title: Comparison between 99mTc-sestamibi gated myocardial perfusion SPECT and echocardiography in assessment of left ventricular volumes and ejection fraction--effect of perfusion defect and small heart.
abstract: BACKGROUND
  Agreement between gated myocardial perfusion SPECT (GSPECT) and echocardiography (ECHO) in the calculation of left ventricular end-diastolic volume (EDV), end-systolic volume (ESV) and LVEF was assessed. Effect of perfusion defect and small hearts on this agreement was obtained. Because ECHO is a routine and widely used noninvasive modality for this purpose, we chose this technique for comparison with GSPECT.
  
  
  METHODS
  In a prospective study, 50 consecutive patients (age = 59.7 ± 10.64 years) underwent rest Tc99m-sestamibi GSPECT and 2-D ECHO. The LVEF, EDV and ESV were calculated using QGS (Quantitative Gated SPECT) software.
  
  
  RESULTS
  Fourteen (28%) patients had perfusion defect in rest phase tomograms, while 36 (72%) had no perfusion defect. There was a significant correlation between two modalities in calculation of EDV, ESV and LVEF (all: p < 0.001, Pearson's correlation coefficients: r = 0.764, 0.831 and 0.813, respectively). A good correlation was noticed even in small hearts or in patients with or without previous myocardial infarction. There was a significant difference between GSPECT and ECHO in patients with no perfusion defect as well as in patients with small heart (ESV < 25 ml). On the other hand, no remarkable difference was noticed between two techniques in the presence of perfusion defect or in patients with ESV ≥ 25 ml.
  
  
  CONCLUSIONS
  There was a good agreement between EDV, ESV and LVEF derived from GSPECT and ECHO. There was a significant difference between two modalities in small hearts and in patients without perfusion defect, although in larger ventricles or in the presence of myocardial infarction no remarkable difference between two modalities was noticed.
authors.forename: Seyed Hashem
authors.initials: SH
authors.lastname: Danesh-Sani
authors.forename: Seyed Rasoul
authors.initials: SR
authors.lastname: Zakavi
authors.forename: Leyla
authors.initials: L
authors.lastname: Oskoueian
authors.affiliation: Nuclear Medicine Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. dabbaghvr@mums.ac.ir.
authors.forename: Vahid-Reza Dabbagh
authors.initials: VR
authors.lastname: Kakhki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D009929:Organ Size; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi