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Phase analysis by gated F-18 FDG PET/CT for left ventricular dyssynchrony assessment: a comparison with gated Tc-99m sestamibi SPECT

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Abstract

Purpose

To investigate the value of gated F-18 FDG PET/CT on left ventricular (LV) dyssynchrony assessment in comparison with gated Tc-99m sestamibi SPECT in patients with coronary artery disease (CAD).

Methods

The data of 100 consecutive CAD patients who underwent both gated myocardial Tc-99m sestamibi SPECT and F-18 FDG PET/CT imaging were analyzed. Phase standard deviation (SD) and histogram bandwidth (BW) were derived from phase analysis using Cedars software package. The correlation and agreement of SD and BW between Tc-99m sestamibi SPECT and F-18 FDG PET/CT were examined. Myocardial viability and the site of latest activation assessed by the two imaging methods were compared as well.

Results

A moderate correlation for SD (r = 0.58, p < 0.0001) and BW (r = 0.60, p < 0.0001) was found between gated SPECT and gated F-18 FDG PET/CT. Bland–Altman analysis revealed an overestimation of SD and BW (6.4° ± 14.3° and 22.0° ± 46.8°) by gated F-18 FDG PET/CT. Multivariate logistic regression analysis identified that significant LV remodeling on SPECT imaging, LV functional parameters and F-18 FDG uptake ratio of myocardium to blood pool (SUVM/B) were associated with the overestimation. Myocardial SPECT and F-18 FDG PET/CT had a 67.1 % identity in determining the latest activation site and 5.2 % more viable myocardium was detected by F-18 FDG PET/CT than SPECT.

Conclusion

Gated F-18 FDG PET/CT moderately correlated with gated Tc-99m sestamibi SPECT in assessing LV dyssynchrony. Gated F-18 FDG PET/CT phase analysis should be cautiously applied in CAD patients with significant LV remodeling on SPECT imaging, severe LV functional impairment or poor myocardial F-18 FDG uptake.

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Conflict of interest

The authors indicated they have no financial conflicts of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Li Wang, Hong-Xing Wei & Wei Fang

  2. Department of Nuclear Medicine, Beijing Chaoyang Hospital, Capital Medical University, 8th Gongtinanlu Rd, Chaoyang District, Beijing, 100020, China

    Min-Fu Yang

  3. Biometrics Division, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Jin Guo

  4. Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, 213001, China

    Jian-Feng Wang & Yue-Tao Wang

Authors
  1. Li Wang
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  2. Hong-Xing Wei
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  3. Min-Fu Yang
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  4. Jin Guo
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  5. Jian-Feng Wang
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  6. Wei Fang
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  7. Yue-Tao Wang
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Correspondence to Min-Fu Yang or Yue-Tao Wang.

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Wang, L., Wei, HX., Yang, MF. et al. Phase analysis by gated F-18 FDG PET/CT for left ventricular dyssynchrony assessment: a comparison with gated Tc-99m sestamibi SPECT. Ann Nucl Med 27, 325–334 (2013). https://doi.org/10.1007/s12149-013-0691-y

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  • DOI: https://doi.org/10.1007/s12149-013-0691-y

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