Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2010

01-08-2010 | Original Article

Reliability of myocardial perfusion gated SPECT for the reproducible evaluation of resting left ventricular functional parameters in long-term follow-up

Authors: Roberto Sciagrà, Valentina Berti, Sabrina Genovese, Alberto Pupi

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2010

Login to get access

Abstract

Purpose

Perfusion gated single photon emission computed tomography (SPECT) can assess with good reproducibility left ventricular (LV) volumes and ejection fraction (EF). Whether this reproducibility is maintained in long-term follow-up is unknown.

Methods

We compared LV end-diastolic (ED) and end-systolic (ES) volumes (V) as well as EF calculated using gated SPECT and QGS software in 103 coronary artery disease patients studied twice at > 1-year interval because of standard clinical indications. Patients were divided into two groups: (A) 67 patients without major clinical changes and with stable resting perfusion and (B) 36 with modified clinical status or resting perfusion.

Results

The relationship between gated SPECT 2 EF (=y) and gated SPECT 1 EF (=x) was for group A: y = 0.91 x + 5.34, r = 0.92, p < 0.0001, SEE=4 and for group B: y = 0.67 x + 13.6, r = 0.63, p < 0.0001, SEE=10. The 95% limit of agreement was 8 EF units for group A and 20.6 EF units for group B. For EDV, the 95% limit of agreement was 22 ml for group A and 52 ml for group B. For ESV, the 95% limit of agreement was 13 ml for group A and 44 ml for group B.

