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Yao Y, Wang DW, Fang W, Tian YQ, Shen R, Sun XX, Guo F, Chu KW, Cui C, Zhao SH, He ZX. Evaluation of left ventricular volumes and ejection fraction by 99mTc-MIBI gated SPECT and 18F-FDG gated PET in patients with prior myocardial infarction. J Nucl Cardiol 2021; 28:560-574. [PMID: 30993654 DOI: 10.1007/s12350-019-01709-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/29/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND This study aimed to compare the accuracy of gated-SPECT (GSPECT) and gated-PET (GPET) in the assessment of left ventricular (LV) end-diastolic volumes (EDVs), end-systolic volumes (ESVs) and LV ejection fractions (LVEFs) among patients with prior myocardial infarction (MI). METHODS One hundred and sixty-eight consecutive patients with MI who underwent GSPECT and GPET were included. Of them, 76 patients underwent CMR in addition to the two imaging modalities. The measurements of LV volumes and LVEF were performed using Quantitative Gated SPECT (QGS), Emory Cardiac Toolbox (ECTB), and 4D-MSPECT (4DM). RESULTS The correlation between GPET, GSPECT, and CMR were excellent for LV EDV (r = 0.855 to 0.914), ESV (r = 0.852 to 0.949), and LVEF (r = 0.618 to 0.820), as calculated from QGS, ECTB, and 4DM. In addition, subgroup analysis revealed that EDV, ESV, and LVEF measured by GPET were accurate in patients with different extents of total perfusion defect (TPD), viable myocardium, and perfusion/metabolic mismatch. Furthermore, multivariate regression analysis identified that mismatch score was associated with the difference in EDV (P < 0.05) measurements between GPET and CMR. CONCLUSIONS In patients with MI, LV volumes and LVEF scores measured by both GSPECT and GPET imaging were comparable to those determined by CMR, but should not be interchangeable in individual patients.
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Affiliation(s)
- Yong Yao
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Da-Wei Wang
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Wei Fang
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Yue-Qin Tian
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Rui Shen
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Xiao-Xin Sun
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Feng Guo
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Ke-Wei Chu
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China
| | - Chen Cui
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shi-Hua Zhao
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Zuo-Xiang He
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China.
- Department of Nuclear Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, People's Republic of China.
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Gimelli A, Liga R, Magro S, Novo S, Pedrinelli R, Petronio AS, Marzullo P, Pepe A. Evaluation of left ventricular mass on cadmium-zinc-telluride imaging: Validation against cardiac magnetic resonance. J Nucl Cardiol 2019; 26:899-905. [PMID: 29043554 DOI: 10.1007/s12350-017-1086-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/26/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Single-photon emission computed tomography has shown relevant limitations in the quantification of left ventricular (LV) mass. We sought to compare the estimates of LV mass on Cadmium-Zinc-Telluride (CZT) myocardial perfusion imaging (MPI) as compared to cardiac magnetic resonance (CMR). METHODS AND RESULTS Twenty-five patients underwent MPI on a CZT camera and CMR on a 1.5 T scanner within 12 ± 3 weeks. LV mass was quantified on CZT images using two softwares: 4D-MSPECT (4DM) and Emory Cardiac Toolbox (ECTb). LV mass by CMR was quantified using MASS software (Medis, Leiden, The Netherlands). LV mass values obtained with 4DM and ECTb were highly reproducible [intraclass correlation coefficients .98 (95% CI .97-.99), and .98 (95% CI 0.97-.99), respectively]. The mean LVM mass values were 151 ± 44 g on CMR, 151 ± 43 g with 4DM (P = NS vs CMR), and 157 ± 42 g with ECTb (P < .001 vs CMR; P = .007 vs 4DM) CZT images. There was an excellent correlation between LV mass values between CMR and both 4DM (R2 = .95; P < .001) and ECTb (R2 = .98; P < .001) with narrow limits of agreement (- 13.6% to + 13.4% for 4DM, and - 5.6% to + 14.1% for ECTb). CONCLUSIONS The evaluation of LV mass is feasible on CZT images, showing excellent agreement with CMR.
