Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide
Wanda Acampa1, Maria Grazia Caprio, Emanuele Nicolai
1Department of Biomorphological and Functional Sciences, Institute of Biostructures and Bioimages, National Council of Research, University Federico II, Naples, Italy.
Insights
Gated SPECT and radionuclide angiocardiography show good agreement for measuring left ventricular ejection fraction. However, gated SPECT may slightly underestimate post-stress ejection fraction in patients with perfusion abnormalities.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Left ventricular (LV) ejection fraction (EF) is a critical measure of cardiac function.
- Accurate LV-EF assessment is vital for diagnosing and managing cardiovascular diseases.
Purpose of the Study:
- To compare the accuracy of LV ejection fraction measurements between gated Single-Photon Emission Computed Tomography (SPECT) and equilibrium radionuclide angiocardiography (ERNA).
- To evaluate the agreement between these two imaging modalities in a large patient cohort.
Main Methods:
- 514 patients with suspected or known coronary artery disease underwent same-day stress-rest (99m)Tc-sestamibi gated SPECT and ERNA within one week.
- Data acquisition for both techniques occurred after exercise and after 3 hours of rest.
Main Results:
- A strong correlation was found between gated SPECT and ERNA for LV-EF at rest (r=0.82) and after stress (r=0.83).
- Mean differences in LV-EF were minimal (-0.6% at rest, 1.7% post-stress) in the overall population.
- In patients with perfusion abnormalities, gated SPECT showed a slight underestimation of post-stress LV-EF compared to ERNA (mean difference 2.5%).
Conclusions:
- Gated SPECT and ERNA demonstrate good agreement for assessing LV ejection fraction in a large patient cohort.
- While generally comparable, gated SPECT may slightly underestimate post-stress LV-EF in patients with perfusion abnormalities.
Purpose:
We compared left ventricular (LV) ejection fraction obtained by gated SPECT with that obtained by equilibrium radionuclide angiocardiography in a large cohort of patients.
Methods:
Within 1 week, 514 subjects with suspected or known coronary artery disease underwent same-day stress-rest (99m)Tc-sestamibi gated SPECT and radionuclide angiocardiography. For both studies, data were acquired 30 min after completion of exercise and after 3 h rest.
Results:
In the overall study population, a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.82, p<0.0001) and after stress (r=0.83, p<0.0001). In Bland-Altman analysis, the mean differences in ejection fraction (radionuclide angiocardiography minus gated SPECT) were -0.6% at rest and 1.7% after stress. In subjects with normal perfusion (n=362), a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.72, p<0.0001) and after stress (r=0.70, p<0.0001) and the mean differences in ejection fraction were -0.9% at rest and 1.4% after stress. Also in patients with abnormal perfusion (n=152), a good correlation between the two techniques was observed both at rest (r=0.89, p<0.0001) and after stress (r=0.90, p<0.0001) and the mean differences in ejection fraction were 0.1% at rest and 2.5% after stress.
Conclusion:
In a large study population, a good agreement was observed in the evaluation of LV ejection fraction between gated SPECT and radionuclide angiocardiography. However, in patients with perfusion abnormalities, a slight underestimation in poststress LV ejection fraction was observed using gated SPECT as compared to equilibrium radionuclide angiocardiography.
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