Left Ventricular Ejection Fraction Assessment by Tl‐201 Gated SPECT: A Comparison With Echocardiography

Park

et al. 2019

Nucl Med Mol Imaging

Purpose Left ventricular (LV) ejection fraction (EF) is an important parameter for assessing cardiac systolic function and predicting prognosis in patients with cardiovascular disease. The aim of this study was to evaluate the feasibility of assessing LVEF by Tl-201 hybrid myocardial single-photon emission computed tomography (SPECT)/CT using two attenuation correction methods in patients with angina pectoris. Methods A total of 339 patients with angina pectoris (62.8 ± 12.9 years, male:female = 206:133) were analyzed. All patients underwent Tl-201 myocardial SPECT/CT and transthoracic two-dimensional (2D) echocardiograph. We compared LVEF assessed by SPECT/CT using two attenuation correction methods: CT-based attenuation correction (CTAC) and nonattenuation correction (non-AC) methods and 2D echocardiography. Results LVEF assessed by either of the two attenuation correction techniques and 2D echocardiography showed moderate correlation in all patients with angina pectoris (r = 0.487 for CTAC and r = 0.473 for non-AC, p < 0.001). Results were similar in the subgroup of patients with perfusion abnormalities on myocardial SPECT/CT images. Overall diagnostic performances were similar for the CTAC and non-AC methods for evaluating normal and decreased LVEF by myocardial SPECT/CT. Conclusion LVEF measured by the CTAC method of Tl-201-gated myocardial SPECT/CT was comparable with the conventional non-AC method in patients with angina pectoris and in the subgroup of patients with perfusion abnormality. Tl-201-gated myocardial hybrid SPECT/CT can be a reliable tool in the assessment of LVEF in clinic.

Section: Discussioncontrasting

confidence: 58%

Assessment of Left Ventricular Ejection Fraction by Thallium-201 Myocardial SPECT-CT in Patients with Angina Pectoris: Comparison with 2D Echocardiography

Park

et al. 2019

Nucl Med Mol Imaging

“…Quantification of LVEF and LV volumes using gated SPECT was a reliable complementary tool 25,26 . Several factors may affect the accuracy, including LV size 27–29 , gender 30–32 , perfusion defects 33,34 and technological issues.…”

Section: Discussionmentioning

confidence: 99%

The clinical value and safety of ECG-gated dipyridamole myocardial perfusion imaging in patients with aortic stenosis

Liu

Wang

Shiau

et al. 2019

Sci Rep

The role of vasodilator myocardial perfusion imaging (MPI) for aortic stenosis (AS) is controversial due to safety and accuracy concerns. In addition, its utility after aortic valve (AV) interventions remains unclear. Patients with AS who underwent thallium-201-gated dipyridamole MPI using a cadmium-zinc-telluride camera were retrospectively reviewed and divided into three groups: mild AS, moderate-to-severe AS, and prior AV interventions. Patients with coronary artery disease with ≥50% stenosis, severe arrhythmia, left ventricular ejection fraction (LVEF) <40%, left bundle branch block or no follow-up were excluded. Relationships between the severity of AS, clinical characteristics, hemodynamic response, serious adverse events (SAE) and MPI parameters were analyzed. None of the 47 patients had SAE, including significant hypotension or LVEF reduction. The moderate-to-severe AS group had higher summed stress scores (SSSs) and depressed LVEF than the mild AS group, however there were no differences after AV interventions. SSS was positively correlated with AV mean pressure gradient, post-stress lung-heart ratio (LHRs), and post-stress end-diastolic volume (EDVs) ( P < 0.05). In multivariate analysis, LHRs and EDVs were independent contributors to SSS. Dipyridamole-induced ischemia and LV dysfunction is common, and dipyridamole stress could be a safe diagnostic tool in evaluation and follow-up in patients with AS.

IJC Heart & Vasculature

“…Maunoury et al showed good correlations in left ventricular volumes and function between Tc-99m sestamibi gated SPECT and Tl-201 gated SPECT [14] . We as well as other groups have shown that gated Tl-201 gated SPECT is a reliable method for assessing left ventricular volumes and function with good correlation when compared to echocardiography [7] , [8] , [9] , [15] . However, there has been no report assessing its reliability in patients with AS.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that left ventricular ejection fraction (EF) is strongly associated with outcome in patients with AS [4] , [5] , [6] , and it is clinically important to assess left ventricular volumes and function. Echocardiography and quantitative gated single photon emission computed tomography (SPECT) [QGS] are commonly used for assessing left ventricular volumes and function, and several studies have shown good correlations between the 2 methods [7] , [8] , [9] . However, their correlations in patients with AS remain to be investigated.…”

Section: Introductionmentioning

confidence: 99%

Thallium-201 gated single-photon emission tomography for assessing left ventricular volumes and function in patients with aortic valve stenosis: Comparison with echocardiography as the reference standard

Kurisu

Iwasaki

Ikenaga

et al. 2014

BackgroundAortic valve stenosis (AS) is characterized by chronic left ventricular pressure overload, leading to left ventricular hypertrophy (LVH). We assessed correlations in left ventricular volumes and function between echocardiography and quantitative gated SPECT (QGS) in patients with AS.Methods and resultsThe study population consisted of 28 patients with AS defined as a peak velocity of > 3.0 m/s and 28 age- and sex-matched control subjects. Patients with AS had a peak pressure gradient of 73.4 ± 24.5 mm Hg and a larger LVM index compared to control subjects (115.5 ± 29.2 g/m2 vs 78.3 ± 12.1 g/m2, p < 0.01). There were good correlations in end-diastolic volume and end-systolic volume between echocardiography and QGS in patients with AS as well as control subjects. Bland–Altman plot for end-systolic volume showed a significant negative slope of − 0.51 in patients with AS. There was a good correlation in ejection fraction between the 2 methods in patients with AS as well as control subjects. However, Bland–Altman plots showed significant negative slopes of − 0.40 in patients with AS and − 0.74 in control subjects.ConclusionsOur data suggested that QGS was a useful method for assessing left ventricular volumes and function even in patients with AS. Cardiologists should recognize its specific characteristics.