PubMed · 11337533
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G Germano, D S Berman. 2001. Quantitative gated SPECT.. https://pubmed.ncbi.nlm.nih.gov/11337533/
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The year 2001 has been very fertile for innovations and developments in the field of cardiac imaging. In Nuclear Cardiology, this year has been marked above all by a very large number of studies on the gated-SPECT, which allows joint analysis of the perfusion and contraction of the left ventricle. The contribution of this technique is recognised as being very significant in all fields using conventional tomoscintigraphy (screening for cardiac disease, evaluations of prognosis and viability,...). Innovation has also been focused in the field of radio-tracers, with studies on the very promising markers of apoptosis or cellular hypoxia. Lastly, much work has been conducted on the gamma-camera, especially to adapt it for imaging with the tracers used in positron emission tomography (PET). This will enable the distribution to all the Nuclear Medicine services of FDG imaging, which is the reference technique for studying myocardial viability. In MRI much work has been carried out on sequences using gadolinium, a vascular contrast agent, in order to identify and localise the sequelae of infarction, even when they are limited to the sub-endocardium. The most spectacular technical innovations were probably in the methods allowing an increase of the recorded signal (SENSE) and in updating the imaging sequences in real time, without apnoea and without ECG synchronisation. But, as every year, significant progress has also been made in MRI angiography of the coronary vessels, and thus in the analysis of myocardial tissue perfusion, with sequences which can be used without the injection of contrast medium.
UNLABELLED: Gated blood-pool SPECT (GBPS), inherently 3-dimensional (3D), has the potential to replace planar equilibrium radionuclide angiography (ERNA) for computation of left ventricular ejection fraction (LVEF), analysis of regional wall motion (RWM), and analysis of right heart function. The purpose of this study was to compare GBPS and ERNA for the assessment of ventricular function in a large, multicenter cohort of patients. METHODS: One hundred seventy-eight patients referred in the usual manner for nuclear medicine studies underwent ERNA followed by GBPS. Each clinical site followed a GBPS acquisition protocol that included 180 degrees rotation, a 64 by 64 matrix, and 64 or 32 views using single- or double-head cameras. Transverse GBPS images were reconstructed with a Butterworth filter (cutoff frequency, 0.45-0.55 Nyquist; order, 7), and short-axis images were created. All GBPS studies were processed with a new GBPS program, and LVEF was computed from the isolated left ventricular chamber and compared with standard ERNA LVEF. Reproducibility of GBPS LVEF was evaluated, and right ventricular ejection fraction (RVEF) was computed in a subset of patients (n = 33). Using GBPS, RWM and image quality from 3D surface-shaded and volume-rendered cine displays were evaluated qualitatively in a subset of patients (n = 30). RESULTS: The correlation between GBPS LVEF and planar LVEF was excellent (r = 0.92). Mean LVEF was 62.2% for GBPS and 54.1% for ERNA. The line of linear regression was GBPS LVEF = (1.04 x ERNA LVEF) + 6.1. Bland-Altman plotting revealed an increasing bias in GBPS LVEF with increasing LVEF (Y = 0.13x + 0.61; r = 0.30; mean difference = 8.1% +/- 7.0%). Interoperator reproducibility of GBPS LVEF was good (r = 0.92). RVEF values averaged 59.8%. RWM assessment using 3D cine display was enhanced in 27% of the studies, equivalent in 67%, and inferior in 7%. CONCLUSION: GBPS LVEF was reproducible and correlated well with planar ERNA. GBPS LVEF values were somewhat higher than planar ERNA, likely because of the exclusion of the left atrium.
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