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Affiliation(s)
- Alessia Gimelli
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
| | - Riccardo Liga
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy.
| | - Serena Magro
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
- Department of Cardiology, University of Palermo, Palermo, Italy
| | - Salvatore Novo
- Department of Cardiology, University of Palermo, Palermo, Italy
| | - Roberto Pedrinelli
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Anna Sonia Petronio
- Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy
| | - Paolo Marzullo
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Alessia Pepe
- Fondazione Toscana/CNR G. Monasterio, Via Moruzzi, 1, 56124, Pisa, Italy
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Habeeb NM, Youssef OI, Elguindy WM, Ibrahim AS, Hussein WH. Three Dimensional (3D) Echocardiography as a Tool of Left Ventricular Assessment in Children with Dilated Cardiomyopathy: Comparison to Cardiac MRI. Open Access Maced J Med Sci 2018; 6:2310-2315. [PMID: 30607182 PMCID: PMC6311485 DOI: 10.3889/oamjms.2018.270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/02/2018] [Accepted: 10/15/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND: Left ventricular (LV) volumes and ejection fraction (EF) is Strong prognostic indicators for DCM. Cardiac MRI (CMRI) is a preferred technique for LV volumes and EF assessment due to high spatial resolution and complete volumetric datasets. Three-dimensional echocardiography is a promising new technique under investigations. AIM: Evaluate 3D echocardiography as a tool in LV assessment in DCM children about CMRI. PATIENTS AND METHODS: A group of 20 DCM children (LVdiastolic diameter < 2 Z score, LVEF < 35%) at Children s Hospital, Ain-Shams University (gp1) (mean age 6.6 years) were compared to 20 age and sex-matched children as controls (gp2). Patients were subjected to: clinical examination, conventional echocardiography, automated 3D LV quantification, 3D speckle tracking echocardiography (3D-STE) (VIVID E9 Vingmed, Norway) and CMRI (Philips Achieva Nova, 1.5 Tesla scanner) for LV end systolic volume (LVESV), LVend diastolic volume (LVEDV) that were indexed to body surface area, EF% and wall motion abnormalities assessment. RESUTS: No statistically significant difference was found between automated 3D LV quantification echocardiography, 3D-STE, and CMRI in ESV/BSA and EDV/BSA assessment (p = 1, 0.99 respectively), between automated LV quantification echocardiography and CMRI in EF% assessment (p = 0.99) and between CMRI and 3D-STE in LV Global hypokinesia detection (P = 0.255). As for segmental hypokinesia CMRI was more sensitive [45% of patients vs. 40%, (P = 0,036), basal septal hypokinesia 85% vs. 75%, (p = 0.045), mid septal hypokinesia 80% vs. 65%, (p = 0.012) and lateral wall hypokinesia 75% vs. 65%, (p = 0.028)]. CONCLUSION: Automated 3D LV quantification echocardiography and 3D-STE are reliable tools in LV volumetric and systolic function assessment about CMRIas a standard method. 3D speckle echocardiography is comparable to CMRI in global wall hypokinesia detection but less sensitive in segmental wall hypokinesia which mandates further studies.
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Affiliation(s)
| | | | | | - Ahmed Samir Ibrahim
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Walaa Hamed Hussein
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Kotha VK, Deva DP, Connelly KA, Freeman MR, Yan RT, Mangat I, Kirpalani A, Barfett JJ, Sloninko J, Lin HM, Graham JJ, Crean AM, Jimenez-Juan L, Dorian P, Yan AT. Cardiac MRI and radionuclide ventriculography for measurement of left ventricular ejection fraction in ICD candidates. Magn Reson Imaging 2018; 52:69-74. [PMID: 29859946 DOI: 10.1016/j.mri.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/26/2018] [Accepted: 05/27/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Current guidelines provide left ventricular ejection fraction (LVEF) criterion for use of implantable cardioverter defibrillators (ICD) but do not specify which modality to use for measurement. We compared LVEF measurements by radionuclide ventriculography (RNV) vs cardiac MRI (CMR) in ICD candidates to assess impact on clinical decision making. METHODS This single-centre study included 124 consecutive patients referred for assessment of ICD implantation who underwent RNV and CMR within 30 days for LVEF measurement. RNV and CMR were interpreted independently by experienced readers. RESULTS Among 124 patients (age 64 ± 11 years, 77% male), median interval between CMR and RNV was 1 day; mean LVEF was 32 ± 12% by CMR and 33 ± 11% by RNV (p = 0.60). LVEF by CMR and RNV showed good correlation, but Bland-Altman analysis showed relatively wide limits of agreement (-12.1 to 11.4). CMR LVEF reclassified 26 (21%) patients compared to RNV LVEF (kappa = 0.58). LVEF by both modalities showed good interobserver reproducibility (ICC 0.96 and 0.94, respectively) (limits of agreement -7.27 to 5.75 and -8.63 to 6.34, respectively). CONCLUSION Although LVEF measurements by CMR and RNV show moderate agreement, there is frequent reclassification of patients for ICD placement based on LVEF between these modalities. Future studies should determine if a particular imaging modality for LVEF measurement may enhance ICD decision making and treatment benefit.
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Affiliation(s)
- Vamshi K Kotha
- Department of Radiology, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
| | - Djeven P Deva
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Kim A Connelly
- University of Toronto, Toronto, ON, Canada; Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Michael R Freeman
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | | | - Iqwal Mangat
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Anish Kirpalani
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Joseph J Barfett
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Joanna Sloninko
- Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - Hui Ming Lin
- Department of Medical Imaging, St. Michael's Hospital, Toronto, ON, Canada
| | - John J Graham
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Andrew M Crean
- University of Toronto, Toronto, ON, Canada; Department of Medical Imaging and Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Laura Jimenez-Juan
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Paul Dorian
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Andrew T Yan
- Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
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Chen-Scarabelli C, McRee C, Leesar MA, Hage FG, Scarabelli TM. Comprehensive review on cardio-oncology: Role of multimodality imaging. J Nucl Cardiol 2017; 24:906-935. [PMID: 27225513 DOI: 10.1007/s12350-016-0535-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
Cancer and cardiovascular disease are the two leading causes of mortality worldwide. Evolving oncologic therapy, including the use of newer targeted agents, has led to an improvement in survival from childhood- and adult-onset cancers. Consequently, there has been a growing realization of cardiotoxic complications related to cancer therapy, with some complications manifesting over months to decades after completion of cancer treatment. This paper reviews cancer therapeutics-related cardiovascular toxicity and its manifestations, multimodality imaging techniques for surveillance and detection of this complication, and the current state of knowledge in this emerging field.
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Affiliation(s)
- Carol Chen-Scarabelli
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chad McRee
- Division of Cardiovascular Disease, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, Alabama, 35294-0006, USA
| | - Massoud A Leesar
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Cardiovascular Disease, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, Alabama, 35294-0006, USA
| | - Fadi G Hage
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Division of Cardiovascular Disease, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, Alabama, 35294-0006, USA
| | - Tiziano M Scarabelli
- Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
- Division of Cardiovascular Disease, University of Alabama at Birmingham, 1530 3rd Avenue, South Tinsley Harrison Tower, Birmingham, Alabama, 35294-0006, USA.
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Shojaeifard M, Ghaedian T, Yaghoobi N, Malek H, Firoozabadi H, Bitarafan-Rajabi A, Haghjoo M, Amin A, Azizian N, Rastgou F. Comparison of Gated SPECT Myocardial Perfusion Imaging with Echocardiography for the Measurement of Left Ventricular Volumes and Ejection Fraction in Patients With Severe Heart Failure. Res Cardiovasc Med 2016; 5:e29005. [PMID: 26889455 PMCID: PMC4750009 DOI: 10.5812/cardiovascmed.29005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/15/2015] [Accepted: 05/20/2015] [Indexed: 11/24/2022] Open
Abstract
Background: Gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is known as a feasible tool for the measurement of left ventricular ejection fraction (EF) and volumes, which are of great importance in the management and follow-up of patients with coronary artery diseases. However, considering the technical shortcomings of SPECT in the presence of perfusion defect, the accuracy of this method in heart failure patients is still controversial. Objectives: The aim of the present study was to compare the results from gated SPECT MPI with those from echocardiography in heart failure patients to compare echocardiographically-derived left ventricular dimension and function data to those from gated SPECT MPI in heart failure patients. Patients and Methods: Forty-one patients with severely reduced left ventricular systolic function (EF ≤ 35%) who were referred for gated SPECT MPI were prospectively enrolled. Quantification of EF, end-diastolic volume (EDV), and end-systolic volume (ESV) was performed by using quantitative gated spect (QGS) (QGS, version 0.4, May 2009) and emory cardiac toolbox (ECTb) (ECTb, revision 1.0, copyright 2007) software packages. EF, EDV, and ESV were also measured with two-dimensional echocardiography within 3 days after MPI. Results: A good correlation was found between echocardiographically-derived EF, EDV, and ESV and the values derived using QGS (r = 0.67, r = 0.78, and r = 0.80 for EF, EDV, and ESV, respectively; P < 0.001) and ECTb (r = 0.68, 0.79, and r = 0.80 for EF, EDV, and ESV, respectively; P < 0.001). However, Bland-Altman plots indicated significantly different mean values for EF, 11.4 and 20.9 using QGS and ECTb, respectively, as compared with echocardiography. ECTb-derived EDV was also significantly higher than the EDV measured with echocardiography and QGS. The highest correlation between echocardiography and gated SPECT MPI was found for mean values of ESV different. Conclusions: Gated SPECT MPI has a good correlation with echocardiography for the measurement of left ventricular EF, EDV, and ESV in patients with severe heart failure. However, the absolute values of these functional parameters from echocardiography and gated SPECT MPI measured with different software packages should not be used interchangeably.
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Affiliation(s)
- Maryam Shojaeifard
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Tahereh Ghaedian
- Nuclear Medicine and Molecular Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Nahid Yaghoobi
- Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hadi Malek
- Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hasan Firoozabadi
- Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ahmad Bitarafan-Rajabi
- Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Majid Haghjoo
- Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Ahmad Amin
- Department of Heart Failure and Transplantation, Rajaie Cardiovascular Medical and Research Center Iran University of Medical Sciences, Tehran, IR Iran
| | - Nasrin Azizian
- Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Feridoon Rastgou
- Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Feridoon Rastgou, Department of Nuclear Medicine and Molecular Imaging, Rajaie Cardiovascular Medical and Research Center, Vali-Asr St., Niayesh Blvd, Tehran, IR Iran. Tel: +98-2123922480, Fax: +98-2122042026, E-mail:
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Zhang X, Yang Y, Wei H, Tian Y, Shi H, Wang Y, Li S, He ZX, Li Y, Liu XJ. State and Recent Progress of Nuclear Cardiology in China. CURRENT CARDIOVASCULAR IMAGING REPORTS 2015. [DOI: 10.1007/s12410-015-9332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Evaluation of left ventricular myocardial perfusion and function using gated SPECT in patients with hypertrophic obstruction cardiomyopathy following percutaneous transluminal septal myocardial ablation. Nucl Med Commun 2014; 35:762-6. [PMID: 24681766 DOI: 10.1097/mnm.0000000000000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study was designed to evaluate the left ventricular myocardial perfusion and function in hypertrophic obstruction cardiomyopathy patients following percutaneous transluminal septal myocardial ablation (PTSMA) using rest single-photon emission computed tomography (SPECT) myocardial perfusion imaging. PATIENTS AND METHODS Thirty-five patients (24 men and 11 women, 48±11 years old) with hypertrophic obstruction cardiomyopathy underwent rest-gated Tc-MIBI SPECT imaging 4±10 days before (baseline) and 4.7±1.0 days (short-term) and 15.5±8.2 months (mid-term) after PTSMA. Semiquantitative and QGS quantitative evaluations of perfusion and function were carried out in 17 left ventricular segments. RESULTS Myocardial perfusion of the septum following PTSMA was significantly reduced compared with baseline in all patients (P<0.05), but the myocardial perfusion in the basal septum was significantly higher at mid-term compared with short-term following PTSMA (P<0.05). Left ventricular ejection fraction was significantly decreased following PTSMA (P<0.05). Regional wall motion assessed in the basal anterior, basal septum, and basal inferior areas following PTSMA was significantly reduced compared with baseline (P<0.05), and wall thickening of the interventricular septum was decreased following PTSMA (P<0.05). CONCLUSION Rest-gated SPECT imaging can be used to assess left ventricular myocardial perfusion and function and to investigate the efficacy of PTSMA during follow-up.
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Li Y, Wang L, Zhao SH, He ZX, Wang DY, Guo F, Fang W, Yang MF. Gated F-18 FDG PET for assessment of left ventricular volumes and ejection fraction using QGS and 4D-MSPECT in patients with heart failure: a comparison with cardiac MRI. PLoS One 2014; 9:e80227. [PMID: 24404123 PMCID: PMC3880258 DOI: 10.1371/journal.pone.0080227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 10/01/2013] [Indexed: 12/02/2022] Open
Abstract
Purpose Ventricular function is a powerful predictor of survival in patients with heart failure (HF). However, studies characterizing gated F-18 FDG PET for the assessment of the cardiac function are rare. The aim of this study was to prospectively compare gated F-18 FDG PET and cardiac MRI for the assessment of ventricular volume and ejection fraction (EF) in patients with HF. Methods Eighty-nine patients with diagnosed HF who underwent both gated F-18 FDG PET/CT and cardiac MRI within 3 days were included in the analysis. Left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), and EF were obtained from gated F-18 FDG PET/CT using the Quantitative Gated SPECT (QGS) and 4D-MSPECT software. Results LV EDV and LV ESV measured by QGS were significantly lower than those measured by cardiac MRI (both P<0.0001). In contrast, the corresponding values for LV EDV for 4D-MSPECT were comparable, and LV ESV was underestimated with borderline significance compared with cardiac MRI (P = 0.047). LV EF measured by QGS and cardiac MRI showed no significant differences, whereas the corresponding values for 4D-MSPECT were lower than for cardiac MRI (P<0.0001). The correlations of LV EDV, LV ESV, and LV EF between gated F-18 FDG PET/CT and cardiac MRI were excellent for both QGS (r = 0.92, 0.92, and 0.76, respectively) and 4D-MSPECT (r = 0.93, 0.94, and 0.75, respectively). However, Bland-Altman analysis revealed a significant systemic error, where LV EDV (−27.9±37.0 mL) and ESV (−18.6±33.8 mL) were underestimated by QGS. Conclusion Despite the observation that gated F-18 FDG PET/CT were well correlated with cardiac MRI for assessing LV function, variation was observed between the two imaging modalities, and so these imaging techniques should not be used interchangeably.
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Affiliation(s)
- Yan Li
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Li Wang
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shi-Hua Zhao
- Department of Radiology, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zuo-Xiang He
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dao-Yu Wang
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Guo
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Fang
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (WF); (M-FY)
| | - Min-Fu Yang
- Department of Nuclear Medicine, Chaoyang Hospital, Capital Medical University, Beijing, China
- * E-mail: (WF); (M-FY)
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10
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Comparison of Coronary CT Angiography and Stress/Rest Myocardial Perfusion SPECT Imaging in a Chinese Population. Clin Nucl Med 2013; 38:798-804. [DOI: 10.1097/rlu.0b013e3182a43060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Zhang L, Tian YQ, Zhang XL, Sun XX, Guo F, Wei HX, Xu YY, He ZX. Left ventricular functional changes after adenosine vasodilator stress evaluated by gated single-photon emission computed tomography. Cardiology 2013; 125:104-9. [PMID: 23711817 DOI: 10.1159/000348857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 02/06/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging is useful in assessing left ventricular (LV) myocardial perfusion and function. This study evaluated the LV functional changes after adenosine vasodilator stress, using gated SPECT. METHODS The study population consisted of 70 patients who underwent adenosine-mediated stress and rest SPECT. All patients underwent coronary angiography. Semi-quantitative assessment of perfusion was analyzed and produced the summed rest score (SRS), the summed stress score (SSS) and the summed difference score (SDS). The global LV function parameters [ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV)] and regional LV function [the summed motion score (SMS) and the summed thickening score (STS)] were quantified by gated SPECT. RESULTS Patients were divided into 2 groups: group 1 comprised 16 patients with worsening of LVEF (LVEFrest-LVEFado ≥5%), and group 2 comprised the other 54 patients. Compared with group 2, patients in group 1 had a significantly higher SSS and SDS (9.1 ± 6.8 vs. 5.6 ± 4.5 and 6.6 ± 3.8 vs. 3.6 ± 4.0, respectively; p < 0.05) and the severity of coronary artery stenosis was more serious (p < 0.05). CONCLUSION Worsening of LVEF after adenosine-induced vasodilator stress, as shown by (99m)Tc-MIBI gated SPECT, is a valuable nonperfusion marker of significant CAD.
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Affiliation(s)
- Ling Zhang
- Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, PR China
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Comparison of (99m)Tc-MIBI SPECT/18F-FDG PET imaging and cardiac magnetic resonance imaging in patients with idiopathic dilated cardiomyopathy: assessment of cardiac function and myocardial injury. Clin Nucl Med 2013; 37:1163-9. [PMID: 23154474 DOI: 10.1097/rlu.0b013e3182708794] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the agreement between myocardial F-FDG PET imaging and cardiac magnetic resonance imaging (cMRI) in assessing cardiac function and relationship of cMRI late gadolinium enhancement (cMRI-LGE) and myocardial perfusion/metabolism pattern in patients with idiopathic dilated cardiomyopathy (IDCM). METHODS Forty-two consecutive patients diagnosed with IDCM were enrolled. All patients underwent Tc-MIBI SPECT, gated F-FDG PET imaging, and cMRI within 3-7 days. Cardiac function parameters were calculated using PET and cMRI. The segments analysis was performed using a 17-segment model. Patterns of perfusion/metabolism were classified as normal, mismatch, mild-to-moderate match, and severe match, and cMRI-LGE was classified into 3 categories (non-LGE, mid-wall LGE, and transmural LGE). RESULTS The correlation between gated PET and cMRI was excellent for end-diastolic volume (EDV; r = 0.948, P < 0.001), end-systolic volume (ESV; r = 0.939, P < 0.001), and left ventricular ejection fraction (LVEF; r = 0.685, P < 0.001). EDV and ESV were underestimated, whereas LVEF was slightly overestimated by gated PET in comparison to cMRI. Perfusion/metabolism patterns varied in 3 different categories of non-LGE, mid-wall LGE, and transmural LGE (χ = 14.276, P < 0.001). Also, 71.0% (44/62) segments with mid-wall LGE had normal perfusion/metabolism patterns, and 75.9% (63/83) perfusion/metabolism mismatch segments were shown as non-LGE. The incidence of LGE was significantly higher in segments with severe match than the other 3 segment groups (χ = 112.53, P < 0.001). CONCLUSION There is an excellent agreement between gated PET and cMRI in assessment of cardiac function. LGE-cMRI is much more sensitive in detecting moderate fibrosis, while PET could detect more impaired but viable myocardium. Combining the 2 imaging modalities is useful for providing more comprehensive evaluations of myocardial injury in patients with IDCM.
