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Influences of radionuclides on left ventricular phase analysis of gated myocardial perfusion single-photon emission computed tomography images in ischemic heart disease

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Abstract

Objective

Phase analysis is expected to improve the accuracy of myocardial ischemia diagnosis in conjunction with myocardial perfusion and wall motion imaging and quantification. Although previous studies have reported perfusion image disagreements in relation to radionuclides, a few reports have examined the influences of radionuclides on phase analysis. We evaluated the influences of different radionuclides on stress-induced left ventricular mechanical dyssynchrony by phase analysis using electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT) (MPS) imaging in patients with ischemic heart disease (IHD).

Methods

A total of 202 patients with suspected or known IHD were investigated retrospectively. All the patients underwent coronary arteriography and were subsequently classified into the following groups: 43 patients without any coronary lesion (0VD), 71 patients with single-vessel disease (1VD), 59 patients with two-vessel disease (2VD), and 29 patients with three-vessel disease (3VD). Both stress and rest gated-MPS were performed using 99mTc-methoxyisobutylisonitrile (MIBI)/tetrofosmin (TF) in 118 patients and with 201TlCl in 84 patients. Phase analysis was performed to obtain the peak phase, phase standard deviation (SD), and bandwidth. Finally, we investigated potential differences between the phase analysis indices and the respective radionuclides used.

Results

The peak phase did not exhibit any significant differences in the numbers of affected branches in either 99mTc-MPS or 201Tl-MPS during stress or rest MPS. Furthermore, both the phase SD and bandwidth demonstrated a tendency to increase in patients with increased numbers of affected branches. A significant difference was observed in the stress MPS when 99mTc-MIBI/TF was used (p < 0.05), but no significant difference was observed in the stress MPS when 201TlCl was used. Both the phase SD and bandwidth of all patients in 99mTc-MPS during stress were significantly larger than those at rest (p < 0.05). Conversely, both the phase SD and bandwidth of all patients in 201Tl-MPS at stress was significantly smaller than that at rest (p < 0.05).

Conclusion

Phase analysis using 99mTc-MPS was considered to be useful for the detection of stress-induced left ventricular mechanical dyssynchrony, although it is necessary to be careful when using 201Tl-MPS.

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References

  1. Rigo P, Bailey IK, Griffith LSC, Pitt B, Burow RD, Wagner HN, et al. Value and limitations of segmental analysis of stress thallium myocardial imaging for localization of coronary artery disease. Circulation. 1980;61:973–81.

    Article  CAS  Google Scholar 

  2. Rehn T, Griffith LSC, Achuff SC, Bailey IK, Bulkley BH, Burow R, et al. Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific. Am J Cardiol. 1981;48:217–23.

    Article  CAS  Google Scholar 

  3. Dash H, Massie BM, Botvinick EH, Brundage BH. The noninvasive identification of left main and three-vessel coronary artery disease by myocardial stress perfusion scintigraphy and treadmill exercise electrocardiography. Circulation. 1979;60:276–84.

    Article  CAS  Google Scholar 

  4. 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.

    CAS  PubMed  Google Scholar 

  5. Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, et al. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol. 2005;12:687–95.

    Article  Google Scholar 

  6. Leitha T, Gwechenberger M, Pruckmayer M, Staudenherz A, Bailer H, Kronik G. Does motion analysis in postexercise gated sestamibi SPECT reflect rest left ventricular motion even in severe coronary artery disease? Clin Nucl Med. 2001;26:694–700.

    Article  CAS  Google Scholar 

  7. Borges-Neto S, Javaid A, Shaw LK, Kong DF, Hanson MW, Pagnanelli RA, et al. Poststress measurements of left ventricular function with gated perfusion SPECT: comparison with resting measurements by using a same-day perfusion-function protocol. Radiology. 2000;215:529–33.

    Article  CAS  Google Scholar 

  8. Henneman MM, Chen J, Dibbets-Schneider P, Stokkel MP, Bleeker GB, Ypenburg C, et al. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med. 2007;48:1104–11.

    Article  Google Scholar 

  9. Hida S, Chikamori T, Tanaka H, Igarashi Y, Shiba C, Usui Y, et al. Diagnostic value of left ventricular dyssynchrony after exercise and at rest in the detection of multivessel coronary artery disease on single-photon emission computed tomography. Circ J. 2012;76:1942–52.