Conclusion

In stable patients with an unmodified resting perfusion pattern the functional parameters derived from perfusion gated SPECT have good reproducibility even after a prolonged time interval. This supports the value of gated SPECT for serial evaluations of LV function.
Literature
1.
go back to reference Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138–47.PubMed Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138–47.PubMed
2.
go back to reference Cullom SJ, Case JA, Bateman TM. Electrocardiographically gated myocardial perfusion SPECT: technical principles and quality control considerations. J Nucl Cardiol 1998;5:418–25.CrossRefPubMed Cullom SJ, Case JA, Bateman TM. Electrocardiographically gated myocardial perfusion SPECT: technical principles and quality control considerations. J Nucl Cardiol 1998;5:418–25.CrossRefPubMed
3.
go back to reference Paul AK, Nabi HA. Gated myocardial perfusion SPECT: basic principles, technical aspects, and clinical applications. J Nucl Med Technol 2004;32:179–87.PubMed Paul AK, Nabi HA. Gated myocardial perfusion SPECT: basic principles, technical aspects, and clinical applications. J Nucl Med Technol 2004;32:179–87.PubMed
4.
go back to reference Sciagrà R, Leoncini M. Gated single-photon emission computed tomography. The present-day “one-stop-shop” for cardiac imaging. Q J Nucl Med Mol Imaging 2005;49:19–29.PubMed Sciagrà R, Leoncini M. Gated single-photon emission computed tomography. The present-day “one-stop-shop” for cardiac imaging. Q J Nucl Med Mol Imaging 2005;49:19–29.PubMed
5.
go back to reference Abidov A, Germano G, Hachamovitch R, Berman DS. Gated SPECT in assessment of regional and global left ventricular function: major tool of modern nuclear imaging. J Nucl Cardiol 2006;13:261–79.PubMed Abidov A, Germano G, Hachamovitch R, Berman DS. Gated SPECT in assessment of regional and global left ventricular function: major tool of modern nuclear imaging. J Nucl Cardiol 2006;13:261–79.PubMed
6.
go back to reference Gunning MG, Anagnostopoulos C, Davies G, Forbat SM, Ell PJ, Underwood SR. Gated technetium-99m-tetrofosmin SPECT and cine MRI to assess left ventricular contraction. J Nucl Med 1997;38:438–42.PubMed Gunning MG, Anagnostopoulos C, Davies G, Forbat SM, Ell PJ, Underwood SR. Gated technetium-99m-tetrofosmin SPECT and cine MRI to assess left ventricular contraction. J Nucl Med 1997;38:438–42.PubMed
7.
go back to reference Manrique A, Faraggi M, Véra P, Vilain D, Lebtahi R, Cribier A, et al. 201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography. J Nucl Med 1999;40:805–9.PubMed Manrique A, Faraggi M, Véra P, Vilain D, Lebtahi R, Cribier A, et al. 201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography. J Nucl Med 1999;40:805–9.PubMed
8.
go back to reference Cwajg E, Cwajg J, He ZX, Hwang WS, Keng F, Nagueh SF, et al. Gated myocardial perfusion tomography for the assessment of left ventricular function and volumes: comparison with echocardiography. J Nucl Med 1999;40:1857–65.PubMed Cwajg E, Cwajg J, He ZX, Hwang WS, Keng F, Nagueh SF, et al. Gated myocardial perfusion tomography for the assessment of left ventricular function and volumes: comparison with echocardiography. J Nucl Med 1999;40:1857–65.PubMed
9.
go back to reference Tadamura E, Kudoh T, Motooka M, Inubushi M, Shirakawa S, Hattori N, et al. Assessment of regional and global left ventricular function by reinjection Tl-201 and rest Tc-99m sestamibi ECG-gated SPECT: comparison with three-dimensional magnetic resonance imaging. J Am Coll Cardiol 1999;33:991–7.CrossRefPubMed Tadamura E, Kudoh T, Motooka M, Inubushi M, Shirakawa S, Hattori N, et al. Assessment of regional and global left ventricular function by reinjection Tl-201 and rest Tc-99m sestamibi ECG-gated SPECT: comparison with three-dimensional magnetic resonance imaging. J Am Coll Cardiol 1999;33:991–7.CrossRefPubMed
10.
go back to reference Bavelaar-Croon CD, Kayser HW, van der Wall EE, de Roos A, Dibbets-Schneider P, Pauwels EK, et al. Left ventricular function: correlation of quantitative gated SPECT and MR imaging over a wide range of values. Radiology 2000;217:572–5.PubMed Bavelaar-Croon CD, Kayser HW, van der Wall EE, de Roos A, Dibbets-Schneider P, Pauwels EK, et al. Left ventricular function: correlation of quantitative gated SPECT and MR imaging over a wide range of values. Radiology 2000;217:572–5.PubMed
