Feasibility study of a novel general purpose CZT-based digital SPECT camera: initial clinical results

Background: The performance of a prototype novel digital single-photon emission computed tomography (SPECT) camera with multiple pixelated CZT detectors and high sensitivity collimators (Digital SPECT; Valiance X12 prototype, Molecular Dynamics) was evaluated in various clinical settings. Images obtained in the prototype system were compared to images from an analog camera fitted with high-resolution collimators. Clinical feasibility, image quality, and diagnostic performance of the prototype were evaluated in 36 SPECT studies in 35 patients including bone (n = 21), brain (n = 5), lung perfusion (n = 3), and parathyroid (n = 3) and one study each of sentinel node and labeled white blood cells. Images were graded on a scale of 1-4 for sharpness, contrast, overall quality, and diagnostic confidence. Results: Digital CZT SPECT provided a statistically significant improvement in sharpness and contrast in clinical cases (mean score of 3.79 +/- 0.61 vs. 3.26 +/- 0.50 and 3.92 +/- 0.29 vs. 3.34 +/- 0.47 respectively, p < 0.001 for both). Overall image quality was slightly higher for the digital SPECT but not statistically significant (3.74 vs. 3.66). Conclusion: CZT SPECT provided significantly improved image sharpness and contrast compared to the analog system in the clinical settings evaluated. Further studies will evaluate the diagnostic performance of the system in large patient cohorts in additional clinical settings.