title: Comparison of radionuclide ventriculography using SPECT and planar techniques in different cardiac conditions.
abstract: OBJECTIVE
  Accurate assessment of ventricular function is required to optimize therapeutic management of cardiac diseases. The aim of this study was to correlate planar equilibrium multigated acquisition (MUGA) with tomographic ventriculography (SPECT) in patients with diverse volumes and wall motion abnormalities.
  
  
  METHODS
  Eighty-three studies in 80 patients (56+/-14 years; 56% women) were classified according to ventricular dilation, wall motion abnormalities and systolic dysfunction. Left and right ventricular ejection fraction (LVEF and RVEF) and end-diastolic and end-systolic left ventricular volumes (EDV and ESV) were obtained using a commercial QBS program for SPECT. On planar acquisition, LVEF and RVEF were obtained using standard techniques and volumes were determined using the count-based method, without blood sampling.
  
  
  RESULTS
  A. Total group: With the planar method, LVEF was 44+/-17%, RVEF 42+/-13%, left EDV 147+/-97 ml (range 31-487 ml) and left ESV 93+/-85 ml (range 15-423 ml); with SPECT the corresponding values were 40+/-20%, 49+/-16%,131+/-95 ml and 91+/-89 ml, respectively (p=NS for all but RVEF). Linear correlation was 0.845 for LVEF, 0.688 for RVEF, 0.927 for left EDV and 0.94 for left ESV, with good intra-class correlation. B. Subgroups: Global and intra-class correlations between planar imaging and SPECT were high for volumes, RVEF and LVEF in all subgroups, except in patients with normal wall motion and function, who showed smaller volumes with SPECT. The group with diffuse wall motion abnormalities had a lower EDV on SPECT. In the abnormal left ventricle, RVEF was higher with SPECT.
  
  
  CONCLUSIONS
  Good correlation and agreement exist between SPECT and planar MUGA with respect to LVEF and left ventricular volumes. SPECT is useful in patients with functional abnormalities, but less reliable in those with normal small cavities. A combined technique is still necessary, and RVEF should be interpreted cautiously.
authors.affiliation: Medicine Department, Nuclear Medicine Section, University of Chile - Clinical Hospital, Santos Dumont 999-1E, Independencia, Santiago, Chile. tmassardo@redclinicauchile.cl
authors.forename: Teresa
authors.initials: T
authors.lastname: Massardo
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jaimovich
authors.forename: Hugo
authors.initials: H
authors.lastname: Lavados
authors.forename: Daniela
authors.initials: D
authors.lastname: Gutiérrez
authors.forename: J Carlos
authors.initials: JC
authors.lastname: Rodríguez
authors.forename: J Miguel
authors.initials: JM
authors.lastname: Saavedra
authors.forename: Rita
authors.initials: R
authors.lastname: Alay
authors.forename: Héctor
authors.initials: H
authors.lastname: Gatica
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*