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Comparison between segmental wall motion and wall thickening in patients with coronary artery disease using
M B Imran1, K Morita, I Adachi
1Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Insights
Regional wall motion and thickening show similarity in coronary artery disease patients using gated SPECT. However, separate analysis of wall motion and thickening is recommended for accurate myocardial functional assessment.
Area of Science:
- Cardiovascular Imaging
- Nuclear Cardiology
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) diagnosis relies on assessing myocardial function.
- Gated myocardial perfusion single photon emission computed tomography (SPECT) is a key imaging modality.
- Evaluating regional wall motion (WM) and wall thickening (WT) provides insights into myocardial health.
Purpose of the Study:
- To evaluate regional wall motion (WM) and wall thickening (WT) using gated myocardial perfusion SPECT.
- To determine the similarity and disparity between WM and WT in patients with CAD.
- To assess the clinical utility of QGS software in analyzing these parameters.
Main Methods:
- 44 patients with CAD underwent 1-day stress/rest MIBI gated SPECT.
- Quantitative Gated SPECT (QGS) software was used for 3D and cine-mode display.
- Left ventricle segments were scored for WM and WT by six observers; mean scores were calculated.
Main Results:
- A good correlation was found between WM and WT (r = 0.62, p < 0.0001) with 85% concordance.
- Significant differences (WM - WT ≥ 2) were noted in 15 segments, primarily with greater WM abnormalities.
- Anteroseptal segments showed more WM abnormalities, particularly in post-coronary artery bypass grafting (CABG) patients.
Conclusions:
- WM and WT demonstrate similarity in QGS studies for CAD patients.
- Separate assessment of WM and WT in gated SPECT is crucial for robust myocardial functional evaluation.
- Relying solely on WM assessment may lead to inaccurate conclusions, especially in septal regions.
Abstract:
This study was performed to evaluate regional wall motion (WM) and wall thickening (WT) using gated myocardial perfusion single photon emission computed tomography (SPECT) and to determine their similarity and disparity in patients with coronary artery disease (CAD). A total of 44 patients underwent 1 day stress/rest (MIBI) gated SPECT. Commercially available quantitative analysis of gated SPECT (QGS) software was used to generate 3D surface display and cine-mode SPECT display. Left ventricle was divided into nine segments to score WM and WT from 0 (no abnormality) to 4 (severe abnormality) by six independent observers. Finally a mean score was calculated for each segment from the scores of six observers. There was fairly good correlation between WM and WT of individual segments (r = 0.62, p < 0.0001). Concordance rate (IWM - WTI < 1) was 85%. A large difference between WM and WT (WM - WT > or = 2) was observed in 15 segments, including 12 segments with greater WM abnormalities and 3 segments with greater WT abnormalities (lateral and inferior walls). Greater WM abnormalities were most commonly observed in anteroseptal segments especially in post coronary artery bypass grafting (CABG) patients. In conclusion, WM and WT showed similarity on QGS studies. However, these two parameters may be determined separately in gated SPECT studies for comprehensive and robust evaluation of the functional status of myocardium. Analyses based on WM assessment alone may lead to erroneous results especially in septal regions.