11.
go back to reference Nakajima K, Higuchi T, Taki J, Kawano M, Tonami N. Accuracy of ventricular volume and ejection fraction measured by gated myocardial SPECT: comparison of 4 software programs. J Nucl Med 2001;42:1571–8.PubMed Nakajima K, Higuchi T, Taki J, Kawano M, Tonami N. Accuracy of ventricular volume and ejection fraction measured by gated myocardial SPECT: comparison of 4 software programs. J Nucl Med 2001;42:1571–8.PubMed
12.
go back to reference Schaefer WM, Lipke CS, Standke D, Kühl HP, Nowak B, Kaiser HJ, et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med 2005;46:1256–63.PubMed Schaefer WM, Lipke CS, Standke D, Kühl HP, Nowak B, Kaiser HJ, et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med 2005;46:1256–63.PubMed
13.
go back to reference Acampa W, Caprio MG, Nicolai E, Liuzzi R, De Luca S, Capasso E, et al. Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide angiocardiography. Eur J Nucl Med Mol Imaging 2010;37:349–56.CrossRefPubMed Acampa W, Caprio MG, Nicolai E, Liuzzi R, De Luca S, Capasso E, et al. Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide angiocardiography. Eur J Nucl Med Mol Imaging 2010;37:349–56.CrossRefPubMed
14.
go back to reference Lee DS, Cheon GJ, Ahn JY, Chung JK, Lee MC. Reproducibility of assessment of myocardial function using gated 99Tc(m)-MIBI SPECT and quantitative software. Nucl Med Commun 2000;21:1127–34.CrossRefPubMed Lee DS, Cheon GJ, Ahn JY, Chung JK, Lee MC. Reproducibility of assessment of myocardial function using gated 99Tc(m)-MIBI SPECT and quantitative software. Nucl Med Commun 2000;21:1127–34.CrossRefPubMed
15.
go back to reference Lee DS, Ahn JY, Kim SK, Oh BH, Seo JD, Chung JK, et al. Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography. Eur J Nucl Med 2000;27:185–91.CrossRefPubMed Lee DS, Ahn JY, Kim SK, Oh BH, Seo JD, Chung JK, et al. Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography. Eur J Nucl Med 2000;27:185–91.CrossRefPubMed
16.
go back to reference Huyn IY, Kwan J, Park KS, Lee WH. Reproducibility of Tl-201 and Tc-99m sestamibi gated myocardial perfusion SPECT measurement of myocardial function. J Nucl Cardiol 2001;8:182–7.CrossRef Huyn IY, Kwan J, Park KS, Lee WH. Reproducibility of Tl-201 and Tc-99m sestamibi gated myocardial perfusion SPECT measurement of myocardial function. J Nucl Cardiol 2001;8:182–7.CrossRef
17.
go back to reference Vallejo E, Chaya H, Plancarte G, Victoria D, Bialostozky D. Variability of serial same-day left ventricular ejection fraction using quantitative gated SPECT. J Nucl Cardiol 2002;9:377–84.CrossRefPubMed Vallejo E, Chaya H, Plancarte G, Victoria D, Bialostozky D. Variability of serial same-day left ventricular ejection fraction using quantitative gated SPECT. J Nucl Cardiol 2002;9:377–84.CrossRefPubMed
18.
go back to reference Verberne HJ, Dijkgraaf MG, Somsen GA, van Eck-Smit BL. Stress-related variations in left ventricular function as assessed with gated myocardial perfusion SPECT. J Nucl Cardiol 2003;10:456–63.CrossRefPubMed Verberne HJ, Dijkgraaf MG, Somsen GA, van Eck-Smit BL. Stress-related variations in left ventricular function as assessed with gated myocardial perfusion SPECT. J Nucl Cardiol 2003;10:456–63.CrossRefPubMed
19.
go back to reference De Winter O, De Bondt P, Van De Wiele C, De Backer G, Dierckx RA, De Sutter J. Day-to-day variability of global left ventricular functional and perfusional measurements by quantitative gated SPECT using Tc-99m tetrofosmin in patients with heart failure due to coronary artery disease. J Nucl Cardiol 2004;11:47–52.CrossRefPubMed De Winter O, De Bondt P, Van De Wiele C, De Backer G, Dierckx RA, De Sutter J. Day-to-day variability of global left ventricular functional and perfusional measurements by quantitative gated SPECT using Tc-99m tetrofosmin in patients with heart failure due to coronary artery disease. J Nucl Cardiol 2004;11:47–52.CrossRefPubMed
20.
