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Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: comparison to cardiac magnetic resonance imaging

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

CZT technology allows ultrafast low-dose myocardial scintigraphy but its accuracy in assessing left ventricular function is still to be defined.

Methods

The study group comprised 55 patients (23 women, mean age 63 ± 9 years) referred for myocardial perfusion scintigraphy. The patients were studied at rest using a CZT camera (Discovery NM530c; GE Healthcare) and a low-dose 99mTc-tetrofosmin clinical protocol (mean dose 264 ± 38 MBq). Gated SPECT imaging was performed as a 6-min list-mode acquisition, 15 min after radiotracer injection. Images were reformatted (8-frame to 16-frame) using Lister software on a Xeleris workstation (GE Healthcare) and then reconstructed with a dedicated iterative algorithm. Analysis was performed using Quantitative Gated SPECT (QGS) software. Within 2 weeks patients underwent cardiac magnetic resonance imaging (cMRI, 1.5-T unit CVi; GE Healthcare) using a 30-frame acquisition protocol and dedicated software for analysis (MASS 6.1; Medis).

Results

The ventricular volumes obtained with 8-frame QGS showed excellent correlations with the cMRI volumes (end-diastolic volume (EDV), r = 0.90; end-systolic volume (ESV), r = 0.94; p < 0.001). However, QGS significantly underestimated the ventricular volumes (mean differences: EDV, −39.5 ± 29 mL; ESV, −15.4 ± 22 mL; p < 0.001). Similarly, the ventricular volumes obtained with 16-frame QGS showed an excellent correlations with the cMRI volumes (EDV, r = 0.92; ESV, r = 0.95; p < 0.001) but with significant underestimations (mean differences: EDV, −33.2 ± 26 mL; ESV, −17.9 ± 20 mL; p < 0.001). Despite significantly lower values (47.9 ± 16 % vs. 51.2 ± 15 %, p < 0.008), 8-frame QGS mean ejection fraction (EF) was closely correlated with the cMRI values (r = 0.84, p < 0.001). The mean EF with 16-frame QGS showed the best correlation with the cMRI values (r = 0.91, p < 0.001) and was similar to the mean cMRI value (49.6 ± 16 %, p not significant). Regional analysis showed a good correlation between both 8-frame and 16-frame QGS and cMRI wall motion score indexes (8-frame WMSI, r = 0.85; 16-frame WMSI, r = 0.89; p < 0.01).

Conclusion

Low-dose gated SPECT with a CZT camera provides ventricular volumes that correlate well with cMRI results despite significant underestimation in the measure values. EF estimation appeared to be more accurate with 16-frame reformatted images than with 8-frame images.

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References

  1. Garcia EV, Faber TL, Esteves FP. Cardiac dedicated ultrafast SPECT cameras: new designs and clinical implications. J Nucl Med. 2011;52:210–7.

    Article  PubMed  Google Scholar 

  2. Esteves FP, Raggi P, Folks RD, Keidar Z, Askew JW, Rispler S, et al. Novel solid-state-detector dedicated cardiac camera for fast myocardial perfusion imaging: multicenter comparison with standard dual detector cameras. J Nucl Cardiol. 2009;16:927–34.

    Article  PubMed  Google Scholar 

  3. Duvall WL, Croft LB, Ginsberg ES, Einstein AJ, Guma KA, George T, et al. Reduced isotope dose and imaging time with a high-efficiency CZT SPECT camera. J Nucl Cardiol. 2011;18:847–57.

    Article  PubMed  Google Scholar 

  4. Gimelli A, Bottai M, Genovesi D, Giorgetti A, Di Martino F, Marzullo P. High diagnostic accuracy of low-dose gated-SPECT with solid-state ultrafast detectors: preliminary clinical results. Eur J Nucl Med Mol Imaging. 2012;39(1):83–90.

    Article  PubMed  CAS  Google Scholar 

  5. Giorgetti A, Genovesi D, Marzullo P. Nuclear cardiology at the door of a new era: better to save mSv or to reduce imaging time? Eur J Nucl Med Mol Imaging. 2012;39(12):1898–900.

    Article  PubMed  Google Scholar 

  6. Germano G, Erel J, Lewin H, Kavanagh PB, Berman DS. Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol. 1997;30(5):1360–7.

    Article  PubMed  CAS  Google Scholar 

  7. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical assessment. Lancet. 1986;1:307–10.

    Article  PubMed  CAS  Google Scholar 

  8. Hammermeister KE, de Rouen TA, Dodge HT. Variables predictive of survival in patients with coronary disease. Selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic, and quantitative angiographic evaluations. Circulation. 1979;59:421–30.

    Article  PubMed  CAS  Google Scholar 

  9. Grover S, Leong DL, Selvanayagam JB. Evaluation of left ventricular function using cardiac magnetic resonance imaging. J Nucl Cardiol. 2011;18:351–65.

