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Quantitative LVEF and qualitative regional function from gated thallium-201 perfusion SPECT
1Department of Medical Physics and Imaging, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Summary
Routine clinical 201Tl gated perfusion SPECT (gated Tl) is feasible and comparable to 99mTc-sestamibi gated perfusion SPECT (gated MIBI) for assessing left ventricular ejection fraction (LVEF) and myocardial function.
Area of Science:
- Nuclear cardiology
- Cardiovascular imaging
- Medical diagnostics
Background:
- Gated single-photon emission computed tomography (SPECT) is crucial for assessing myocardial perfusion and function.
- Comparison of different radiotracers for gated SPECT is essential for optimizing clinical protocols.
Purpose of the Study:
- To evaluate the feasibility of routine clinical use of Thallium-201 gated perfusion SPECT (gated Tl).
- To compare quantitative left ventricular ejection fraction (LVEF) and visual assessment of regional wall motion/thickening with 99mTc-sestamibi gated perfusion SPECT (gated MIBI).
Main Methods:
- 121 patients underwent separate rest gated Tl and post-stress gated MIBI SPECT protocols.
- Quantitative LVEF was automatically calculated, and regional function was visually scored.
- A dual-detector camera was used for imaging.
Main Results:
- Quantitative LVEFs from gated Tl and gated MIBI correlated well (r=0.918).
- Image quality for gated Tl was acceptable in most patients (66.1% excellent/good).
- Agreement for segmental myocardial function (motion and thickening) was high in nonischemic patients (92.2% and 95.4%).
Conclusions:
- Thallium-201 gated SPECT is feasible for routine clinical use.
- It allows assessment of both myocardial perfusion and function with a single injection and imaging sequence.
- This offers an alternative to 99mTc-based agents for comprehensive cardiac evaluation.