ECG-gated SPECT Research Articles

Does ECG-gated SPECT provide accurate measurement of left ventricular ejection fraction and volumes? A meta-analysis

Does ECG-gated SPECT provide accurate measurement of left ventricular ejection fraction and volumes? A meta-analysis

Measurement of left ventricular chamber and myocardial volume in hypertrophic cardiomyopathy patients by ECG-gated myocardial perfusion SPECT: application of a newly developed edge-detection algorithm

Quantitative gated SPECT (QGS) software has been reported to demonstrate inaccurate edge detection in the left ventricular chamber in hypertrophic cardiomyopathy patients. In this study we developed a method to calculate left ventricular volume (LVV) and left myocardial volume (LMV) from gated SPECT data using a newly developed edge-detection algorithm, and we compared it with the QGS method of calculating LVV and LMV in a phantom study. Our method gave more accurate measurements LVV and LMV whereas the QGS method underestimated LMV. Compared with QGS LVV and LMV, our method yielded better results in the phantom study.

16.45 Factors affecting the random error of left ventricular ejection fraction measured with T1-201 ecg-gated myocardial perfusion spect

16.45 Factors affecting the random error of left ventricular ejection fraction measured with T1-201 ecg-gated myocardial perfusion spect

16.50 ECG-gated blood pool SPECT versus planar imaging for the determination of left ventricular filling pressure coronary artery disease

16.50 ECG-gated blood pool SPECT versus planar imaging for the determination of left ventricular filling pressure coronary artery disease

10.17 Accuracy and reproducibility of four softwares for the left-ventricular function with ECG-gated myocardial perfusion SPECT

10.17 Accuracy and reproducibility of four softwares for the left-ventricular function with ECG-gated myocardial perfusion SPECT

16.36 Reliability of cardiac ecg-gated blood pool SPECT versus planar radionuclide angiography for the measurement of left ventricular ejection fraction

16.36 Reliability of cardiac ecg-gated blood pool SPECT versus planar radionuclide angiography for the measurement of left ventricular ejection fraction

10.47 Reliability of two three-dimensional rest ECG-gated TL-201 SPECT methods for the assessment of left ventricle (LV) ejection fraction and volumes

10.47 Reliability of two three-dimensional rest ECG-gated TL-201 SPECT methods for the assessment of left ventricle (LV) ejection fraction and volumes

3.1 The accuracy of left-ventricular time volume curve derived from ECG-gated myocardial perfusion SPECT

3.1 The accuracy of left-ventricular time volume curve derived from ECG-gated myocardial perfusion SPECT

心電図同期心筋SPECTの臨床応用と今後の展開

心電図同期心筋SPECTの臨床応用と今後の展開

Segmental cardiac function computed from ECG-gated SPECT images throughsolution of equations of continuity for fluids

Segmental contractions were quantified from images ofelectrocardiographic-gated single-photon emission computed tomography.Counts were integrated in 64 angles about the centre on short-axis images andprojected onto a cylindrical screen. Changes in the projected count were shownto obey the equation of continuity for two-dimensional fluids (the Poissonequation). Displacements of each pixel point were calculated from the velocityfield to quantify the amount of dislocation. Changes in the configuration ofthe pixel points were projected back on the cardiac wall, and finallysegmental contractions were evaluated as a percentage reduction of the area.Computer simulations were performed for numerical models of circumferentialand long-axial contractions, uneven eccentric contractions and rotations.These models were blurred with a three-dimensional Gaussian function. Theresults obtained using this method (quantification of segmental function bysolving the Poisson equation (QSFP)) were compared with the wall-thickeningmethod (WTM) and the maximum-count method. Both QSFP and WTM yieldedgood agreement with predicted values for circumferential and long-axialcontractions. Only QSFP gave satisfactory results for uneven eccentriccontractions, and rotation models. QSFP should provide a useful tool for in vivo quantification of contraction tangential to the cardiac wall byeliminating errors due to displacements.

Simultaneous assessment of Tc-99m-sestamibi and I-123-BMIPP myocardial distribution in patients with myocardial infarction: evaluation of left ventricular function with ECG-gated myocardial SPECT.