    Article  PubMed  Google Scholar 

  10. Nakajima K, Higuchi T, Taki J, Kawano M, Tonami N. Accuracy of ventricular volume and ejection fraction measured by gated myocardial SPECT: comparison of 4 software programs. J Nucl Med. 2001;42:1571–8.

    PubMed  CAS  Google Scholar 

  11. Bavelaar-Croon CDL, Kayser HWM, van der Wall EE, de Roos A, Dibbets-Schneider P, Pauwels EK, et al. Left ventricular function: correlation of quantitative gated SPECT and MR imaging over a wide range of values. Radiology. 2000;217:572–5.

    Article  PubMed  CAS  Google Scholar 

  12. Bax JJ, Lamb H, Dibbets P, Pelikan H, Boersma E, Viergever EP, et al. Comparison of gated single-photon emission computed tomography with magnetic resonance imaging for evaluation of left ventricular function in ischemic cardiomyopathy. Am J Cardiol. 2000;86:1299–305.

    Article  PubMed  CAS  Google Scholar 

  13. Faber TL, Vansant JP, Pettigrew RI, Galt JR, Blais M, Chatzimavroudis G, et al. Evaluation of left ventricular endocardial volumes and ejection fractions computed from gated perfusion SPECT with magnetic imaging: comparison of two methods. J Nucl Cardiol. 2001;8:645–51.

    Article  PubMed  CAS  Google Scholar 

  14. Vaduganathan P, He Z, Vick III GW, Mahmarian JJ, Verani MS. Evaluation of left ventricular wall motion, volumes, and ejection fraction by gated myocardial tomography with technetium 99m-labeled tetrofosmin: a comparison with cine magnetic resonance imaging. J Nucl Cardiol. 1998;6:3–10.

    Article  Google Scholar 

  15. Lipke CSA, Kühl HP, Nowak B, Kaiser HJ, Reinartz P, Buell U, et al. Validation of 4D-MSPECT and QGS for quantification of left ventricular volumes and ejection fraction from gated Tc-MIBI SPET: comparison with cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging. 2004;31:482–90.

    Article  PubMed  Google Scholar 

  16. Nakajima K, Taki J, Higuchi T, Kawano M, Taniguchi M, Maruhashi K, et al. Gated SPET quantification of small hearts: mathematical simulation and clinical application. Eur J Nucl Med. 2000;27:1372–9.

    Article  PubMed  CAS  Google Scholar 

  17. Sharir T, Kang X, Germano G, Bax JJ, Shaw LJ, Gransar H, et al. Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: gender-related differences in normal limits and outcomes. J Nucl Cardiol. 2006;13:495–506.

    Article  PubMed  Google Scholar 

  18. Peace RA, Adams PC, Lloyd JJ. Effect of sex, age, and weight on ejection fraction and end-systolic volume reference limits in gated myocardial perfusion SPECT. J Nucl Cardiol. 2008;15:86–93.

    Article  PubMed  Google Scholar 

  19. Tadamura E, Kudoh T, Motooka M, Inubushi M, Shirakawa S, Hattori N, et al. 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. J Am Coll Cardiol. 1999;33:991–7.

    Article  PubMed  CAS  Google Scholar 

  20. Cochet H, Bullier E, Gerbaud E, Durieux M, Godbert Y, Lederlin M, et al. Absolute quantification of left ventricular global and regional function at nuclear MPI using ultrafast CZT SPECT: initial validation versus cardiac MR. J Nucl Med. 2013;54(4):556–63.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Fondazione CNR/Regione Toscana “G. Monasterio”, Via Moruzzi 1, 56124, Pisa, Italy

    Assuero Giorgetti, Pier Giorgio Masci, Gavino Marras, Alessia Gimelli, Dario Genovesi & Massimo Lombardi

  2. Department of internal medicine Central Customs Hospital, Azerbaijan Medical University, Baku, Azerbaijan

    Yasmine K. Rustamova

  3. Istituto di Fisiologia Clinica del CNR, via Moruzzi 1, Pisa, 56124, Italy

    Paolo Marzullo

Authors
  1. Assuero Giorgetti
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  2. Pier Giorgio Masci
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  3. Gavino Marras
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  4. Yasmine K. Rustamova
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  5. Alessia Gimelli
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  6. Dario Genovesi
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  7. Massimo Lombardi
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  8. Paolo Marzullo
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Correspondence to Assuero Giorgetti.

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Giorgetti, A., Masci, P.G., Marras, G. et al. Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: comparison to cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging 40, 1869–1875 (2013). https://doi.org/10.1007/s00259-013-2505-9

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  • DOI: https://doi.org/10.1007/s00259-013-2505-9

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