Skip to main content
SpringerLink
Log in

Effect of left ventricular function on diagnostic accuracy of FDG SPECT

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objectives

Fluorine-18 fluorodeoxyglucose (FDG) SPECT has emerged as an alternative to dedicated PET imaging. However, it remains uncertain whether FDG SPECT is an as accurate for viability assessment as FDG PET in patients with severely reduced left ventricular function. The aim of the study was to assess the diagnostic accuracy of FDG SPECT in a head-to-head comparison with FDG PET, and divide the patients according to the severity of left ventricular dysfunction.

Methods

A total of 47 patients, with a history of myocardial infarction underwent FDG/perfusion (99mTc-sestamibi or201T1) SPECT as well as FDG/13N-ammonia PET. The patients were divided into 2 subgroups based on the left ventricular ejection fraction (LVEF) (35% cutoff). The left ventricular myocardium was divided into 13 segments, and each segment was classified as viable or scar using a semi-quantitative scoring system based on defect severity and the presence or absence of perfusion-FDG mismatch.

Results

Of the 47 patients studied, 23 had LVEF < 35% (low LVEF group; mean 25 ± 7%), whereas the remaining 24 had LVEF > 35% (high LVEF group; mean 47 ± 6%). In the low LVEF group, 213 segments (71%) were dysfunctional, as compared to 102 (33%) in the high LVEF group. The agreement for detection of viability between PET and SPECT in the low LVEF group was 82% (kappa 0.63), which was not different from the agreement in the high LVEF group (85%, kappa 0.66, p = 0.42 versus low LVEF group).

Conclusions

The results indicate that FDG SPECT can be used for tissue viability assessment regardless of the severity of left ventricular dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tillisch J, Brunken R, Marshall R, Schwaiger M, Mandelkern M, Phelps M, et al. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography.N Engl J Med 1986; 314: 884–888.

    PubMed  CAS  Google Scholar 

  2. vom-Dahl J, Eitzman DT, Al-Aouar ZR, Kanter HL, Hicks RJ, Deeb GM, et al. Relation of regional function, perfusion, and metabolism in patients with advanced coronary artery disease undergoing surgical revascularization.Circulation 1994; 90: 2356–2366.

    PubMed  CAS  Google Scholar 

  3. Tamaki N, Kawamoto M, Tadamura E, Magata Y, Yonekura Y, Nohara R, et al. Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography.Circulation 1995; 91:1697–1705.

    PubMed  CAS  Google Scholar 

  4. Bax JJ, Visser FC, van Lingen A, Huitink JM, Kamp O, van Leeuwen GR, et al. Feasibility of assessing regional myo-cardial uptake of18F-fluorodeoxyglucose using single photon emission computed tomography.Eur Heart J 1993; 14:1675–1682.

    PubMed  CAS  Google Scholar 

  5. Bax JJ, Visser FC, Blanksma PK, Veening MA, Tan ES, Willemsen TM, et al. Comparison of myocardial uptake of fluorine-18-fluorodeoxyglucose imaged with PET and SPECT in dyssynergic myocardium.J Nucl Med 1996; 37:1631–1636.

    PubMed  CAS  Google Scholar 

  6. Bax JJ, Cornel JH, Visser FC, Fioretti PM, van Lingen A, Huitink JM, et al. Prediction of improvement of contractile function in patients with ischemic ventricular dysfunction after revascularization by fluorine-18 fluorodeoxyglucose single-photon emission computed tomography.J Am Coll Cardiol 1997; 30: 377–383.

    Article  PubMed  CAS  Google Scholar 

  7. Haas F, Haehnel CJ, Picker W, Nekolla S, Martinoff S, Meisner H, et al. Preoperative positron emission tomo-graphic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease.J Am Coll Cardiol 1997; 30: 1693–1700.

    Article  PubMed  CAS  Google Scholar 

  8. Matsunari I, Kanayama S, Yoneyama T, Matsudaira M, Nakajima K, Taki J, et al. Electrocardiographic-gated dual-isotope simultaneous acquisition SPET using18F-FDG and99mTc-sestamibi to assess myocardial viability and function in a single study.Eur J Nucl Med Mol Imaging 2005; 32:195–202.

    Article  PubMed  Google Scholar 

  9. Matsunari I, Kanayama S, Yoneyama T, Matsudaira M, Nakajima K, Taki J, et al. Myocardial distribution of (18)F-FDG and (99m)Tc-sestamibi on dual-isotope simultaneous acquisition SPET compared with PET.Eur J Nucl Med Mol Imaging 2002; 29: 1357–1364.