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Morales MA, Prediletto R, Rossi G, Catapano G, Lombardi M, Rovai D. Routine Chest X-ray: Still Valuable for the Assessment of Left Ventricular Size and Function in the Era of Super Machines? J Clin Imaging Sci 2012; 2:25. [PMID: 22754739 PMCID: PMC3385501 DOI: 10.4103/2156-7514.96540] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/07/2012] [Indexed: 01/25/2023] Open
Abstract
Objectives: The development of technologically advanced, expensive techniques has progressively reduced the value of chest X-ray in clinical practice for the assessment of left ventricular (LV) dilatation and dysfunction. Although controversial data are reported on the role of this widely available technique in cardiac assessment, it is known that the cardio-thoracic ratio is predictive of risk of progression in the NYHA Class, hospitalization, and outcome in patients with LV dysfunction. This study aimed to evaluate the reliability of the transverse diameter of heart shadow [TDH] by chest X-ray for detecting LV dilatation and dysfunction as compared to Magnetic Resonance Imaging (MRI) performed for different clinical reasons. Materials and Methods: In 101 patients, TDH was measured in digital chest X-ray and LV volumes and ejection fraction (EF) by MRI, both exams performed within 2 days. Results: A direct correlation between TDH and end-diastolic volumes (r = .75, P<0.0001) was reported. TDH cut-off values of 14.5 mm in females identified LV end-diastolic volumes >150 mL (sensitivity: 82%, specificity: 69%); in males a cut-off value of 15.5 mm identified LV end-diastolic volumes >210 mL (sensitivity: 84%; specificity: 72%). A negative relation was found between TDH and LVEF (r = -.54, P<0.0001). The above cut-off values of TDH discriminated patients with LV systolic dysfunction – LVEF <35% (sensitivity and specificity: 67% and 57% in females; 76% and 59% in males, respectively). Conclusions: Chest X-ray may still be considered a reliable technique in predicting LV dilatation by the accurate measurement of TDH as compared to cardiac MRI. Technologically advanced, expensive, and less available imaging techniques should be performed on the basis of sound clinical requests.
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Xie BQ, Tian YQ, Zhang J, Zhao SH, Yang MF, Guo F, Wang DY, Wei HX, Chu KW, He ZX. Evaluation of left and right ventricular ejection fraction and volumes from gated blood-pool SPECT in patients with dilated cardiomyopathy: comparison with cardiac MRI. J Nucl Med 2012; 53:584-91. [PMID: 22393224 DOI: 10.2967/jnumed.111.096057] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED This prospective study evaluated the accuracy of electrocardiogram-gated blood-pool SPECT (GBPS) for the assessment of left ventricular (LV) and right ventricular (RV) ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) in patients with dilated cardiomyopathy (DCM), using cardiac magnetic resonance (CMR) imaging as the reference standard. METHODS Thirty-two patients (24 men and 8 women; mean age, 51 y) with a diagnosis of idiopathic DCM underwent GBPS and CMR. LV and RV parameters including EDV, ESV, and EF from GBPS were calculated using fully automated gradient software and compared with those obtained by CMR. RESULTS Biventricular volumes were underestimated by GBPS, compared with CMR (P < 0.001). We found no statistical difference between these 2 methods in the assessment of LV EF (P = 0.23), whereas RV EF was overestimated by GBPS (P < 0.001 vs. CMR). Regression analysis yielded significant correlations between GBPS and CMR in the assessments of biventricular parameters (r = 0.83 for LV EDV, 0.88 for LV ESV, 0.89 for LV EF, 0.86 for RV EDV, 0.86 for RV ESV, and 0.62 for RV EF; all P < 0.001). Comparison of the deviations of RV indices between GBPS and CMR with the ratio of RV EDV to LV EDV showed that there was a statistically significant trend for RV volumes to be underestimated and for RV EF to be overestimated as the biventricular volumetric ratio decreased (r = 0.61 for RV EDV, 0.68 for RV ESV, and -0.55 for RV EF; all P < 0.001). CONCLUSION For patients with DCM, GBPS correlated well with CMR for the assessment of biventricular parameters, but RV indices should be cautiously interpreted.
