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European Journal of Nuclear Medicine and Molecular Imaging

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01-11-2008 | Original Article

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Authors: Kenichi Nakajima, Nagara Tamaki, Yoichi Kuwabara, Masaya Kawano, Ichiro Matsunari, Junichi Taki, Shigeyuki Nishimura, Akira Yamashina, Yoshio Ishida, Hitonobu Tomoike

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2008

Abstract

Backgrounds

Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies.

Methods

A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using ^99mTc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments.

Results

Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p < 0.0001 for non-gated; 64 ± 16% and 51 ± 17% for ES percent uptake, p < 0.0001). The area under the curve of receiver operating characteristics curve for non-gated percent uptake, ES percent uptake, end-diastolic percent uptake and visual perfusion defect score was 0.70, 0.71, 0.61, and 0.56, respectively. Sensitivity and specificity of percent uptake were 68% and 64% for non-gated map and 80% and 52% for ES percent uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES percent uptake values.

Conclusion

Segmental ^99mTc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study.

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Title: Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan
Authors: Kenichi Nakajima
Nagara Tamaki
Yoichi Kuwabara
Masaya Kawano
Ichiro Matsunari
Junichi Taki
Shigeyuki Nishimura
Akira Yamashina
Yoshio Ishida
Hitonobu Tomoike
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-0838-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Abstract

Backgrounds

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusion

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