Advertisement

Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies

  • Giulia Montelatici
  • Roberto SciagràEmail author
  • Alessandro Passeri
  • Manjola Dona
  • Alberto Pupi
Original Article

Abstract

Purpose

Conflicting data exist about the difference between 8- and 16-frame gated single-photon emission computed tomography (SPECT) left ventricular volumes and ejection fraction (EF); moreover, the influence of framing on detection of stress-induced functional changes is unknown.

Methods

In 133 patients, two separate gated SPECT studies, one with 8 and one with 16 frames, were simultaneously acquired during a single gantry orbit using dedicated software. In 33 of 133 patients, two additional studies (with 8 and 16 frames, respectively) were acquired using arrhythmia rejection. Left ventricular EF and volumes were calculated using the QGS software. Stress-induced ischemia was identified on summed perfusion images.

Results

Arrhythmia-rejection did not influence volumes and EF independently of framing rate. Using data without arrhythmia-rejection, there was a significant difference in volumes and EF between 8 and 16 frames both in resting and post-stress gated SPECT. However, the difference was small: 2.6% for resting and 2.8% for post-stress EF. Both using 8 and 16 frames, there were significantly larger volumes and lower EF in patients with than without stress-induced ischemia. A stress-induced decrease >5 EF units was observed in 26 of 133 patients using 8 and in 23 of 133 using 16 frames, respectively, with finding agreement in 19 patients.

Conclusions

Comparing two simultaneously acquired studies, the use of 16 instead of 8 frames has minor and predictable influence on functional data. Furthermore, there are no differences in the detection of stress-induced functional changes. The advantage of 16 over 8 frames in the daily clinical practice appears questionable.

Keywords

Gated SPECT Left ventricular ejection fraction Left ventricular volumes Stress myocardial perfusion imaging 

Notes

Conflict of interest statement

None declared.