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Affiliation(s)
- Bo-Qia Xie
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Cai M, Wang F, Zhang J, He ZX. Body mass index and rest myocardial perfusion defect predicts cardiac death in patients with chronic heart failure. Int J Cardiovasc Imaging 2012; 28 Suppl 1:77-85. [PMID: 22327940 DOI: 10.1007/s10554-012-0023-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 01/21/2012] [Indexed: 12/20/2022]
Abstract
Gated single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to be invaluable not only in assessing myocardial perfusion, but also in providing functional and volumetric information. The aim of this study was to investigate the value of clinical variables and rest gated SPECT myocardial perfusion imaging for predicting cardiac death in patients with chronic heart failure (CHF). Seventy-three consecutive hospitalized patients with CHF (aged 50.7 ± 16.5 years, 60 men and 13 women; 25 ischemic CHF and 48 non-ischemic CHF) and left ventricular ejection fraction on echocardiography <40%, who underwent rest gated SPECT myocardial perfusion imaging, were followed up for this study. Univariate and multivariate analysis of clinical characteristics and gated SPECT parameters for prediction of cardiac death were performed. During the follow-up period (18.6 ± 8.5 months), 14 (19.2%) cardiac deaths occurred. Multivariate Cox analysis showed that body mass index (BMI, 23.3 ± 4.1 kg/m(2), hazard ratio = 0.85, P = 0.025) and summed rest score (SRS, 11.8 ± 11.5, hazard ratio = 1.05, P = 0.021) were predictive for cardiac death. The optimal threshold of BMI was 25 kg/m(2) and patients with BMI < 25 kg/m(2) had lower survival rate (P = 0.013). The optimal threshold of SRS was set as 11 and patients with SRS > 11 had lower survival rate (P = 0.009). Rest gated SPECT myocardial perfusion imaging provides prognostic information in patients with CHF. BMI and SRS are both predictors of cardiac death in patients with CHF.
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Affiliation(s)
- Min Cai
- Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Lu, Beijing100037, China
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Abstract
The evaluation of left ventricular systolic function is one of the most common reasons for referral for a non-invasive cardiac imaging study. In addition to its diagnostic and prognostic value, an assessment of ejection fraction can also be used to guide medical and device therapy. Thus, obtaining an accurate and reproducible assessment of LVEF is essential for patient management. This review will focus on novel multi-modality techniques used for the quantification of left ventricular systolic function. Emerging echocardiography techniques such as three-dimensional echocardiography and strain imaging and their incremental role over traditional 2D imaging will be discussed. In addition, new developments expanding nuclear imaging techniques' evaluation of left ventricular systolic function will be reviewed. Finally, an overview of advances in imaging techniques such as cardiac magnetic resonance and cardiac computed tomography, which now allow for an accurate and highly reproducible assessment of LVEF, will be presented.
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Affiliation(s)
- Sonal Chandra
- Non-invasive Cardiac Imaging Center, Section of Cardiology, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5084, Chicago, IL 60637, USA
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Sex-specific normal limits of left ventricular ejection fraction and volumes estimated by gated myocardial perfusion imaging in adult patients in Taiwan: a comparison between two quantitative methods. Nucl Med Commun 2011; 32:113-20. [PMID: 21150486 DOI: 10.1097/mnm.0b013e3283422838] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The left ventricular (LV) ejection fraction (EF) and end-diastolic and end-systolic volumes are strong predictors for prognosis of cardiac death. Quantitative-gated myocardial perfusion single-photon emission computed tomography (SPECT) is widely used to measure LV functional parameters. However, systematic differences may exist between referred populations. We sought to derive sex-specific normal values for LV functional parameters obtained using two quantitative methods. METHODS Among 1044 consecutive patients who underwent dipyridamole stress myocardial perfusion-gated 201Tl SPECT in 2008, a total of 140 (56 men) with normal perfusion imaging were selected. None had cardiac diseases or experienced cardiac events during 1-year follow-up. LV EF and end-diastolic and end-systolic volumes were calculated by quantitative-gated SPECT (QGS) and four-dimensional-myocardial single photon emission computed tomography (4D-MSPECT), respectively. RESULTS There was excellent intrareader and interreader reproducibility for both QGS and 4D-MSPECT algorithms. The differences in LV volumes and EF between the software packages were small. High prevalence of small heart was noted in the study population, especially in women (>60%). Volumetric measures were significantly greater (P<0.001) in men than in women, even after adjustment for body surface area. Women had a higher LV EF than men when using QGS methods, but not when using the 4D-MSPECT method. Compared with 4D-MSPECT, sex remained significantly associated with EF determined by QGS methods, independent of age and body weight. CONCLUSION LV functional parameters determined by means of gated 201Tl SPECT need to be corrected for sex and algorithms. Separate reference values of LV EF and volumes need to be applied in both women and men depending on the software package used.