go back to reference Nakajima K, Nishimura T. Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin: a multicentre study involving 106 hospitals. Eur J Nucl Med Mol Imaging 2006;33:127–33.CrossRefPubMed Nakajima K, Nishimura T. Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin: a multicentre study involving 106 hospitals. Eur J Nucl Med Mol Imaging 2006;33:127–33.CrossRefPubMed
21.
go back to reference Fukuchi K, Yasumura Y, Kiso K, Hayashida K, Miyatake K, Ishida Y. Gated myocardial SPECT to predict response to beta-blocker therapy in patients with idiopathic dilated cardiomyopathy. J Nucl Med 2004;45:527–31.PubMed Fukuchi K, Yasumura Y, Kiso K, Hayashida K, Miyatake K, Ishida Y. Gated myocardial SPECT to predict response to beta-blocker therapy in patients with idiopathic dilated cardiomyopathy. J Nucl Med 2004;45:527–31.PubMed
22.
go back to reference Sciagrà R, Giaccardi M, Porciani MC, Colella A, Michelucci A, Pieragnoli P, et al. Myocardial perfusion imaging using gated SPECT in heart failure patients undergoing cardiac resynchronization therapy. J Nucl Med 2004;45:164–8.PubMed Sciagrà R, Giaccardi M, Porciani MC, Colella A, Michelucci A, Pieragnoli P, et al. Myocardial perfusion imaging using gated SPECT in heart failure patients undergoing cardiac resynchronization therapy. J Nucl Med 2004;45:164–8.PubMed
23.
go back to reference Sciagrà R. The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene. Eur J Nucl Med Mol Imaging 2007;34:1107–22.CrossRefPubMed Sciagrà R. The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene. Eur J Nucl Med Mol Imaging 2007;34:1107–22.CrossRefPubMed
24.
go back to reference Thorley PJ, Smith JM. Repeatability of left ventricular ejection fraction and volume measurement for 99mTc-tetrofosmin gated single photon emission computed tomography (SPECT). Nucl Med Commun 2005;26:345–9.CrossRefPubMed Thorley PJ, Smith JM. Repeatability of left ventricular ejection fraction and volume measurement for 99mTc-tetrofosmin gated single photon emission computed tomography (SPECT). Nucl Med Commun 2005;26:345–9.CrossRefPubMed
25.
go back to reference Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535–43.PubMed Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 1998;97:535–43.PubMed
26.
go back to reference Germano G, Erel J, Lewin H, Kavanagh PB, Berman DS. Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol 1997;30:1360–7.CrossRefPubMed Germano G, Erel J, Lewin H, Kavanagh PB, Berman DS. Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol 1997;30:1360–7.CrossRefPubMed
27.
go back to reference Nichols K, Dorbala S, DePuey EG, Yao SS, Sharma A, Rozanski A. Influence of arrhythmias on gated SPECT myocardial perfusion and function quantification. J Nucl Med 1999;40:924–34.PubMed Nichols K, Dorbala S, DePuey EG, Yao SS, Sharma A, Rozanski A. Influence of arrhythmias on gated SPECT myocardial perfusion and function quantification. J Nucl Med 1999;40:924–34.PubMed
28.
go back to reference Nichols K, Yao SS, Kamran M, Faber TL, Cooke CD, DePuey EG. Clinical impact of arrhythmias on gated SPECT cardiac myocardial perfusion and function assessment. J Nucl Cardiol 2001;8:19–30.CrossRefPubMed Nichols K, Yao SS, Kamran M, Faber TL, Cooke CD, DePuey EG. Clinical impact of arrhythmias on gated SPECT cardiac myocardial perfusion and function assessment. J Nucl Cardiol 2001;8:19–30.CrossRefPubMed
29.
go back to reference Ramakrishna G, Miller TD, Hodge DO, O’Connor MK, Gibbons RJ. Differences in left ventricular ejection fraction and volumes measured at rest and poststress by gated sestamibi SPECT. J Nucl Cardiol 2006;13:668–74.CrossRefPubMed Ramakrishna G, Miller TD, Hodge DO, O’Connor MK, Gibbons RJ. Differences in left ventricular ejection fraction and volumes measured at rest and poststress by gated sestamibi SPECT. J Nucl Cardiol 2006;13:668–74.CrossRefPubMed
30.
go back to reference Johnson LL, Verdesca SA, Aude WY, Xavier RC, Nott LT, Campanella MW, et al. Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms. J Am Coll Cardiol 1997;30:1641–8.CrossRefPubMed Johnson LL, Verdesca SA, Aude WY, Xavier RC, Nott LT, Campanella MW, et al. Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms. J Am Coll Cardiol 1997;30:1641–8.CrossRefPubMed
31.
