Advances in Imaging Instrumentation for Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology Advances in Imaging Instrumentation for Nuclear Cardiology Jae Sung Lee1, Gil Kovalski2, Tali Sharir3, Dong Soo Lee1 1Seoul National University, Seoul, Korea 2General Electric Healthcare, Haifa, Israel 3Assuta Medical Centers, Tel Aviv, Israel Copyright American Society of Nuclear Cardiology

Dedicated Cardiac CZT SPECT Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology Dedicated Cardiac CZT SPECT Advantages of CZT detectors Direct convertor of gamma-ray to electrical signal Pixelated nature improving the intrinsic spatial resolution Compact physical size, leading to efficient system designs Improved performance in the rejection of scatter and crosstalk Efficacy of cardiac CZT scanners Reduced acquisition time Reduced radiation dose Stationary dynamic SPECT scan Copyright American Society of Nuclear Cardiology

SPECT/CT CT-based attenuation correction Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology SPECT/CT CT-based attenuation correction More accurate reconstruction of SPECT data with reliable attenuation maps with high counting statistics Absolute quantification of myocardial blood flow (MBF) and myocardial flow reserve (MFR) Additional anatomical information Coronary artery calcium (CAC) deposit assessment CT coronary angiography Copyright American Society of Nuclear Cardiology

29% 17% A B LAD LCX RCA stress rest difference SA VLA HLA Figure 4. SPECT-MPI and CT-CAC of a 72 year old male obtained via a SPECT/CT camera. (A) MPI showing only mild ischemia, and (B) CT demonstrating extensive coronary artery calcification.

PET/CT and PET/MRI PET detector components Semiconductor photosensors Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology PET/CT and PET/MRI PET detector components Cerium-doped lutetium silicate scintillators (e.g., LSO, LYSO, and LGSO) Fast PMTs and semiconductor photosensors Precise electronics for timing measurement Semiconductor photosensors Avalanche photodiode (APD) and silicon photomultiplier (SiPM) Relatively compact and impervious to magnetic fields Increased use in PET/MRI and PET/CT scanners Copyright American Society of Nuclear Cardiology

PET/CT and PET/MRI (Cont’) Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology PET/CT and PET/MRI (Cont’) Time-of-flight (TOF) PET Enhanced image quality Less sensitive to inconsistent correction data Better performance in the joint estimation of activity and attenuation employing only emission data Motion-corrected cardiac PET Dual motion (cardiac and respiratory) corrected cardiac images Coronary PET motion correction guided by CT angiography Cardiac PET motion correction using tagged MRI Copyright American Society of Nuclear Cardiology