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History: 55 y/o man with family history of father with CABG at ~55 y/o. Cholesterol = 240. Complaints of exertional sub-sternal chest pain and shortness of breath.

Height: 6' 5”

Weight: 235 pounds.

Tracer dose: 31.2 mCi at peak treadmill stress

Timing: Tracer was injected at peak treadmill exercise. After a 57 minute delay, SPECT images were obtained on a conventional, dual-detector, dedicated cardiac SPECT system. Approximately one hour later, images were obtained on the CardiArc® scanner. No additional tracer was administered between the two scans.

Scan findings: (stress images):

Dual-detector system with high-resolution collimation (LEHR): Large sized inferobasal defect. Small apical defect.
CardiArc®: Large defect involving the inferobasal, inferior, posterolateral and inferolateral walls and the apex.

Catheterization findings: Isolated, high-grade, proximal stenosis of the PDA (posterior descending artery).

Conventional system - 10.6 min acquisition
(click image for full screen comparison)

CardiArc® - 4.7 min acquisition
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Concentional system - 10.6 min acquisition
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CardiArc® - 4.7 min acquisition
(click image for full screen comparison)

Concentional system - 10.6 min acquisition
(click image for full screen comparison)

CardiArc® - 4.7 min acquisition
(click image for full screen comparison)

Discussion: The proximal nature of the stenosis and the extensive ECG findings are more consistent with the CardiArc® images. The higher lesion contrast of CardiArc® may make it easier to define the full extent of perfusion abnormalities.

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