Prospective Paired Comparison of 123I-FP-CIT SPECT Images Obtained With a 360°-CZT and a Conventional Camera

Purpose This study aimed to compare 123 I-FP-CIT SPECT imaging obtained from a 360° cadmium-zinc-telluride (CZT) camera with different focus configurations and from a conventional Anger camera. Methods This prospective study (NCT03980418) included patients referred to 123 I-FP-CIT SPECT imaging who consecutively underwent a 30-minute acquisition on a conventional camera immediately followed by two 15-minute acquisitions on the 360°-CZT camera with, respectively, striatum and brain focus and reconstruction parameters to give equivalent contrast ratios, albeit with higher spatial resolution for the CZT camera. Tomographic count sensitivities were calculated. The images were analyzed through visual, according to 5 independent physicians, and automatic semiquantitative analyses. Results Ninety-two patients were included in this study. The 360°-CZT camera tomographic count sensitivities showed increases of +25% and +18% for striatum and brain focus, respectively, as well as significantly higher quality scores ( P ≤ 0.04) in comparison to the conventional camera. The κ scores of consensual visual analysis were 0.80 and 0.85, and correlation coefficients of semiquantitative analysis for striatum uptakes were 0.75 and 0.76 for the comparisons of images obtained with the 2 cameras, with striatum and brain focus, respectively, for the CZT camera. Advanced age was the single predictor of discordant cases (10/92 [11%]) showing systematically abnormal scans with the conventional camera, potentially as a result of partial volume effect. Conclusions Irrespective of focus mode, this high-sensitivity 360°-CZT camera provides concordant 123 I-FP-CIT SPECT results when compared with a conventional camera, but with shorter acquisition times, higher image quality, and few discordant cases possibly explained by its higher spatial resolution.