Advertisement

Study of Cardiac Function with PET or SPECT

  • Guido Germano
Chapter
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 202)

Abstract

The measurement and knowledge of myocardial function is extremely important for the diagnostic and prognostic assessment of the cardiac patient. It is well known, for example, that the likelihood of 1-year survival after myocardial infarction is directly and exponentially proportional to the value of the resting left ventricular ejection fraction (LVEF)1. Measurement of myocardial function has traditionally been implemented with planar nuclear (first pass, gated blood pool) and planar non-nuclear techniques (echocardiography, contrast ventriculography), as well as, more recently, with tomographic nuclear (gated perfusion SPECT, gated blood pool SPECT, gated PET) and tomographic non-nuclear techniques (cine MRI, cine CT). Of all these techniques, only gated perfusion SPECT and PET offer the opportunity to simultaneously acquire information on both the perfusion and the function of the left ventricle, and to do it in threedimensional and quantitative fashion. Since it is increasingly being reported that the knowledge of global LVEF provides incremental prognostic value over that of myocardial perfusion alone2, gated perfusion SPECT and PET are likely to be increasingly utilized in this era of health care cost containment and emphasis on outcomes, and will represent the main focus of this chapter. The myocardial function parameters obtainable from gated perfusion SPECT and gated PET are LVEF, regional (segmental) myocardial wall motion and wall thickening. Before addressing each of them in detail, it is appropriate to briefly describe the acquisition of a gated SPECT or PET study.

