Evaluation of Left and Right Ventricular Ejection Fraction and Volumes from Gated Blood-Pool SPECT in Patients with Dilated Cardiomyopathy: Comparison with Cardiac MRI

Abstract

This prospective study evaluated the accuracy of electrocardiogram-gated blood-pool SPECT (GBPS) for the assessment of left ventricular (LV) and right ventricular (RV) ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) in patients with dilated cardiomyopathy (DCM), using cardiac magnetic resonance (CMR) imaging as the reference standard. Methods: Thirty-two patients (24 men and 8 women; mean age, 51 y) with a diagnosis of idiopathic DCM underwent GBPS and CMR. LV and RV parameters including EDV, ESV, and EF from GBPS were calculated using fully automated gradient software and compared with those obtained by CMR. Results: Biventricular volumes were underestimated by GBPS, compared with CMR (P , 0.001). We found no statistical difference between these 2 methods in the assessment of LV EF (P 5 0.23), whereas RV EF was overestimated by GBPS (P , 0.001 vs. CMR). Regression analysis yielded significant correlations between GBPS and CMR in the assessments of biventricular parameters (r 5 0.83 for LV EDV, 0.88 for LV ESV, 0.89 for LV EF, 0.86 for RV EDV, 0.86 for RV ESV, and 0.62 for RV EF; all P , 0.001). Comparison of the deviations of RV indices between GBPS and CMR with the ratio of RV EDV to LV EDV showed that there was a statistically significant trend for RV volumes to be underestimated and for RV EF to be overestimated as the biventricular volumetric ratio decreased (r 5 0.61 for RV EDV, 0.68 for RV ESV, and 20.55 for RV EF; all P , 0.001). Conclusion: For patients with DCM, GBPS correlated well with CMR for the assessment of biventricular parameters, but RV indices should be cautiously interpreted.

18F-FDG-labeled red blood cell PET for blood-pool imaging: preclinical evaluation in rats

“…Nuclear medicine techniques using red blood cells (RBCs) labeled with several single-photon emitters such as 99m Tc have been used for blood-pool imaging (BPI). The purposes of BPI include the detection of gastrointestinal bleeding [ 1 , 2 ], evaluation of cardiac function [ 3 , 4 ], localization of hemangiomas [ 5 , 6 ], and regional cerebral blood volume measurement [ 7 ]. RBCs would be a more suitable tracer for BPI than radionuclide-labeled plasma proteins because plasma proteins tend to leak into extravascular spaces [ 8 ].…”

Radiation reduction and faster acquisition times with SPECT gated blood pool scans using a high-efficiency cardiac SPECT camera

“…[13][14][15] The inability to distinguish the left atrium from the left ventricle is commonly cited as the reason that planer gated blood pool LVEF's do not match SPECT gated blood pool LVEF's. 16 In a multicenter study comparing traditional Na-I SPECT gated blood pool acquisition to planar acquisition, values for LVEF were on average 8.1% ± 7.0% higher for SPECT acquisition with an increasing bias with increasing LVEF.…”

Role of Cardiac Magnetic Resonance in the Evaluation of Dilated Cardiomyopathy: Diagnostic Contribution and Prognostic Significance

“…If compared to direct competitors like stress-echo and SPECT, CMR-perfusion offers higher spatial resolution, permitting direct visualization of subendocardial ischemia with stress first-pass contrast-enhanced techniques and combining perfusional findings with IR-CE sequences allowing direct identification of subtle subendocardial lesions which are usually not visible with nuclear medicine modalities [152–154]. …”