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Performance of 8- vs 16 ECG-gated reconstructions in assessing myocardial function using Rubidium-82 myocardial perfusion imaging: Findings in a young, healthy population

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Current imaging guidelines recommend using at least 16 ECG gates when performing MUGA and cardiac SPECT to assess left ventricular ejection fraction (LVEF). However, for Rubidium-82 (82Rb) PET, 8 ECG-gated reconstructions have been a mainstay. This study investigated the implications of quantitative assessments when employing 16 gate, instead of 8 gate, reconstructions for 82Rb myocardial perfusion imaging (MPI).

Methods

The study comprised 25 healthy volunteers (median age 23 years) who underwent repeat MPI sessions employing 82Rb PET/CT. We report LVEF, its reserve (stress LVEF – rest LVEF), and their repeatability measures (RMS method) obtained for 8- and 16 ECG-gated reconstructions.

Results

Similar LVEF and LVEF reserve estimates were found for the 8- and 16-gated reconstructions ([%] LVEF (8/16 gates): rest = 61 ± 6/64 ± 6, stress = 68 ± 7/71 ± 6, LVEF reserve (8/16 gates): 8 ± 3/6 ± 4, and all P ≥ 0.13). Similar test–retest repeatability measures were observed for rest and stress LVEF and their reserves [LVEF (8/16 gates); Rest = 4.5/4.6 (P = 0.81), Stress = 3.5/3.2 (P = 0.33), LVEF reserve = 46.7/49.3 (P = 0.13)].

Conclusion

In healthy subjects, 8 and 16 ECG gates can be used interchangeably if only volumetric assessments are desired. However, if filling and emptying rates are of interest, a minimum of 16 ECG gates should be employed.

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Abbreviations

82Rb:

Rubidium-82

ANOVA:

Analysis of variance

EDV:

End-diastolic volume

LVEF:

Left ventricular ejection fraction

MPI:

Myocardial perfusion imaging

PET/CT:

Positron emission tomography/computed tomography

SV:

Stroke volume

PER:

Peak emptying rate

PFR:

Peak filling rate

TTPF:

Time-to-peak filling

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Acknowledgements

This project received funding from the European Union’s Horizon 2020 research and innovation program under grant agreements no. 670261 (ERC Advanced Grant) and 668532 (Click-It), the Lundbeck Foundation, the Novo Nordisk Foundation, the Innovation Fund Denmark, the Danish Cancer Society, Arvid Nilsson Foundation, the Neye Foundation, the Research Foundation of Rigshospitalet, the Danish National Research Foundation (grant 126), the Research Council of the Capital Region of Denmark, the Danish Health Authority, the Hørslev Foundation, and the John and Birthe Meyer Foundation and Research Council for Independent Research. Andreas Kjaer is a Lundbeck Foundation Professor.

Disclosures

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Section 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Martin Lyngby Lassen PhD, Christina Byrne MD, PhD, Andreas Kjaer MD, PhD, DMSc & Philip Hasbak MD, DMSc

  2. Department of Cardiology, Copenhagen University Hospital – Herlev and Gentofte, Copenhagen, Denmark

    Mads Wissenberg MD, PhD

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  1. Martin Lyngby Lassen PhD
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  2. Mads Wissenberg MD, PhD
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  3. Christina Byrne MD, PhD
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  4. Andreas Kjaer MD, PhD, DMSc
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  5. Philip Hasbak MD, DMSc
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Correspondence to Martin Lyngby Lassen PhD.

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Lassen, M.L., Wissenberg, M., Byrne, C. et al. Performance of 8- vs 16 ECG-gated reconstructions in assessing myocardial function using Rubidium-82 myocardial perfusion imaging: Findings in a young, healthy population. J. Nucl. Cardiol. 30, 1406–1413 (2023). https://doi.org/10.1007/s12350-022-03193-0

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  • DOI: https://doi.org/10.1007/s12350-022-03193-0

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