[Quantitative image analysis in nuclear cardiology as a decision aid in addition to visual assessment of findings]

Quantitative analysis of nuclear cardiology procedures has stimulated tremendous work in the past and will continue to do so in the future. The impact on routine patient care has grown at a slower pace and should be assessed separately for tissue perfusion and for myocardial contraction. The current status will be presented, focusing on patients with coronary heart disease. In the preinfarct period myocardial scintigraphy with thallium-201 and emission computer tomography (ECT) is the preferred method. The procedure for quantitation includes transfer of all data into a standard polar map and comparing the numbers with a normal, gender-matched data base. The result reveals areas of reduced tracer uptake, color-coded according to the level of significance. Interpretation of these colored polar maps might appear simple, but in fact requires a substantial amount of knowledge to avoid overinterpretation of the results. This has led us to a restricted use of this quantitative tool: following an initial step of reading the original data in terms of short and long axes slices of the left myocardium, the polar map is utilized for verification and for suggestions of any additional lesions. This has to be confirmed by a second reading of the slices, and only this last step defines the lesions to be reported. Quantitation used in this dialectic approach avoids inclusion of artefacts, and at the same time is useful experience for trainees. Furthermore, it allows easy presentation during the clinical conference and statistical analysis of groups.(ABSTRACT TRUNCATED AT 250 WORDS)