Keywords

Leave Ventricular Ejection Fraction Myocardial Perfusion Myocardial Perfusion SPECT Transient Ischemic Dilation Gated SPECT 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Risk stratification and survival after myocardial infarction. N Engl J Med 1983; 309:331–6.Google Scholar
  2. 2.
    Mahmarian JJ, Mahmarian AC, Marks GF, Pratt CM, Verani MS. Role of adenosine thallium-201 tomography for defining long-term risk in patients after acute myocardial infarction. J Am Coll Cardiol 1995; 25:1333–40.PubMedCrossRefGoogle Scholar
  3. 3.
    Kuhle WG, Porenta G, Huang SC, Phelps ME, Schelbert HR. Issues in the quantitation of reoriented cardiac PET images. J Nucl Med 1992; 33:1235–42.PubMedGoogle Scholar
  4. 4.
    Germano G, Kavanagh PB, Su HT, et al. Automatic reorientation of threedimensional, transaxial myocardial perfusion SPECT images. J Nucl Med 1995; 36:1107–14.PubMedGoogle Scholar
  5. 5.
    Germano G, Kavanagh PB, Chen J, et al. Operator-less processing of myocardial perfusion SPECT studies. J Nucl Med 1995; 36:2127–32.PubMedGoogle Scholar
  6. 6.
    Miller TR, Wallis JW, Landy BR, Gropler RJ, Sabharwal CL. Measurement of global and regional left ventricular function by cardiac PET. J Nucl Med 1994; 35:999–1005.PubMedGoogle Scholar
  7. 7.
    Mazzanti M, Germano G, Kiat H, Friedman J, Berman DS. Fast technetium 99m-labeled sestamibi gated single-photon emission computed tomography for evaluation of myocardial function. J Nucl Cardiol 1996; 3:143–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Nichols K, DePuey EG, Rozanski A. Automation of gated tomographic left ventricular ejection fraction. J Nucl Cardiol 1996; 3:475–82.PubMedCrossRefGoogle Scholar
  9. 9.
    Faber TL, Akers MS, Peshock RM, Corbett JR. Three-dimensional motion and perfusion quantification in gated single-photon emission computed tomograms. J Nucl Med 1991; 32:2311–7.PubMedGoogle Scholar
  10. 10.
    Germano G, Kiat H, Kavanagh PB, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995; 36:2138–47.PubMedGoogle Scholar
  11. 11.
    Hoffman EJ, Huang SC, Phelps ME. Quantitation in positron emission computed tomography: 1. Effect of object size. J Comput Assist Tomogr 1979:3:299–308.PubMedCrossRefGoogle Scholar
  12. 12.
    Moriel M, Germano G, Kiat H, et al. Automatic measurement of left ventricular ejection fraction by gated SPECT Tc-99m sestamibi: a comparison with radionuclide ventriculography [abstract]. Circulation 1993; 88(4 Suppl):1582.Google Scholar
  13. 13.
    He ZX, Mahmarian JJ, Preslar JS, Verani MS. Correlations of left ventricular ejection fractions determined by gated SPECT with thallium and sestamibi and by first-pass radionuclide angiography [abstract]. J Nucl Med 1997; 38(5 Suppl):27P.Google Scholar
  14. 14.
    Everaert H, Franken P, Flamen P, Momen A, Bossuyt A. Left ventricular volumes and ejection fraction from gated SPECT myocardial perfusion studies [abstract]. J Nucl Cardiol 1997; 4(1 part 2):S102.CrossRefGoogle Scholar
  15. 15.
    Zanger D, Bhatnagar A, Hausner E, et al. Automated calculation of ejection fraction from gated Tc-99m sestamibi images — comparison to quantitative echocardiography. J Nucl Cardiol 1997; 4(1 part 2):S78.CrossRefGoogle Scholar
  16. 16.
    Di Leo C, Bestetti A, Tagliabue L, et al. 99mTc-tetrofosmin gated-SPECT LVEF: correlation with echocardiography and contrastographic ventriculography [abstract]. J Nucl Cardiol 1997; 4(1 part 2):S56.Google Scholar
  17. 17.
    Blanksma PK. Personal communication. 1997.Google Scholar
  18. 18.
    Faber TL, Stokely EM, Peshock RM, Corbett JR. A model-based fourdimensional left ventricular surface detector. IEEE Trans Med Imaging 1991:10:321–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Mazzanti M, Germano G, Kiat H, et al. Identification of severe and extensive coronary artery disease by automatic measurement of transient ischemic dilation of the left ventricle in dual-isotope myocardial perfusion SPECT. J Am Coll Cardiol 1996; 27:1612–20.PubMedCrossRefGoogle Scholar
  20. 20.
    Berman DS, Kiat H, Friedman JD, et al. Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: a clinical validation study. J Am Coll Cardiol 1993; 22:1455–64.PubMedCrossRefGoogle Scholar
  21. 21.
    Cooke CD, Garcia EV, Cullom SJ, Faber TL, Pettigrew Rl. Determining the accuracy of calculating systolic wall thickening using a fast Fourier transform approximation: a simulation study based on canine and patient data. J Nucl Med 1994; 35:1185–92.PubMedGoogle Scholar
  22. 22.
    DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med 1995; 36:952–5.PubMedGoogle Scholar
  23. 23.
    Mochizuki T, Murase K, Fujiwara Y, Tanada S, Hamamoto K, Tauxe WN. Assessment of systolic thickening with thallium-201 ECG-gated single-photon emission computed tomography: a parameter for local left ventricular function. J Nucl Med 1991:32:1496–500.PubMedGoogle Scholar