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Comparison of left ventricular functional parameters obtained from three different commercial automated software cardiac quantification program packages and their intraobserver reproducibility. Ann Nucl Med 2010; 25:125-31. [DOI: 10.1007/s12149-010-0435-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 09/27/2010] [Indexed: 10/18/2022]
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Fang W, Zhang J, He ZX. Myocardial ischemia in patients with dilated cardiomyopathy. Nucl Med Commun 2010; 31:981-4. [DOI: 10.1097/mnm.0b013e32833f393f] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Assessment of left ventricular volumes; reliable by gated SPECT? Int J Cardiovasc Imaging 2010; 27:635-8. [PMID: 20924791 PMCID: PMC3101353 DOI: 10.1007/s10554-010-9717-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 09/23/2010] [Indexed: 11/24/2022]
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Sipola P, Peuhkurinen K, Vanninen E. Comparison of gated single-photon emission computed tomography with magnetic resonance imaging for evaluation of left ventricular volumes and ejection fraction in patients with idiopathic dilated cardiomyopathy. Int J Cardiovasc Imaging 2010; 27:629-34. [DOI: 10.1007/s10554-010-9702-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 09/10/2010] [Indexed: 11/25/2022]
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The consequences of a new software package for the quantification of gated-SPECT myocardial perfusion studies. Eur J Nucl Med Mol Imaging 2010; 37:1736-44. [PMID: 20503046 PMCID: PMC2918795 DOI: 10.1007/s00259-010-1465-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 03/29/2010] [Indexed: 11/27/2022]
Abstract
Purpose Semiquantitative analysis of myocardial perfusion scintigraphy (MPS) has reduced inter- and intraobserver variability, and enables researchers to compare parameters in the same patient over time, or between groups of patients. There are several software packages available that are designed to process MPS data and quantify parameters. In this study the performances of two systems, quantitative gated SPECT (QGS) and 4D-MSPECT, in the processing of clinical patient data and phantom data were compared. Methods The clinical MPS data of 148 consecutive patients were analysed using QGS and 4D-MSPECT to determine the end-diastolic volume, end-systolic volume and left ventricular ejection fraction. Patients were divided into groups based on gender, body mass index, heart size, stressor type and defect type. The AGATE dynamic heart phantom was used to provide reference values for the left ventricular ejection fraction. Results Although the correlations were excellent (correlation coefficients 0.886 to 0.980) for all parameters, significant differences (p < 0.001) were found between the systems. Bland-Altman plots indicated that 4D-MSPECT provided overall higher values of all parameters than QGS. These differences between the systems were not significant in patients with a small heart (end-diastolic volume <70 ml). Other clinical factors had no direct influence on the relationship. Additionally, the phantom data indicated good linear responses of both systems. Conclusion The discrepancies between these software packages were clinically relevant, and influenced by heart size. The possibility of such discrepancies should be taken into account when a new quantitative software system is introduced, or when multiple software systems are used in the same institution.
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Shiraki K, Satoh H, Saitoh T, Saotome M, Urushida T, Katoh H, Takehara Y, Sakahara H, Hayashi H. Comparison of global and regional abnormalities in 99mTc-sestamibi and cardiac magnetic resonance imaging in dilated cardiomyopathy. J Card Fail 2010; 16:641-8. [PMID: 20670843 DOI: 10.1016/j.cardfail.2010.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 02/09/2010] [Accepted: 03/04/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The clinical relevance of perfusion defects and increased washout rate (WOR) in (99m)Tc-sestamibi (Tc MIBI) imaging has not been well characterized in dilated cardiomyopathy (DCM). We analyzed abnormalities in Tc MIBI imaging in relation to those in cardiac magnetic resonance (CMR) imaging. METHODS AND RESULTS Nineteen DCM patients underwent both Tc MIBI and CMR imaging. The perfusion defects and global and regional MIBI WORs were evaluated with planar and single photon emission computed tomography (SPECT) images. The left ventricular function and the delayed enhancement (DE) were estimated with the cine- and DE-mode CMR. In the DCM patients, the Tc MIBI SPECT showed perfusion defects in 65 segments of 14 patients. The global and regional Tc MIBI WORs were higher than those in 10 normal volunteers (19.4 +/- 9.1% vs. 11.7 +/- 6.8% in global and 13.8 +/- 8.6% vs. 9.6 +/- 8.2% in regional WORs; mean +/- SD, P < .01). The DE-mode CMR demonstrated DE in 103 segments of 14 patients. The severity of perfusion defects was correlated with the extent of DE (r = 0.71, P < .01). The regional Tc MIBI WOR was highest in the segments with perfusion defects or DE, but the Tc MIBI WOR in segments without them was also higher than that in the normal volunteers. There was a weak but significant negative correlation between the regional Tc MIBI WOR and wall thickening (r = -0.23, P < .01). CONCLUSIONS In DCM, the severity of perfusion defects and the increase in Tc MIBI WOR reflect the spread of myocardial fibrosis and/or scar. The increase in Tc MIBI WOR is potentially associated with regional dysfunction of LV wall.
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Affiliation(s)
- Katsunori Shiraki
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan
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