ECG-gated 99mTc single-photon emission CT for assessment of right ventricular structure and function: is the

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Franz C Aepfelbacher1, Susan B Yeon, Kalon K L Ho

  • 1Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA 02215, USA.

Chest
|July 11, 2003
PubMed

Insights

Technetium-99m SPECT and ECG-gated SPECT show good agreement with 2D-ECHO for normal right ventricular (RV) function and size. However, SPECT imaging poorly detects RV dilation, hypertrophy, and systolic dysfunction compared to echocardiography.

Area of Science:

  • Nuclear Medicine
  • Cardiology
  • Diagnostic Imaging

Background:

  • Right ventricular (RV) assessment is crucial in cardiovascular diagnostics.
  • (99m)Tc single-photon emission CT (SPECT) and ECG-gated SPECT are established imaging modalities.
  • The diagnostic utility of SPECT for RV evaluation requires formal assessment.

Purpose of the Study:

  • To evaluate the utility of (99m)Tc SPECT and ECG-gated SPECT for assessing RV cavity size, wall thickness, and systolic function.
  • To compare SPECT findings with transthoracic two-dimensional Doppler echocardiography (2D-ECHO).

Main Methods:

  • Retrospective analysis of 194 patients undergoing SPECT and 2D-ECHO within 24 hours.
  • Visual assessment of RV size and function by both modalities.
  • Measurement of RV wall thickness by 2D-ECHO and visual assessment by SPECT.

Main Results:

  • Good agreement between SPECT and 2D-ECHO for normal RV cavity size (94%).
  • Poor agreement for RV dilation (17% concordance).
  • SPECT identified significantly fewer patients with abnormal RV systolic function (2 vs. 18) and poor correlation in wall thickness measurements compared to 2D-ECHO.

Conclusions:

  • SPECT and 2D-ECHO demonstrate good agreement for normal RV parameters.
  • Significant discrepancies exist in detecting RV dilation, hypertrophy, and systolic dysfunction.
  • 2D-ECHO remains superior for comprehensive RV functional and structural assessment.
Abstract

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