References

  1. 1.
    Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005;32:855–97.PubMedCrossRefGoogle Scholar
  2. 2.
    DePuey EG, Nichols K, Dobrinsky C. Left ventricular ejection fraction assessed from gated technetium-99 m-sestamibi SPECT. J Nucl Med 1993;34:1871–6.PubMedGoogle Scholar
  3. 3.
    Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138–47.PubMedGoogle Scholar
  4. 4.
    Stollfuss JC, Haas F, Matsunari I, Neverve J, Nekolla S, Schneider-Eicke J, et al. Regional myocardial wall thickening and global ejection fraction in patients with low angiographic left ventricular ejection fraction assessed by visual and quantitative resting ECG-gated 99 m Tetrofosmin single-photon emission tomography and magnetic resonance imaging. Eur J Nucl Med 1998;25:522–30.PubMedCrossRefGoogle Scholar
  5. 5.
    Nichols K, Amis J, dePuey G, Mieres J, Malhotra S, Rozanski A. Relationship of gated SPECT ventricular function parameters to angiographic measurements. J Nucl Cardiol 1998;5:295–303.PubMedCrossRefGoogle Scholar
  6. 6.
    Manrique A, Faraggi M, Vera P, Vilain D, Lebtahi R, Cribier A, et al. 201-Tl and 99 m-Tc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography. J Nucl Med 1999;40:805–9.PubMedGoogle Scholar
  7. 7.
    Vaduganathan P, He ZX, Vick W, Mahmarian JJ, Verani MS. Evaluation of left ventricular wall motion, volumes and ejection fraction by gated myocardial tomography with technetium 99 m-labeled tetrofosmin: a comparison with cine magnetic resonance imaging. J Nucl Cardiol 1999;6:3–10.PubMedCrossRefGoogle Scholar
  8. 8.
    Akincioglu C, Berman DS, Nishina H, Kavanagh PB, Slomka PJ, Abidov A, et al. Assessment of diastolic function using 16-frame 99mTc-sestamibi gated myocardial perfusion SPECT: normal values. J Nucl Med 2005;46:1102–8.PubMedGoogle Scholar
  9. 9.
    Visser JJ, Busemann Sokole E, Verberne HJ, Habraken JB, van de Stadt HJ, Jaspers JE, et al. A realistic 3-D gated cardiac phantom for quality control of gated myocardial perfusion SPET: the Amsterdam gated (AGATE) cardiac phantom. Eur J Nucl Med Mol Imaging 2004;31:222–8.PubMedGoogle Scholar
  10. 10.
    Kumita S, Cho K, Nakajo H, Toba M, Uwamori M, Mizumura S, et al. Assessment of left ventricular diastolic function with electrocardiography-gated myocardial perfusion SPECT: comparison with multigated equilibrium radionuclide angiography. J Nucl Cardiol 2001;8:568–74.PubMedCrossRefGoogle Scholar
  11. 11.
    Navare SM, Wackers FJ, Liu YH. Comparison of 16-frame and 8-frame gated SPET imaging for determination of left ventricular volumes and ejection fraction. Eur J Nucl Med Mol Imaging 2003;30:1330–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Schaefer WM, Kaiser HJ, Kuehl H, Koch KC, Nowak B, Buell U. Quantification of left ventricular volumes and ejection fraction from 16- and rebinned 8-frame gated (99 m)Tc-tetrofosmin SPECT — Comparison of 4D-MSPECT and QGS. Nuklearmedizin 2007;46:22–8.PubMedGoogle Scholar
  13. 13.
    ASNC Executive Council. American Society of Nuclear Cardiology position statement on electrocardiographic gating of myocardial perfusion SPECT scintigrams. J Nucl Cardiol 1999;6:470–1.CrossRefGoogle Scholar
  14. 14.
    Sharir T, Germano G, Waechter PB, Kavanagh PB, Areeda JS, Gerlach J, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. II: validation and diagnostic yield. J Nucl Med 2000;41:720–7.PubMedGoogle Scholar
  15. 15.
    Ramakrishna G, Miller TD, Hodge DO, O’Connor MK, Gibbons RJ. Differences in left ventricular ejection fraction and volumes measured at rest and poststress by gated sestamibi SPECT. J Nucl Cardiol 2006;13:668–74.PubMedCrossRefGoogle Scholar
  16. 16.
    Hida S, Chikamori T, Tanaka H, Usui Y, Igarashi Y, Nagao T, et al. Diagnostic value of left ventricular function after stress and at rest in the detection of multivessel coronary artery disease as assessed by electrocardiogram-gated SPECT. J Nucl Cardiol 2007;14:68–74.PubMedCrossRefGoogle Scholar
  17. 17.
    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–10.PubMedGoogle Scholar
  18. 18.
    Johnson LL, Verdesca SA, Aude WY, Xavier RC, Nott LT, Campanella MW, et al. Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms. J Am Coll Cardiol 1997;30:1641–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Sharir T, Bacher-Stier C, Dhar S, Lewin HC, Miranda R, Friedman JD, et al. Identification of severe and extensive coronary artery disease by postexercise regional wall motion abnormalities in Tc-99 m sestamibi gated single-photon emission computed tomography. Am J Cardiol 2000;86:1171–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Toba M, Kumita S, Cho K, Ibuki C, Kumazaki T, Takano T. Usefulness of gated myocardial perfusion SPECT imaging soon after exercise to identify postexercise stunning in patients with single-vessel coronary artery disease. J Nucl Cardiol 2004;11:697–703.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Giulia Montelatici
    • 1
  • Roberto Sciagrà
    • 1
    Email author
  • Alessandro Passeri
    • 1
  • Manjola Dona
    • 1
  • Alberto Pupi
    • 1
  1. 1.Nuclear Medicine Unit, Department of Clinical PhysiopathologyUniversity of FlorenceFlorenceItaly

Personalised recommendations