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Comparison of two three-dimensional gated SPECT methods with thallium in patients with large myocardial infarction
Authors:Pierre Véra  René Koning  Alain Cribier  Alain Manrique
Institution:Department of Nuclear Medicine, Rouen University Hospital and Henri Becquerel Center, France. pierre.vera@rouen.fnclcc.fr
Abstract:BACKGROUND: Two different commercially available gated single photon emission computed tomography (GSPECT) methods were compared in a population of patients with a major myocardial infarction. METHODS: Rest thallium GSPECT was performed with a 90-degree dual-detector camera, 4 hours after injection of thallium-201 (Tl-201; 185 MBq) in 43 patients (mean age, 62+/-12 years) with a large myocardial infarction (mean defect size, 33%+/-16%). End-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were calculated by using QGS (Cedars Sinai) and MultiDim (Sopha Medical Vision International, Buc, France). Images were reconstructed by using a 2.5 zoom and a Butterworth filter (order, 5; cut-off frequency, 0.20). LVEF was calculated in all patients by using equilibrium radionuclide angiocardiography (ERNA). EDV, ESV, and LVEF were also measured by using left ventriculography (LVG). RESULTS: Compared with LVG, QGS underestimated LVEF by means of an underestimation of mean EDV. MultiDim overestimated EDV and ESV. GSPECT EDV and ESV overestimation was demonstrated by means of Bland-Altman analysis to increase with left ventricular volume size (P<.05). The difference between LVG and GSPECT volumes was demonstrated by means of regression analysis to be correlated with infarction size. This effect was particularly important with MultiDim (P<.0001). CONCLUSION: In Tl-201 GSPECT, LVEF and volume measurements will vary according to the type of software used.
Keywords:Gated single photon emission computed tomography  thallium  volume measurements  left ventricular ejection fraction  myocardial infarction
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