Comparison of two three-dimensional gated SPECT methods with thallium in patients with large myocardial infarction.
BACKGROUND
Two different commercially available gated single photon emission computed tomography (GSPECT) methods were compared in a population of patients with a major myocardial infarction.


METHODS
Rest thallium GSPECT was performed with a 90-degree dual-detector camera, 4 hours after injection of thallium-201 (Tl-201; 185 MBq) in 43 patients (mean age, 62+/-12 years) with a large myocardial infarction (mean defect size, 33%+/-16%). End-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were calculated by using QGS (Cedars Sinai) and MultiDim (Sopha Medical Vision International, Buc, France). Images were reconstructed by using a 2.5 zoom and a Butterworth filter (order, 5; cut-off frequency, 0.20). LVEF was calculated in all patients by using equilibrium radionuclide angiocardiography (ERNA). EDV, ESV, and LVEF were also measured by using left ventriculography (LVG).


RESULTS
Compared with LVG, QGS underestimated LVEF by means of an underestimation of mean EDV. MultiDim overestimated EDV and ESV. GSPECT EDV and ESV overestimation was demonstrated by means of Bland-Altman analysis to increase with left ventricular volume size (P<.05). The difference between LVG and GSPECT volumes was demonstrated by means of regression analysis to be correlated with infarction size. This effect was particularly important with MultiDim (P<.0001).


CONCLUSIONS
In Tl-201 GSPECT, LVEF and volume measurements will vary according to the type of software used.
Véra
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Department of Nuclear Medicine, Rouen University Hospital and Henri Becquerel Center, France. pierre.vera@rouen.fnclcc.fr
Koning
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Cribier
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Manrique
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D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D013318:Stroke Volume; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016277:Ventricular Function, Left
D013794:Thallium Radioisotopes