Comparison of regional myocardial technetium-99m-MIBI uptake between ECG-gated and ungated SPECT imaging.
Technetium-99m-MIBI uptake was compared between ECG-gated and ungated SPECT images in 10 normal subjects and 10 patients with coronary artery disease to investigate the effects of wall motion on regional myocardial uptake.


METHODS
Left ventricular ejection fraction (LVEF) and wall motion were evaluated using the first-pass data acquired immediately after injection of 1110 MBq 99mTc-MIBI. A transaxial ungated image was reconstructed with cumulative data during a cardiac cycle. For transaxial gated images, data during a cardiac cycle were divided into eight frames and the first seven frames were used. The lateral/septal ratios for ungated and gated images were obtained using the counts in the ROIs drawn in the lateral and the septal walls.


RESULTS
In 10 normal subjects, the lateral/septal ratio for gated increased during end-systole. The mean of the lateral/septal ratio was significantly lower for ungated than for gated (1.025 vs. 1.077, p < 0.05). In patients with septal wall asynergy and a normokinetic lateral wall, the mean of the lateral/septal ratios was significantly lower for ungated than for gated (1.267 vs. 1.325, p < 0.01).


CONCLUSIONS
Ungated SPECT acquisition may underestimate regional myocardial uptake when myocardial wall motion is good, therefore, ECG-gated data should be acquired for accurate assessment of regional myocardial uptake of 99mTc-MIBI.
Onoguchi
M
M
School of Health Sciences, Kanazawa University, Japan.
Maruno
H
H
Fujinaga
T
T
Komiyama
N
N
Takayama
T
T
Murata
H
H
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000378:metabolism; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi