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[Assessment of cardiac function and left ventricular regional wall motion by 99mTc multigated cardiac blood-pool
1Department of Radiology, University of Occupational and Environmental Health, School of Medicine.
Insights
Multigated cardiac blood pool SPECT using 99mTc effectively evaluates left ventricular function and regional wall motion. This nuclear imaging technique shows good correlation with conventional methods like left ventriculography and MRI.
Area of Science:
- Nuclear Medicine
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Accurate assessment of cardiac function is crucial for patient management.
- Multigated cardiac blood pool SPECT (SPECT) offers a non-invasive approach to evaluate ventricular volumes and motion.
Purpose of the Study:
- To assess the clinical utility of multigated cardiac blood pool SPECT for quantifying left and right ventricular volumes and left ventricular regional wall motion.
- To compare SPECT-derived parameters with established methods like left ventriculography (LVG) and magnetic resonance imaging (MRI).
Main Methods:
- Analysis of left and right ventricular (LV and RV) volumes and LV regional wall motion in 43 patients using 99mTc-labeled SPECT.
- Phantom studies were conducted to determine optimal background cutoff levels for accurate volume calculation.
- Comparison of SPECT data with LVG and MRI for validation.
Main Results:
- SPECT-derived LV end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) showed good correlation with LVG and MRI, particularly with horizontal long axial images.
- RV stroke volume (SV) correlated well with LV SV using horizontal long axial images, though the stroke volume ratio (LVSV/RVSV) was not consistently 1.
- SPECT evaluation of LV wall motion, using multicontour systolic display and phase analysis, correlated better with LVG than gated planar images.
Conclusions:
- Multigated cardiac blood pool SPECT is a clinically valuable tool for assessing overall cardiac function.
- SPECT provides reliable evaluation of left ventricular regional wall motion, offering an alternative to traditional imaging modalities.
Abstract:
Forty-three patients underwent the analysis of left and right ventricular (LV and RV) volumes, and LV regional wall motion by multigated cardiac blood pool single photon emission computed tomography (SPECT) with 99mTc. To calculate the cardiac volume correctly, the optimal cutoff level in relation to background level was first obtained by a phantom study. Left ventricular end-diastolic, end-systolic volume (EDV and ESV) and ejection fraction (EF) calculated thus with SPECT were correlated well with the data obtained with left ventriculography (LVG) and magnetic resonance imaging (MRI), especially using horizontal long axial image. RV stroke volume (SV) without shunt or valvular diseases was also correlated well with that of LV when it was calculated using horizontal long axial image. However, SV ratio (LVSV/RVSV) was not necessarily ideal numerical 1. In addition LV wall motion was evaluated by multicontour systolic display and phase analysis in SPECT and gated planar images. The results obtained with SPECT were better correlated with those of LVG than gated planar images. It is concluded that multigated cardiac blood pool SPECT is a clinically useful method for an evaluation of cardiac function and left ventricular regional wall motion.