Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol: Comparison to cardiac magnetic resonance imaging

Assuero Giorgetti, Pier Giorgio Masci, Gavino Marras, Yasmine K. Rustamova, Alessia Gimelli, Dario Genovesi, Massimo Lombardi, Paolo Marzullo

Research output: Contribution to journalArticle

Abstract

Purpose: CZT technology allows ultrafast low-dose myocardial scintigraphy but its accuracy in assessing left ventricular function is still to be defined. Methods: The study group comprised 55 patients (23 women, mean age 63 ± 9 years) referred for myocardial perfusion scintigraphy. The patients were studied at rest using a CZT camera (Discovery NM530c; GE Healthcare) and a low-dose 99mTc-tetrofosmin clinical protocol (mean dose 264 ± 38 MBq). Gated SPECT imaging was performed as a 6-min list-mode acquisition, 15 min after radiotracer injection. Images were reformatted (8-frame to 16-frame) using Lister software on a Xeleris workstation (GE Healthcare) and then reconstructed with a dedicated iterative algorithm. Analysis was performed using Quantitative Gated SPECT (QGS) software. Within 2 weeks patients underwent cardiac magnetic resonance imaging (cMRI, 1.5-T unit CVi; GE Healthcare) using a 30-frame acquisition protocol and dedicated software for analysis (MASS 6.1; Medis). Results: The ventricular volumes obtained with 8-frame QGS showed excellent correlations with the cMRI volumes (end-diastolic volume (EDV), r = 0.90; end-systolic volume (ESV), r = 0.94; p <0.001). However, QGS significantly underestimated the ventricular volumes (mean differences: EDV, -39.5 ± 29 mL; ESV, -15.4 ± 22 mL; p <0.001). Similarly, the ventricular volumes obtained with 16-frame QGS showed an excellent correlations with the cMRI volumes (EDV, r = 0.92; ESV, r = 0.95; p <0.001) but with significant underestimations (mean differences: EDV, -33.2 ± 26 mL; ESV, -17.9 ± 20 mL; p <0.001). Despite significantly lower values (47.9 ± 16 % vs. 51.2 ± 15 %, p <0.008), 8-frame QGS mean ejection fraction (EF) was closely correlated with the cMRI values (r = 0.84, p <0.001). The mean EF with 16-frame QGS showed the best correlation with the cMRI values (r = 0.91, p <0.001) and was similar to the mean cMRI value (49.6 ± 16 %, p not significant). Regional analysis showed a good correlation between both 8-frame and 16-frame QGS and cMRI wall motion score indexes (8-frame WMSI, r = 0.85; 16-frame WMSI, r = 0.89; p <0.01). Conclusion: Low-dose gated SPECT with a CZT camera provides ventricular volumes that correlate well with cMRI results despite significant underestimation in the measure values. EF estimation appeared to be more accurate with 16-frame reformatted images than with 8-frame images.

Original languageEnglish
Pages (from-to)1869-1875
Number of pages7
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume40
Issue number12
DOIs
Publication statusPublished - 2013

Keywords

  • cMRI
  • CZT
  • Gated SPECT
  • Left ventricular function
  • Radiotracer low-dose

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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