HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Véra, P. Articles by Cribier, A. Search for Related Content PubMed PubMed Citation Articles by Véra, P. Articles by Cribier, A.

Thallium-Gated SPECT in Patients with Major Myocardial Infarction: Effect of Filtering and Zooming in Comparison with Equilibrium Radionuclide Imaging and Left Ventriculography

Departments of Nuclear Medicine and Cardiology, Charles Nicolle University Hospital, Henri Becquerel Center, Rouen, France

Correspondence: For correspondence or reprints contact: Pierre Véra, MD, PhD, Henri Becquerel Center, Nuclear Medicine Department, 1 rue d'Amiens, 76000 Rouen, France.

ABSTRACT

The effect of filtering and zooming on ²⁰¹Tl-gated SPECT was evaluated in patients with major myocardial infarction. Methods: Rest thallium (Tl)-gated SPECT was performed with a 90° dual-head camera, 4 h after injection of 185 MBq ²⁰¹Tl in 32 patients (mean age 61 ± 11 y) with large myocardial infarction (33% ± 17% defect on bull's eye). End diastolic volume (EDV), end systolic volume (ESV) and left ventricular ejection fraction (LVEF) were calculated using a commercially available semiautomatic validated software. First, images were reconstructed using a 2.5 zoom, a Butterworth filter (order = 5) and six Nyquist cutoff frequencies: 0.13 (B5.13), 0.15 (B5.15), 0.20 (B5.20), 0.25 (B5.25), 0.30 (B5.30) and 0.35 (B5.35). Second, images were reconstructed using a zoom of 1 and a Butterworth filter (order = 5) (cutoff frequency 0.20 [B5.20Z1]) (total = 32 x 7 = 224 reconstructions). LVEF was calculated in all patients using equilibrium radionuclide angiocardiography (ERNA). EDV, ESV and LVEF were measured with contrast left ventriculography (LVG). Results: LVEF was 39% ± 2% (mean ± SEM) for ERNA and 40% ± 13% for LVG (P = 0.51). Gated SPECT with B5.20Z2.5 simultaneously offered a mean LVEF value (39% ± 2%) similar to ERNA (39% ± 2%) and LVG (40% ± 3%), optimal correlations with both ERNA (r = 0.83) and LVG (r = 0.70) and minimal differences with both ERNA (–0.9% ± 7.5% [mean ± SD]) and LVG (1.1% ± 10.5%). As a function of filter and zoom choice, correlation coefficients between ERNA or LVG LVEF, and gated SPECT ranged from 0.26 to 0.88; and correlation coefficients between LVG and gated SPECT volumes ranged from 0.87 to 0.94. There was a significant effect of filtering and zooming on EDV, ESV and LVEF (P < 0.0001). Low cutoff frequency (B5.13) overestimated LVEF (P < 0.0001 versus ERNA and LVG). Gated SPECT with 2.5 zoom and high cutoff frequencies (B5.15, B5.20, B5.25, B5.30 and B5.35) overestimated EDV and ESV (P < 0.04) compared with LVG. This volume overestimation with Tl-gated SPECT in patients with large myocardial infarction was correlated to the infarct size. A zoom of 1 underestimated EDV, ESV and LVEF compared with a 2.5 zoom (P < 0.02). Conclusion: Accurate LVEF measurement is possible with Tl-gated SPECT in patients with major myocardial infarction. However, filtering and zooming greatly influence EDV, ESV and LVEF measurements, and TI-gated SPECT overestimates left ventricular volumes, particularly when the infarct size increases.

Key Words: gated SPECT • thallium • left ventricular ejection fraction • myocardial infarction

This article has been cited by other articles:

				P.-Y. Marie, W. Djaballah, P. R. Franken, C. Vanhove, M. A. Muller, H. Boutley, S. Poussier, P. Olivier, G. Karcher, and A. Bertrand OSEM Reconstruction, Associated with Temporal Fourier and Depth-Dependant Resolution Recovery Filtering, Enhances Results from Sestamibi and 201Tl 16-Interval Gated SPECT J. Nucl. Med., November 1, 2005; 46(11): 1789 - 1795. [Abstract] [Full Text] [PDF]

				T Vakhtangandze, D O Hall, F V Zananiri, and M R Rees The effect of Butterworth and Metz reconstruction filters on volume and ejection fraction calculations with 99Tcm gated myocardial SPECT Br. J. Radiol., August 1, 2005; 78(932): 733 - 736. [Abstract] [Full Text] [PDF]

				A. Manrique, A. Hitzel, D. Brasse, and P. Vera Effect of Perfusion Pattern and Imaging Sequence on Gated Perfusion SPECT Evaluation of Myocardial Stunning J. Nucl. Med., January 1, 2005; 46(1): 176 - 183. [Abstract] [Full Text] [PDF]

				M. Nanasato, A. Ando, S. Isobe, M. Nonokawa, H. Hirayama, N. Tsuboi, T. Ito, M. Hirai, M. Yokota, and H. Saito Evaluation of Left Ventricular Function Using Electrocardiographically Gated Myocardial SPECT with 123I-Labeled Fatty Acid Analog J. Nucl. Med., December 1, 2001; 42(12): 1747 - 1756. [Abstract] [Full Text] [PDF]