    Article  Google Scholar 

  10. Miller TD, Christian TF, Hopfenspriger MR, Hodge DO, Hauser MF, Gibbons RJ. Prognosis in patients with spontaneous chest pain, a nondiagnostic electrocardiogram, normal cardiac enzymes, and no evidence of severe resting ischemia by quantitative technetium 99 m sestamibi tomographic imaging. J Nucl Cardiol. 1998;5:64–72.

    Article  CAS  Google Scholar 

  11. Emre A, Ersek B, Gürsürer M, Aksoy M, Siber T, Engin O, et al. Angiographic and scintigraphic (perfusion and electrocardiogram-gated SPECT) correlates of clinical presentation in unstable angina. Clin Cardiol. 2000;23:495–500.

    Article  CAS  Google Scholar 

  12. Kontos MC, Jesse RL, Anderson FP, Schmidt KL, Ornato JP, Tatum JL. Comparison of myocardial perfusion imaging and cardiac troponin I in patients admitted to the emergency department with chest pain. Circulation. 1999;99:2073–8.

    Article  CAS  Google Scholar 

  13. Cwajg E, Cwajg J, He ZX, Hwang WS, Keng F, Nagueh SF, et al. Gated myocardial perfusion tomography for the assessment of left ventricular function and volumes: comparison with echocardiography. J Nucl Med. 1999;40:1857–65.

    CAS  PubMed  Google Scholar 

  14. Véra P, Koning R, Cribier A, Manrique A. Comparison of two three-dimensional gated SPECT methods with thallium in patients with large myocardial infarction. J Nucl Cardiol. 2000;7:312–9.

    Article  Google Scholar 

  15. Maunoury C. Quantification of left ventricular function with thallium-201 myocardial gated SPECT. J Nucl Med. 1998;39:927–8.

    CAS  PubMed  Google Scholar 

  16. He ZX, Cwajg E, Preslar JS, Mahmarian JJ, Verani MS. Accuracy of left ventricular ejection fraction determined by gated myocardial perfusion SPECT with Tl-201 and Tc-99m sestamibi: comparison with first-pass radionuclide angiography. J Nucl Cardiol. 1999;6:412–7.

    Article  CAS  Google Scholar 

  17. Manrique A, Faraggi M, Véra P, Vilain D, Lebtahi R, Cribier A, et al. 201T1 and 99mTc-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.

    CAS  PubMed  Google Scholar 

  18. Tadamura E, Kudoh T, Motooka M, Inubushi M, Shirakawa S, Hattori N, et al. Assessment of regional and global left ventricular function by reinjection Tl-201 and rest Tc-99m Sestamibi ECG-gated SPECT. Comparison with three-dimensional magnetic resonance imaging. J Am Coll Cardiol. 1999;33:991–7.

    Article  CAS  Google Scholar 

  19. Nakae I, Hayashi H, Matsumoto T, Mitsunami K, Horie M. Clinical usefulness of a novel program “Heart Function View” for evaluating cardiac function from gated myocardial perfusion SPECT. Ann Nucl Med. 2014;28:812–23.

    Article  CAS  Google Scholar 

  20. Okuda K, Nakajima K, Matsuo S, Kashiwaya S, Yoneyama H, Shibutani T, et al. Comparison of diagnostic performance of four software packages for phase dyssynchrony analysis in gated myocardial perfusion SPECT. EJNMMI Res. 2017;7:1–9.

    Article  CAS  Google Scholar 

  21. Tanaka H, Chikamori T, Hida S, Igarashi Y, Shiba C, Usui Y, et al. Diagnostic value of vasodilator-induced left ventricular dyssynchrony as assessed by phase analysis to detect multivessel coronary artery disease. Ann Nucl Cardiol. 2015;1:6–17.

    Article  Google Scholar 

  22. Chen C, Shen T, Chang M, Hung G, Chen W, Kao C, et al. Stress-induced myocardial ischemia is associated with early post-stress left ventricular mechanical dyssynchrony as assessed by phase analysis of 201 Tl gated SPECT myocardial perfusion imaging. Eur J Nucl Med Mol Imaging. 2012;39:1904–9.