123I-labeled 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid (BMIPP) is a branched-chain free fatty acid that is used to evaluate various cardiac diseases. The aim of the present study was to investigate the relationship between myocardial perfusion (99mTc-sestamibi) and BMIPP uptake, and to correlate perfusion and metabolic alterations with regional left ventricular dysfunction in patients with myocardial infarction (MI). ECG-gated dual-isotope myocardial SPECT was performed on 130 patients with MI with sestamibi (555 MBq) and BMIPP (148 MBq). The patients were classified into 3 groups according to PTCA therapy and the interval between the onset of infarction and RI injection (OR time). Group A (n = 56) included patients whose OR time was less than one month and who had undergone successful PTCA, Group B (n = 36) had OR times of less than one month and had conservative medical therapy, and Group C (n = 38) had OR times of over one month. The severity scores of the dual-isotope images were calculated from the defect scores in 9 segments. From the ECG-gated SPECT data with sestamibi, the left ventricular ejection fraction (LVEF; %) and regional wall motion were determined automatically using the QGS program LVEF obtained from gated SPECT correlated well with the severity scores for sestamibi and BMIPP (r = -0.68 and -0.76, respectively). The delta severity scores (BMIPP scores - sestamibi scores) of Group A were significantly higher than those of the other two groups (3.6 +/- 3.0 vs. 1.5 +/- 1.7 and 1.0 +/- 1.4, p < 0.001 ). The rate of dysfunctional segments with normal sestamihi distribution was significantly higher in Group A than in Group C (20.7% vs. 6.7%, p < 0.001). ECG-gated dual-isotope SPECT is useful since myocardial perfusion, fatty acid metabolism and left ventricular function can be analyzed during a single examination, so that this procedure has the potential to provide comprehensive information when evaluating patients with ischemic heart disease.

ECG-gated SPECT(&lt;sup&gt;99m&lt;/sup&gt;Tc)の心機能評価 : QGSの収集処理条件の検討

The QGS program is software for highly reproducible evaluation of perfusion in cardiac muscles and cardiac functions, but basic data collection and processing conditions affect the output values of cardiac function analyses. Because these conditions have not been sufficiently evaluated, we determined in this study the optimum cut off, data collection time, and R-R fractions by comparing the outputs calculated from data obtained with a phantom using QGS with the phantom volume. The optimum cut off was 0.41-0.55 cycle/cm in 8 R-R fractions and 0.41-0.52 cycle/cm in 16 R-R fractions. The values calculated using QGS were underestimated by 11.4% compared with the phantom volume. With longer data collection times, statistical errors were smaller. Errors of data collection in 8 fractions over a period of 20 min were about the same as those in 16 fractions over a period of more than 25 min. Comparison between 8 fractions and 16 fractions in EF levels of patients demonstrated that errors were significantly smaller by 3% in 8 fractions than in 16 fractions, and the level was closer to E/G in 16 fractions than in 8 fractions.

Mechanism for abnormal thallium-201 myocardial scintigraphy in patients with left bundle branch block in the absence of angiographic coronary artery disease.

Patients with left bundle branch block (LBBB) often show abnormal images on exercise thallium (T1)-201 scintigraphy without evidence of significant coronary stenosis. We investigated the mechanism for this phenomenon. Six patients with LBBB and without significant coronary stenosis underwent T1-201 SPECT, ECG-gated SPECT imaging with Tc-99m-methoxyisobutyl-isonitrile (MIBI), and atrial pacing stress test. The % count amplitude in Tc-99m-MIBI images was calculated as [(maximal counts) - (minimal counts)]/(minimal counts) x 100. Though all patients had a low count in the septal and inferior wall in T1-201 SPECT images, there was no ischemic production of lactate during an atrial pacing stress test. Nevertheless, gated SPECT images showed attenuated septal activity during systole. In patients with LBBB, the ratios of % count amplitude at the septum to that at the lateral wall at rest (0.47 +/- 0.05, mean +/- SE) were significantly less than the controls (n = 5, 0.83 +/- 0.12, p = 0.014). In conclusion, these results suggest that abnormal T1-201 SPECT images of the septum in patients with LBBB are partially caused by impaired septal wall thickening during systole. Such an abnormal wall motion may reduce blood flow demands to the septum, resulting in reduction of coronary blood flow with little ischemia.

Assessment of regional and global left ventricular function by reinjection Tl-201 and rest Tc-99m sestamibi ECG-gated SPECT: Comparison with three-dimensional magnetic resonance imaging

