed in claim 1, wherein the stressing agent comprises a non-pharmaceutical stressing agent.

19. A SPECT diagnostic method as claimed in claim 18, wherein the non-pharmaceutical stressing agent is selected from a group consisting of cold presser testing, mental stress, bicycle exercise and handgrip exercise.

20. A SPECT diagnostic method as claimed in claim 1, wherein all of steps (A)-(G) are completed in 20 minutes or less.

21. A SPECT diagnostic method as claimed in claim 1, wherein step (F) comprises administering a stress dose of a Technetium-based radiopharmaceutical, wherein step (A) comprises administering a rest dose of a Technetium-based radiopharmaceutical, the stress dose being greater than the rest dose, and wherein the method further comprises the step of subtracting the rest perfusion image from the stress perfusion image to obtain a refined stress perfusion image.

22. A SPECT diagnostic method as claimed in claim 1, wherein the patient is kept stationary from the commencement of step (C) through the completion of steps (C) through (G).

23. A SPECT diagnostic method as claimed in claim 1, wherein the method comprises the step of performing steps (A) through (G) on a patient of a hospital emergency room having symptoms of heart disease.

24. A SPECT diagnostic method as claimed in claim 1, wherein step (E) comprises obtaining stress GPSECT images twice or more.

25. A SPECT diagnostic method as claimed in claim 1, wherein step (G) comprises performing two or more consecutive short perfusion scans, and combining data from the two or more short scans to produce the stress perfusion image.

26. A SPECT diagnostic method as claimed in claim 25, step (G) hailer comprising using the two or more short perfusion scans to detect and correct patient movement during the performance of step (G).

27. A SPECT diagnostic method as claimed in claim 1, wherein the patient remains in a scanning position from step (C) through step (G) inclusive.