    Article  Google Scholar 

  23. Lee DS, Ahn JY, Kim SK, Oh BH, Seo JD, Chung JK, et al. Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography. Eur J Nucl Med. 2000;27:185–91.

    Article  CAS  Google Scholar 

  24. Hyun IY, Kwan J, Park KS, Lee WH. Reproducibility of TI-201 and Tc-99m sestamibi gated myocardial perfusion SPECT measurement of myocardial function. J Nucl Cardiol. 2001;8:182–7.

    Article  CAS  Google Scholar 

  25. Germano G, Erel J, Kiat H, Kavanagh PBBD. Quantitative LVEF and qualitative régional function from gated thallium-201 perfusion SPECT. J Nucl Med. 1997;38:749–54.

    CAS  PubMed  Google Scholar 

  26. Aljaroudi W, Koneru J, Heo J, Iskandrian AE. Impact of ischemia on left ventricular dyssynchrony by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging. J Nucl Cardiol. 2011;18:36–42.

    Article  Google Scholar 

  27. Mukherjee A, Singh H, Patel C, Sharma G, Roy A, Naik N. Normal values of cardiac mechanical synchrony parameters using gated myocardial perfusion single-photon emission computed tomography: impact of population and study protocol. Indian J Nucl Med. 2016;31:255–9.

    Article  Google Scholar 

  28. Kortelainen MJ, Koivumäki TM, Vauhkonen MJ, Hakulinen MA. Dependence of left ventricular functional parameters on image acquisition time in cardiac-gated myocardial perfusion SPECT. J Nucl Cardiol. 2015;22:643–51.

    Article  Google Scholar 

  29. Kita A, Onoguchi M, Shibutani T, Sugimoto K, Kosaka N, Adachi T, et al. Influence of myocardial count on phase dyssynchrony analysis of gated myocardial perfusion single-photon emission computed tomography. Nucl Med Commun. 2019;40:124–30.

    Article  Google Scholar 

  30. Chen CC, Huang WS, Hung GU, Chen WC, Kao CH, Chen J. Left-ventricular dyssynchrony evaluated by Tl-201 gated SPECT myocardial perfusion imaging: a comparison with Tc-99m sestamibi. Nucl Med Commun. 2013;34:229–32.

    Article  Google Scholar 

  31. AlJaroudi W, Jaber WA, Cerqueira MD. Effect of tracer dose on left ventricular mechanical dyssynchrony indices by phase analysis of gated single photon emission computed tomography myocardial perfusion imaging. J Nucl Cardiol. 2012;19:63–72.

    Article  Google Scholar 

  32. Nakajima K, Okuda K, Matsuo S, Kiso K, Kinuya S, Garcia EV. Comparison of phase dyssynchrony analysis using gated myocardial perfusion imaging with four software programs: based on the Japanese Society of Nuclear Medicine working group normal database. J Nucl Cardiol. 2017;24:611–21.

    Article  Google Scholar 

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Acknowledgements

The authors thank the staff of division of cardiovascular medicine, department of radiological technology, Fukuokaken Saiseikai Futsukaichi Hospital for valuable support. MS received scholarship donation from Nihon Medi-Physiscs Co. Ltd. All other authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiological Technology, Fukuokaken Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, Fukuoka, 818-8516, Japan

    Tomohisa Fukunaga & Kenichi Sanui

  2. Division of Cardiovascular Medicine, Fukuokaken Saiseikai Futsukaichi Hospital, 3-13-1 Yumachi, Chikushino-shi, Fukuoka, 818-8516, Japan

    Toshiaki Kadokami

  3. Department of Health Science, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masayuki Sasaki

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  1. Tomohisa Fukunaga
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  4. Masayuki Sasaki
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Correspondence to Masayuki Sasaki.

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Fukunaga, T., Sanui, K., Kadokami, T. et al. Influences of radionuclides on left ventricular phase analysis of gated myocardial perfusion single-photon emission computed tomography images in ischemic heart disease. Ann Nucl Med 35, 735–743 (2021). https://doi.org/10.1007/s12149-021-01615-6

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  • DOI: https://doi.org/10.1007/s12149-021-01615-6

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