  24. 24.
    Marcassa C, Marzullo P, Sambuceti G, Parodi O. Prediction of reversible perfusion defects by quantitative analysis of post-exercise electrocardiogramgated acquisition of technetium-99m 2-methoxyisobutylisonitrile myocardial perfusion scintigraphy. Eur J Nucl Med 1992:19:796–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Marcassa C, Marzullo P, Parodi O, Sambuceti G, L’Abbate A. A new method for noninvasive quantitation of segmental myocardial wall thickening using technetium-99m 2-methoxy-isobutyl-isonitrile scintigraphy-results in normal subjects. J Nucl Med 1990; 31:173–7.PubMedGoogle Scholar
  26. 26.
    Fukuchi K, Uehara T, Morozumi T, et al. Quantification of systolic count increase in technetium-99m-MIBI gated myocardial SPECT. J Nucl Med 1997; 38:1067–73.PubMedGoogle Scholar
  27. 26.
    Williams K, Taillon L. Reversible ischemia in severe stress technetium 99m-labeled sestamibi perfusion defects assessed from gated single-photon emission computed tomographic polar map Fourier analysis. J Nucl Cardiol 1995; 2:199–206.PubMedCrossRefGoogle Scholar
  28. 28.
    Bartlett ML, Buvat I, Vaquero JJ, Mok D, Dilsizian V, Bacharach SL. Measurement of myocardial wall thickening from PET/SPECT images: comparison of two methods. J Comput Assist Tomogr 1996; 20:473–81.PubMedCrossRefGoogle Scholar
  29. 29.
    Yamashita K, Tamaki N, Yonekura Y, et al. Quantitative analysis of regional wall motion by gated myocardial positron emission tomography: validation and comparison with left ventriculography. J Nucl Med 1989; 30:1775–86.PubMedGoogle Scholar
  30. 30.
    Yamashita K, Tamaki N, Yonekura Y, et al. Regional wall thickening of left ventricle evaluated by gated positron emission tomography in relation to myocardial perfusion and glucose metabolism. J Nucl Med 1991; 32:679–85.PubMedGoogle Scholar
  31. 31.
    Buvat I, Bartlett ML, Kitsiou AN, Dilsizian V, Bacharach SL. A “hybrid” method for measuring myocardial wall thickening from gated PET/SPECT images. J Nucl Med 1997; 38:324–9.PubMedGoogle Scholar
  32. 32.
    Germano G, Erel J, Lewin H, Kavanagh P, Berman D. Automatic quantitation of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol 1997; 30:1360–67.PubMedCrossRefGoogle Scholar
  33. 33.
    Sheehan FH, Dodge HT, Mathey D, Brown BG, Bolson EL, Mitten S. Application of the centerline method: analysis of change in regional left ventricular wall motion in serial studies. Comput Cardiol, 1983:97–100.Google Scholar
  34. 34.
    Germano G, Van Train KF, Garcia EV, et al. Quantitation of myocardial perfusion with SPECT: current issues and future trends. In: Zaret BL, Beller G, editors. Nuclear cardiology: state of the art and future directions. St. Louis: Mosby, 1993:77–88.Google Scholar
  35. 35.
    Germano G, Kavanagh PB, Berman DS. Effect of the number of projections collected on quantitative perfusion and left ventricular ejection fraction measurements from gated myocardial perfusion single-photon emission computed tomographic images. J Nucl Cardiol 1996; 3:395–402.PubMedCrossRefGoogle Scholar
  36. 36.
    Sheehan FH. Principles and practice of contrast ventriculography. In: Skorton DJ, editor. Marcus cardiac imaging: a companion to Braunwald’s Heart disease. 2nd ed. Philadelphia: Saunders; 1996:164–87.Google Scholar
  37. 37.
    Katz AS, Force TL, Folland ED, Aebischer N, Sharma S, Parisi AF. Echocardiographic assessement of ventricular systolic function. In: Skorton DJ, editor. Marcus cardiac imaging: a companion to Braunwald’s Heart disease. 2nd ed. Philadelphia: Saunders, 1996:297–324.Google Scholar
  38. 38.
    Weyman AE, Franklin TD Jr., Hogan RD, et al. Importance of temporal heterogeneity in assessing the contraction abnormalities associated with acute myocardial ischemia. Circulation 1984; 70:102–12.PubMedCrossRefGoogle Scholar
  39. 39.
    Garcia EV, Cooke CD, Van Train KF, et al. Technical aspects of myocardial SPECT imaging with technetium-99m sestamibi. Am J Cardiol 1990; 66:23E–31E.PubMedCrossRefGoogle Scholar
  40. 40.
    Van Train KF, Garcia EV, Maddahi J, et al. Multicenter trial validation for quantitative analysis of same-day rest-stress technetium-99m-sestamibi myocardial tomograms. J Nucl Med 1994; 35:609–18.PubMedGoogle Scholar
  41. 41.
    Sechtem U, Sommerhoff BA, Markiewicz W, White RD, Cheitlin MD, Higgins CB. Regional left ventricular wall thickening by magnetic resonance imaging: evaluation in normal persons and patients with global and regional dysfunction. Am J Cardiol 1987; 59:145–51.PubMedCrossRefGoogle Scholar
  42. 42.
    Pflugfelder PW, Sechtem UP, White RD, Higgins CB. Quantification of regional myocardial function by rapid cine MR imaging. AJR Am J Roentgenol 1988; 150:523–9.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Guido Germano

There are no affiliations available

Personalised recommendations

Cite chapter

Buy options