OBJECTIVESThe purpose of this study was to test the ability of reinjection thallium-201 and rest technetium-99m sestamibi ECG (electrocardiographic)-gated SPECT (i.e., reinjection-g-SPECT [single-photon emission computed tomography] and MIBI-g-SPECT) to determine regional and global functional parameters.BACKGROUNDThe ECG-gated perfusion SPECT was reported to provide accurate left ventricular ejection fraction (LVEF) using an automated algorithm. We hypothesized that other various functional data may be obtained using reinjection-g-SPECT and MIBI-g-SPECT.METHODSReinjection-g-SPECT, MIBI-g-SPECT, and three-dimensional magnetic resonance imaging (3DMRI) were conducted in 20 patients with coronary artery disease. Regional wall motion (RWM) and wall thickening (RWT) were analyzed using semiquantitative visual scoring by each g-SPECT and 3DMRI. The left ventricular end-systolic and end-diastolic volumes (EDV, ESV) and LVEF estimated by reinjection- and MIBI-g-SPECT were compared with the results of 3DMRI.RESULTSA high degree of agreement in RWM and RWT assessment was observed between each g-SPECT and 3DMRI (kappa >.70, p < .001). The LVEF values by reinjection- and MIBI-g-SPECT correlated and agreed well with those by 3DMRI (reinjection: r = .92, SEE = 5.9%, SD of differences = 5.7%; sestamibi: r = .94, SEE = 4.4%, SD of differences = 5.1%). The same also pertained to EDV (reinjection: r = .85, SEE = 18.7 ml, SD of differences = 18.4 ml; sestamibi: r = .92, SEE = 13.1 ml, SD of differences = 13.0 ml) and ESV (reinjection: r = .94, SEE = 10.3 ml, SD of differences = 10.3 ml; sestamibi: r = .97, SEE = 6.7 ml [p < .05 vs. reinjection by F test], SD of differences = 6.6 ml [p < .05 vs. reinjection by F test]).CONCLUSIONSReinjection- and MIBI-g-SPECT provide clinically satisfactory various functional data. These functional data in combination with the perfusion information will improve diagnostic and prognostic accuracy without an increase in cost or the radiation dose to the patients.

Left ventricular function at rest and during exercise in normal subjects: Assessment by ECG-gated SPECT

Left ventricular function at rest and during exercise in normal subjects: Assessment by ECG-gated SPECT

ROC Analysis of Three Perfusion Display Options for ECG-gated Perfusion SPECT in Severe CAD

The simultaneous computation and display of wall motion and perfusion patterns in a single 3D ventricular model would considerably ease the assessment of ECG-gated Tc-99m-sestamibi SPECT, yet the effect on the accuracy of allocating regional perfusion has so far not been validated. 3D perfusion mapping (3D Perfusion/Motion Map Software) was compared to the visual assessment of ungated tomographic slices and polar perfusion mapping (Cedars-Sinai PTQ) by correlation analysis and receiver operating characteristics (ROC) analysis at different cut-off levels for coronary stenoses in 50 patients (11 single-, 22 two-, 16 three-vessel disease). Ungated SPECT data were obtained by adding the intervals prior to reconstruction and displaying conventional tomographic slices. All display options were visually assessed in 8 ventricular segments according to a 4-point scoring system and compared to the graded results of coronary angiography. All three display options showed a comparable diagnostic performance for the detection of severe stenoses. The diagnostic gain for the detection of stenoses above 59% was highest for ungated tomographic slices, followed by ungated polar mapping and 3D mapping. Regional assessment revealed a limited performance of 3D mapping in the proximal anterior and distal lateral wall. Polar mapping showed a balanced regional performance. 3D Perfusion mapping provides comparable information to conventional display options with the highest diagnostic strength in severe stenoses. Further improvement of the algorithm is needed in the definition of the valve plane.

Relationship between wall thickening and jeopardized volume using ECG-gated myocardial SPECT with Tc-99m MIBI in patients with acute myocardial infarction

Relationship between wall thickening and jeopardized volume using ECG-gated myocardial SPECT with Tc-99m MIBI in patients with acute myocardial infarction

Equilibrium ECG-gated Tc-99m SPECT radionuclide angiography (RNA) in chronic thromboembolic pulmonary hypertension (CTE-PH)

Equilibrium ECG-gated Tc-99m SPECT radionuclide angiography (RNA) in chronic thromboembolic pulmonary hypertension (CTE-PH)

Transient ischemic dilatation ratio before and after CABG in patients with severe coronary artery disease assessed with stress/reinjection TL-201 ECG-gated SPECT: S. Kubo, E. Tadamura, T. Kudoh, M. Inubushi, N. Hattori, T. Koshiji, K. Nishimura, M. Komeda, J. Konishi

Transient ischemic dilatation ratio before and after CABG in patients with severe coronary artery disease assessed with stress/reinjection TL-201 ECG-gated SPECT: S. Kubo, E. Tadamura, T. Kudoh, M. Inubushi, N. Hattori, T. Koshiji, K. Nishimura, M. Komeda, J. Konishi

Three-dimensional unifiacation of ECG-gated SPECT and coronary MR angiography

Three-dimensional unifiacation of ECG-gated SPECT and coronary MR angiography