go back to reference Toba M, Kumita S, Cho K, Ibuki C, Kumazaki T, Takano T. Usefulness of gated myocardial perfusion SPECT imaging soon after exercise to identify postexercise stunning in patients with single-vessel coronary artery disease. J Nucl Cardiol 2004;11:697–703.CrossRefPubMed Toba M, Kumita S, Cho K, Ibuki C, Kumazaki T, Takano T. Usefulness of gated myocardial perfusion SPECT imaging soon after exercise to identify postexercise stunning in patients with single-vessel coronary artery disease. J Nucl Cardiol 2004;11:697–703.CrossRefPubMed
32.
go back to reference Hida S, Chikamori T, Tanaka H, Usui Y, Igarashi Y, Nagao T, et al. Diagnostic value of left ventricular function after stress and at rest in the detection of multivessel coronary artery disease as assessed by electrocardiogram-gated SPECT. J Nucl Cardiol 2007;14:68–74.CrossRefPubMed Hida S, Chikamori T, Tanaka H, Usui Y, Igarashi Y, Nagao T, et al. Diagnostic value of left ventricular function after stress and at rest in the detection of multivessel coronary artery disease as assessed by electrocardiogram-gated SPECT. J Nucl Cardiol 2007;14:68–74.CrossRefPubMed
33.
go back to reference Nosir YFM, Lequin MH, Kasprzak JD, van Domburg RT, Vletter WB, Yao J, et al. Measurements and day-to-day variabilities of left ventricular volumes and ejection fraction by three-dimensional echocardiography and comparison with magnetic resonance imaging. Am J Cardiol 1998;82:209–14.CrossRefPubMed Nosir YFM, Lequin MH, Kasprzak JD, van Domburg RT, Vletter WB, Yao J, et al. Measurements and day-to-day variabilities of left ventricular volumes and ejection fraction by three-dimensional echocardiography and comparison with magnetic resonance imaging. Am J Cardiol 1998;82:209–14.CrossRefPubMed
34.
go back to reference Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, et al. Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference. Circulation 2006;114:654–61.CrossRefPubMed Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, et al. Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference. Circulation 2006;114:654–61.CrossRefPubMed
35.
go back to reference Soliman OI, Kirschbaum SW, van Dalen BM, van der Zwaan HB, Mahdavian Delavary B, Vletter WB, et al. Accuracy and reproducibility of quantitation of left ventricular function by real-time three-dimensional echocardiography versus cardiac magnetic resonance. Am J Cardiol 2008;102:778–83.CrossRefPubMed Soliman OI, Kirschbaum SW, van Dalen BM, van der Zwaan HB, Mahdavian Delavary B, Vletter WB, et al. Accuracy and reproducibility of quantitation of left ventricular function by real-time three-dimensional echocardiography versus cardiac magnetic resonance. Am J Cardiol 2008;102:778–83.CrossRefPubMed
36.
go back to reference Gandy SJ, Waugh SA, Nicholas RS, Simpson HJ, Milne W, Houston JG. Comparison of the reproducibility of quantitative cardiac left ventricular assessments in healthy volunteers using different MRI scanners: a multicenter simulation. J Magn Reson Imaging 2008;28:359–65.CrossRefPubMed Gandy SJ, Waugh SA, Nicholas RS, Simpson HJ, Milne W, Houston JG. Comparison of the reproducibility of quantitative cardiac left ventricular assessments in healthy volunteers using different MRI scanners: a multicenter simulation. J Magn Reson Imaging 2008;28:359–65.CrossRefPubMed
37.
go back to reference Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005;32:855–97.CrossRefPubMed Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005;32:855–97.CrossRefPubMed
38.
go back to reference Montelatici G, Sciagrà R, Passeri A, Dona M, Pupi A. Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies. Eur J Nucl Med Mol Imaging 2008;35:2059–65.CrossRefPubMed Montelatici G, Sciagrà R, Passeri A, Dona M, Pupi A. Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies. Eur J Nucl Med Mol Imaging 2008;35:2059–65.CrossRefPubMed
Metadata
Title
Reliability of myocardial perfusion gated SPECT for the reproducible evaluation of resting left ventricular functional parameters in long-term follow-up
Authors
Roberto Sciagrà
Valentina Berti
Sabrina Genovese
Alberto Pupi
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-010-1444-y

Other articles of this Issue 9/2010

European Journal of Nuclear Medicine and Molecular Imaging 9/2010 Go to the issue