Creation and characterization of Japanese standards for myocardial perfusion SPECT: Database from Japanese Society of Nuclear Medicine working group activity

Introduction Myocardial SPECT has been utilized as an important tool for optimal decision making in cardiology. The Guidelines for the Clinical Use of Cardiac Radionuclide Imaging were originally published in 1986 in the USA and updated in 1995. 1 In Japan, Nuclear Cardiology Guidelines were also summarized and published in 2005 by the task force of the Japan Circulation Society, Japanese Society of Nuclear Medicine (JSNM) and related societies, and the role of nuclear modalities has been recognized. 2 Among non-invasive technologies currently being developed in the fields of echocardiography, multi-detector x-ray computed tomography and magnetic resonance imaging, nuclear medicine plays a pivotal role in evaluating myocardial perfusion and metabolism. To be accepted as a reliable technology, standard patterns of myocardial radiotracer distribution and function should be defined. However, because myocardial distribution is known to be affected by f a c t o r s o f d a t a a c q u i s i t i o n m e t h o d s , radiopharmaceutical types and gender, one of the most important issues is the standardization of myocardial SPECT studies. Moreover, since the differences in body habitus are not negligible, standards cannot be used interchangeably among populations. In light of this background, the Japanese Society of Nuclear Medicine started working on a group project for creating myocardial standard based on a SPECT study from 2006 during a two-year period. The goal of the project was to create normal database and standard files for computer software and outline characteristics of a Japanese population with respect to perfusion, fatty acid and sympathetic imaging. This first report presents and provides data on the characteristics of a Japanese population with respect to myocardial perfusion SPECT. Abstract Objective: Standards for myocardial single-photon emission computed tomography (SPECT) adapted for a Japanese population have not been available. The purpose of this project was to create standard files approved by the Japanese Society of Nuclear Medicine and to make known the characteristics of the myocardial perfusion pattern of this population. Methods: With the collaboration of nine hospitals, a total of 326 sets of exercise-rest myocardial perfusion images were accumulated from subjects with a low-likelihood of cardiac diseases. The normal database included a 99m Tc-MIBI/tetrofosmin myocardial perfusion study with 360-degree (n=80) and 180-degree (n=56) rotations, 201 Tl study with 360-degree (n=115) and 180-degree rotations (n=54) and a dual-isotope study with 360-degree rotation …