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First-Pass Radionuclide Angiography Using Iodine 123 Myocardial Tracers and a Multicrystal Gamma Camera

Departments of Nuclear Medicine and Cardiovascular Surgery, Second and Third Divisions, and Department of Internal Medicine, Kyoto University Faculty of Medicine, Kyoto, Japan

Correspondence: For correspondence or reprints contact: Eiji Tadamura, MD, Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Faculty of Medicine, Shogoin, Sakyo-ku, Kyoto, 606-01, Japan.

ABSTRACT

The purpose of this study was to validate the accuracy of the assessment of ventricular function by first-pass radionuclide angiography (FPRNA) with ¹²³I myocardial tracers and a multicrystal gammacamera. MethodS: Left ventricular ejection fraction (LVEF) and right ventricular ejection fraction were measured in 69 patients by FPRNA using¹²³I myocardial tracers (126 ± 7 MBq) and ^99mTc tracers (541 ± 141 MBq) on a multicrystal gamma camera wfth a high-sensitivity collimator. For 44 patients, ejection fraction values measuredby ¹²³I-FPRNA were compared to those estimated by equilibrium radionuclide angiography (ERNA). Visual wall-motion analysis was also performed to judge clinical acceptability of ¹²³I FPRNAimages for identification of wall-motion abnormality. ResuIts: Mean LVEFs (%) estimated by ¹²³I-FPRNA and by ^99mTc FPRNA were 49.6 ± 13.6 and 49.1 ± 14.1, respectively (nonsignificant p value). An excellent correlation was found between LVEFs estimated by ¹²³I-FPRNA and ^99mTc-FPRNA (r = 0.96, s.e.e. = 1.9%). Values of LVEF measured by ¹²³I-FPRNA also demonstrated excellent correlation with those measured by ERNA (r = 0.95, s.e.e. = 2.2%). A good correlation was also noted between right ventricular ejection fractions measured by ¹²³I-FPRNA and ^99mTc-FPRNA (r = 0.72, s.e.e. = 4.0%). The Spearman rank correlation coefficient between ¹²³I-FPRNA and ERNA wall-motion scores was 0.87 (n =135,p < 0.001). Conclusion: Resting ventricular function can be reliably measured with ¹²³I-FPRNA in combination with a multicrystal gamma camera. This indicates that the assessment of ventricular function is feasible inconjunction with ¹²³I myocardial imaging without an increase in cost or radiation dose to patients.

Key Words: iodine-123 myocardial tracer • first-pass radionuclide angiography • ejection fraction