    Article  PubMed  CAS  Google Scholar 

  10. Burt RW, Perkins OW, Oppenheim BE, Schauwecker DS, Stein L, Wellman HN, et al. Direct comparison of fluorine-18-FDG SPECT, fluorine-18-FDG PET and rest thallium-201 SPECT for detection of myocardial viability.J Nucl Med 1995; 36: 176–179.

    PubMed  CAS  Google Scholar 

  11. Chen EQ, Maclntyre WJ, Go RT, Brunken RC, Saha GB, Wong CY, et al. Myocardial viability studies using fluorine-18-FDG SPECT: a comparison with fluorine-18-FDG PET.J Nucl Med 1997; 38: 582–586.

    PubMed  CAS  Google Scholar 

  12. Srinivasan G, Kitsiou AN, Bacharach SL, Bartlett ML, Miller-Davis C, Dilsizian V. [18F]fluorodeoxyglucose single photon emission computed tomography: can it replace PET and thallium SPECT for the assessment of myocardial viability?Circulation 1998; 97: 843–850.

    PubMed  CAS  Google Scholar 

  13. Fukuchi K, Katafuchi T, Fukushima K, Shimotsu Y, Toba M, Hayashida K, et al. Estimation of myocardial perfusion and viability using simultaneous99mTc-tetrofosmin—FDG collimated SPECT.J Nucl Med 2000; 41: 1318–1323.

    PubMed  CAS  Google Scholar 

  14. Slart RH, Bax JJ, de Boer J, Willemsen AT, Mook PH, Oudkerk M, et al. Comparison of (99m)Tc-sestamibi/ (18)FDG DISA SPECT with PET for the detection of viability in patients with coronary artery disease and left ventricular dysfunction.Eur J Nucl Med Mol Imaging 2005;32: 972–979.

    Article  PubMed  Google Scholar 

  15. Knuuti MJ, Nuutila P, Ruotsalainen U, Saraste M, Harkonen R, Ahonen A, et al. Euglycemic hyperinsulinemic clamp and oral glucose load in stimulating myocardial glucose utilization during positron emission tomography.J Nucl Med 1992; 33: 1255–1262.

    PubMed  CAS  Google Scholar 

  16. Delbeke D, Videlefsky S, Patton JA, Campbell MG, Martin WH, Ohana I, Sandler MP. Rest myocardial perfusion/ metabolism imaging using simultaneous dual-isotope acquisition SPECT with technetium-99m-MIBI/fluorine-18-FDG.J Nucl Med 1995; 36: 2110–2119.

    PubMed  CAS  Google Scholar 

  17. Chua T, Kiat H, Germano G, Maurer G, van Train K, Friedman J, Berman D. Gated technetium-99m sestamibi for simultaneous assessment of stress myocardial perfusion, postexercise regional ventricular function and myocardial viability. Correlation with echocardiography and rest thallium-201 scintigraphy.J Am Coll Cardiol 1994; 23:1107–1114.

    Article  PubMed  CAS  Google Scholar 

  18. Cwajg E, Cwajg J, Keng F, He ZX, Nagueh S, Verani MS. Comparison of global and regional left ventricular function assessed by gated-SPECT and 2-D echocardiography.Rev Port Cardiol 2000; 19Suppl 1:139–146.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Medical and Pharmacological Research Center Foundation, Wo 32, Inoyama-town, 92-0613, Hakui-city, Ishikawa, Japan

    Ichiro Matsunari & Kinichi Hisada

  2. Department of Cardiology, Leiden University Medical Center, The Netherlands

    Jeroen J. Bax

  3. University Hospital, Groningen, The Netherlands

    Paul K. Blanksma

  4. Free University, Amsterdam, The Netherlands

    Frans C. Visser

  5. Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan

    Sugako Kanayama

  6. Department of Biotracer Medicine, Kanazawa University School of Medicine, Kanazawa, Japan

    Tatsuya Yoneyama & Norihisa Tonami

  7. Nuklearmedizinische Klinik und Poliklinik Technische Universität München, Munich, Germany

    Stephan G. Nekolla

Authors
  1. Ichiro Matsunari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeroen J. Bax
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul K. Blanksma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Frans C. Visser
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sugako Kanayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tatsuya Yoneyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephan G. Nekolla
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Norihisa Tonami
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kinichi Hisada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ichiro Matsunari.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsunari, I., Bax, J.J., Blanksma, P.K. et al. Effect of left ventricular function on diagnostic accuracy of FDG SPECT. Ann Nucl Med 20, 51–56 (2006). https://doi.org/10.1007/BF02985591

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02985591

Key words

Search

Navigation