Évaluation de la faisabilité de la tomoscintigraphie myocardique précoce au sestamibi synchronisée à l’électrocardiogramme

Abstract

Background Our aim was to assess the feasibility of early acquisition (10 min) gated single photon emission computed tomography (SPECT) by comparison to conventional imaging at one hour. Methods and results One hundred and four patients referred for exercise test and SPECT were included. Sequential imaging was started 10 min (SPECT 10) and 60 min (SPECT 60) after injection of the radiotracer (Tc-99m sestamibi). Stress myocardial perfusion was visually analyzed from 10 to 60 min stress by two experienced nuclear-cardiologists. Six patients were further excluded, because of high digestive accumulation: one patient at 10 min, three at 10 and 60 min, two at rest. The participants were classified as follows: group G1 (normal SPECT 10 and 60, n = 53), group G2 (abnormal SPECT 10 and/or SPECT 60, n = 45). The left ventricle ejection fraction (EF) and volumes (end-systolic and end-diastolic volumes, ESV, EDV) were calculated with the Cedars-Sinai program. Results Quality imaging was the same at SPECT 10 min and SPECT 60 min. Perfusion scores: G1 10 min = 0,4 versus G1 60 min = 0,4 ( p = NS); G2 10 min = 10,2 versus G2 60 min = 10,1 ( p = NS); EFG1 10 min = 71 ± 11% versus EFG1 60 min = 68 ± 10% ( p = 4E-04); EFG2 10 min = 56 ± 15% versus EFG2 60 min = 53 ± 15% ( p = 0,002); EDV G1 10 min = 72 ± 20 ml versus EDV G1 60 min = 76 ± 19 ( p = 0,002); EDV G2 10 min = 98 ± 46 ml versus EDV G2 60 min = 105 ± 38 ( p = 0,08); ESVG1 10 min = 22 ± 12 m versus ESV G1 60 min = 25 ± 12 ( p = 9E-04); ESVG2 10 min = 47 ± 35 ml versus ESV G2 60 min = 53 ± 36 ( p = 3E-04). Conclusions This study suggests that early gated Sestamibi SPECT after stress provides same perfusion analysis than classical late imaging.