title: 201Tl gated single photon emission computed tomographic myocardial perfusion imaging in the assessment of global and regional left ventricular function. Would it be favoured over equilibrium radionuclide angiography?
abstract: BACKGROUND
  This study investigates the clinical performance of routine 201Tl gated single photon emission computed tomographic (201Tl GSPECT) myocardial perfusion imaging. Equilibrium radionuclide angiography (ERNA) was used as the standard for comparison.
  
  
  RESULTS
  One hundred and seventy-two consecutive patients were submitted to both myocardial 201Tl GSPECT imaging, at stress and in redistribution, and ERNA. Left ventricular ejection fractions (LVEF) and regional wall motion were assessed from both stress and redistribution 201Tl GSPECT datasets, and from ERNA. Linear regression analysis showed a good correlation between LVEF calculated by ERNA and 201Tl GSPECT (r=0.73 at stress, r=0.75 in redistribution, P<0.0001). However, the 95% prediction intervals of 201Tl GSPECT LVEF from ERNA LVEF were wide (minimum 35.4% at stress and 33.2% in redistribution). Moreover, a difference in LVEF > or =10% between ERNA and 201Tl GSPECT was found in 26.4% of cases at stress and 28.6% of cases in redistribution. A fair agreement between ERNA and 201Tl GSPECT was found in regional wall motion assessment in segments with normal or mildly reduced tracer uptake (kappa=0.32 at stress and kappa=0.33 in redistribution). In segments with moderately to severely reduced tracer uptake, a moderate agreement was found in regional wall motion assessment between ERNA and 201Tl GSPECT (kappa=0.44 at stress and kappa=0.42 in redistribution).
  
  
  CONCLUSIONS
  Left ventricular function may be misinterpreted in a significant proportion of patients if the calculation of LVEF is based on 201Tl GSPECT. Moreover, the evaluation of regional wall motion by 201Tl GSPECT appears unsatisfactory.
authors.affiliation: Department of Nuclear Medicine, Aristotlian University, Hippokration Hospital, Thessaloniki, Greece. emoral@hol.gr
authors.forename: Efstratios
authors.initials: E
authors.lastname: Moralidis
authors.forename: Tryfon
authors.initials: T
authors.lastname: Spyridonidis
authors.forename: Georgios
authors.initials: G
authors.lastname: Arsos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Apostolopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karatzas
authors.forename: Pavlos
authors.initials: P
authors.lastname: Vassilakos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Karakatsanis
mesh_terms: D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D019275:Radiopharmaceuticals; C027549:thallium chloride; D013793:Thallium