The prognostic value of ECG-gated SPECT imaging in patients undergoing stress Tc-99m sestamibi myocardial perfusion imaging

Travin, Mark I.; Heller, Gary V.; Johnson, Lynne L.; Katten, Deborah; Ahlberg, Alan W.; Isasi, Carmen R.; Kaplan, Robert C.; Taub, Cynthia C.; Demus, Diane

doi:10.1016/j.nuclcard.2004.02.005

Cited by 103 publications

(44 citation statements)

References 29 publications

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“…Therefore, the main task of imaging procedures is to help in defining patient prognosis, identifying those subjects at risk for adverse events, mainly cardiac death or nonfatal myocardial infarction. As regards prognostication, several studies have examined the role of gated myocardial perfusion SPECT [85][86][87][88][89][90][91][92][93][94]. In general, the functional parameters improve the predictive models.…”

Section: Incremental Diagnostic Value Of Function Over Perfusionmentioning

confidence: 99%

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

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Background Gating of single-photon emission computed tomography (SPECT) has significantly improved the reliability and diagnostic accuracy of myocardial perfusion imaging. The functional parameters derived from this technique, mainly left ventricular volumes and ejection fraction, have been demonstrated to be accurate and reproducible. They are able to increase the detection of severe and extensive coronary artery disease and show a significant incremental prognostic power over perfusion abnormalities. Therefore, the importance given to gated SPECT functional data has progressively grown. Discussion This circumstance has further expanded the indications for myocardial perfusion imaging and strengthened its position among the different imaging modalities. Moreover, several studies show that the evaluation of ventricular function may have a leading part in justifying the execution of perfusion scintigraphy in various clinical conditions. Aim Aim of this review is to describe this evolution of gated SPECT functional assessment from a supporting rank with respect to perfusion, to a main actor position in the field of cardiac imaging.

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Section: Incremental Diagnostic Value Of Function Over Perfusionmentioning

confidence: 99%

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

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“…Technetium-99m (Tc-99 m) methoxyisobutyl-isonitrile (MIBI) 1 or tetrofosmin 2 is considered the radionuclide of choice for left ventricular ejection fraction (LVEF) assessment by electrocardiogram (ECG) gated single photon emission computed tomography (SPECT). Compared with Tc-99 m labeled compounds, thallium-201 (Tl-201) is considered to possess poor image quality 3 -4 due to its lower photon energy and flux, resulting in increased scatter and attenuation.However,its better physiological propertiesand the recent development of new cameras based on semiconductor detectors like cadmium zinc telluride (CZT) have resulted in a renewed interest in the use of Tl-201 for cardiac perfusion imaging agents.…”

Section: Introductionmentioning

confidence: 99%

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

Harpaz

Asman

Kuperstein

et al. 2010

Clinical Cardiology

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Background: Few studies including only a limited number of patients have compared left ventricular ejection fraction (LVEF) assessed by 2-dimensional echocardiography (2-DE) and electrocardiography-gated Tl-201 single-photon emission computed tomography (SPECT). Hypothesis: LVEF assessment by Tl-201 gated spect is comparable with LVEF assessed by 2-DE in two different echocardiographic laboratories. Material and Methods: Patients (n = 402) underwent Tl-201 gated SPECT in the same laboratory and 2-DE in 2 different laboratories. Patients were divided into 2 groups according to the study laboratory: group 1, at the tertiary hospital and group 2, at a community laboratory. Results: LVEF evaluations were similar (mean LVEF: 50.73%±11.67% by 2-DE vs 50.11%±11.41% by SPECT in group 1 and 57.27%±7.44% by 2-DE vs 57.41%±8.37% by SPECT in group 2). All LVEF measurements were highly correlated (r = 0.7, P<.001). Baseline characteristics differed between the groups, with a higher prevalence of past myocardial infarction in the in-hospital vs the community echo group (46.7% vs 22.2%, P<.01), resulting in a higher LVEF in the latter, both by 2-DE (mean 50.7%±11.7% vs 57.3% ±7.4%, P<.01) and SPECT (50.1%±11.4% vs 57.4%±8.4%, P<.01). Conclusions: The Tl-201 gated SPECT is a reliable clinical tool for LVEF assessment, with good correlation when compared to 2-DE. It may be routinely used as an alternative for patients with poor acoustic visualization and should be performed systematically in patients undergoing myocardial perfusion imaging with Tl-201.

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“…In particular the SSS has been shown to be a powerful independent predictor of cardiac events. 10,[22][23][24] However, most of the observations have been made in a mixed gender population. 10,22-24 Sharir et al 11 showed that for CD and MI, perfusion data provided a larger proportion of the prognostic information for women than they did for men.…”

Section: Prognostic Value Of Perfusion Datamentioning

confidence: 99%

“…This is in line with previous findings that suggest that the extent of defect size and functional abnormalities are more predictive for hard events (CD and MI), whereas the extent of ischemia is more predictive for soft events and/or MI. 10,[25][26][27] By using gated SPECT perfusion imaging, women at increased risk of having a cardiac event could be identified.…”

Section: Prognostic Value Of Perfusion Datamentioning

confidence: 99%

“…4 The addition of regional left ventricular (LV) function parameters by gated single photon emission computed tomography (SPECT) improved the diagnostic accuracy and prognostic value of perfusion imaging, whereby LV function parameters have incremental prognostic value over perfusion data alone. [6][7][8][9][10] Previous studies set normal functional data limits. However, some problems still have to be solved.…”

Section: Introductionmentioning

confidence: 99%

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The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

America

Bax

Boersma

et al. 2009

Journal of Nuclear Cardiology

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Background. The aim of this study was to assess the prognostic value of technetium-99m tetrofosmin gated SPECT imaging in women using quantitative gated single photon emission computed tomography (SPECT) imaging.Methods. We followed 453 consecutive female patients. Average follow-up was 1.33 years (max. 2.55). Hard endpoints were cardiac death, acute myocardial infarction, or documented ventricular fibrillation. Event-free survival curves were obtained. Optimal cutoff values for left ventricular (LV) volumes, LV ejection fraction (LVEF), and perfusion data to predict outcome were determined by ROC curve analysis.Results. A total of 236 patients had an abnormal study, of whom 27 patients experienced hard events (16 deaths) and 47 patients soft events. For hard events summed stress score (SSS) and LVEF, and for any cardiac event SSS showed independent incremental prognostic value. The survival curves were maximally separated when using cutoff values for SSS of ‡22 and LVEF < 52% (P < 0.001, HR 4.61 and P < 0.001 HR 5.24 for SSS and LVEF resp.), and SSS ‡ 14 (P < 0.001 HR 3.76) for any cardiac event.Conclusion. In women, perfusion and functional parameters derived from quantitative gated technetium-99m tetrofosmin SPECT imaging can adequately be used for cardiac risk assessment. Using quantitative gated SPECT, female patients with an LVEF < 52% or an SSS ‡ 22 are at increased risk for subsequent hard events. Furthermore, patients with an SSS ‡ 14 are at increased risk for any cardiac events. (J Nucl Cardiol 2009;16:10-9)

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The prognostic value of ECG-gated SPECT imaging in patients undergoing stress Tc-99m sestamibi myocardial perfusion imaging

Abstract: Ventricular function data from ECG-gated SPECT add important prognostic value to data obtained from perfusion imaging alone in predicting adverse cardiac events.

Cited by 103 publications

References 29 publications

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

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

The additive prognostic value of perfusion and functional data assessed by quantitative gated SPECT in women

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