Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology A new era in gated myocardial perfusion imaging: feasibility of data-driven cardiac contraction gating with multiple pinholes CZT SPECT Doumit Daou1,2, Rémy Sabbah3, Carlos Coaguila4, Yousef Alattar5, Hatem Boulahdour3,6 1 EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France 2 Nuclear Medicine Department, Cochin University Hospital, AP-HP, Paris, France 3 Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France 4 Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France 5 Cardiology Department, Cochin University Hospital, AP-HP, Paris, France 6 EA 4662, Université de Franche-Comté, Besançon, France Institution Picture/Logo Optional Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology BACKGROUND 1- We previously validated the use of a data-driven cardiac respiratory-motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). 2- We adapted the same process used with REGAT for RM to generate data-driven cardiac contraction triggers and corresponding cardiac contraction gated SPECT studies (GSPECT-DD). 3- Aim: to study its feasibility and compare its performances to GSPECT generated with ECG monitor-based triggers (GSPECT-ECG). Copyright American Society of Nuclear Cardiology

METHODS Study type:(Select all that apply) Study subjects: Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology METHODS Study type:(Select all that apply) Prospective/randomized/double blind. Study subjects: 7 nonconsecutive random patients without previously known arrhythmias, CAD or heart failure, having a 1-day 99mTc-Tetrofosmin stress/rest MPI with multi-pinhole CZT SPECT. Study endpoints: degree of agreement between GSPECT-DD and GSPECT-ECG for the classification of acquired images into the 16 categories of mean cardiac cycle, comparison between the 2 methods of ciné image quality and global LV systolic function parameters. Copyright American Society of Nuclear Cardiology

METHODS REGAT processing displaying: Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology METHODS REGAT processing displaying: the non-filtered cardiac motion curve (A), the power spectral density curve used for defining the window of cardiac contraction (window 2) (B), the filtered inverse fast Fourier transform of cardiac contraction curve (C). Curves A and C were zoomed and represented in D and E respectively. In D and E only the first 1000 tomographies are presented to better illustrate the curves’ morphologies. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS GSPECT-ECG: excellent image quality (score 3) in 5/7 stress studies and 7/7 rest studies, good image quality (score 2) in 2/7 stress studies. GSPECT-DD : excellent image quality in 5/7 stress studies and 6/7 rest studies, good image quality in 2/7 stress studies and 1/7 rest studies. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology CONCLUSIONS 1- Data-driven cardiac contraction gating using REGAT appears feasible with low-dose and high-dose MPI CZT SPECT when realized in patients without previously known arrhythmias, CAD or heart failure. 2- It seems to provide: almost perfect agreement between cardiac contraction triggers generated with data-driven and ECG methods, LV global systolic function parameters and cine image quality comparable to those provided by traditionally used ECG. Copyright American Society of Nuclear Cardiology