Comparison of Gated Blood Pool SPECT and Multi-Detector Row Computed Tomography for Measurements of Left Ventricular Volumes and Ejection Fraction in Patients with Atypical Chest Pain: Validation with Radionuclide Ventriculography

Abstract

Gated blood pool SPECT (GBPS) is an alternative to planar radionuclide ventriculography (PRNV) and offers potential advantages. The aim of this study was to compare GBPS, multi-row detector spiral computed tomography (MDCT), and PRNV for the determination of left ventricular ejection fraction (LVEF) and left ventricular volumes (LV) in subjects with atypical chest pain. Method: Twenty-three consecutive patients (14 men, 9 women; mean age 56.2 ± 9.5 years) referred for MDCT for evaluation of atypical chest pain. All patients underwent PRNV, GBPS, and MDCT at the same day. Results: The mean LVEFs calculated with PRNA (57.3 ± 8.6%), GBPS (55.2 ± 6.6%), and MDCT (56 ± 9.1%) were not statistically different (F value 0.3374, p = 0.715). Comparison of LVEFs from GBPS and MDCT yielded correlation coefficients of 0.5238 (p = 0.0178, 95% CI = 0.1057–0.7845). The correlation of LVEFs between GBPS and PRNV showed a correlation coefficient of 0.8073 (p < 0.0001, 95% CI = 0.5676–0.9209) and 0.6190 (p = 0.0036, 95% CI = 0.2431–0.8333) between MDCT and PRNV. The mean LV end-diastolic volume (EDV) calculated with GBPS (82.7 ± 17.5 ml) was significantly lower than MDCT (106.8 ± 18.5 ml) (p = 0.0001). The mean LV end-systolic volume (ESV) calculated with GBPS (37.2 ± 9.6 ml) was also significantly lower than MDCT (48.1 ± 15.8 ml) (p = 0.012). Comparison of EDV from GBPS and MDCT yielded a correlation coefficient of 0.5220 (p = 0.0182, 95% CI = 0.1033–0.7835). The correlation of ESV between GBPS and MDCT showed a correlation coefficient of 0.6642 (p = 0.0014, 95% CI = 0.3140–0.8553). Conclusion: In conclusion, the LVEF, EDV, and ESV calculated by GBPS correlated significantly with those of obtained with 16-MDCT. In addition, there were no statistical differences of LVEF calculated from PRNV, GBPS, and MDCT. However, with regard to LV, EDV and ESV from GBPS revealed statistically significantly lower than those of MDCT. Also, these results should be addressed whether similar results could also be found in patients with cardiac diseases by the consequent larger population-based study.