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Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

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Abstract

Backgrounds

Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies.

Methods

A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99mTc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments.

Results

Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p < 0.0001 for non-gated; 64 ± 16% and 51 ± 17% for ES percent uptake, p < 0.0001). The area under the curve of receiver operating characteristics curve for non-gated percent uptake, ES percent uptake, end-diastolic percent uptake and visual perfusion defect score was 0.70, 0.71, 0.61, and 0.56, respectively. Sensitivity and specificity of percent uptake were 68% and 64% for non-gated map and 80% and 52% for ES percent uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES percent uptake values.

Conclusion

Segmental 99mTc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study.

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Authors and Affiliations

  1. Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Kenichi Nakajima

  2. Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Nagara Tamaki

  3. Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan

    Yoichi Kuwabara

  4. Department of Radiology, Kanazawa Cardiovascular Hospital, Kanazawa, Japan

    Masaya Kawano

  5. The Medical and Pharmacological Research Center Foundation, Hakui, Japan

    Ichiro Matsunari

  6. Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan

    Junichi Taki

  7. Department of Cardiology, Saitama Medical University, Saitama, Japan

    Shigeyuki Nishimura

  8. Department of Cardiology, Tokyo Medical University, Tokyo, Japan

    Akira Yamashina

  9. National Cardiovascular Center, Osaka, Japan

    Yoshio Ishida & Hitonobu Tomoike

Authors
  1. Kenichi Nakajima
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  2. Nagara Tamaki
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  3. Yoichi Kuwabara
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  4. Masaya Kawano
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  5. Ichiro Matsunari
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  6. Junichi Taki
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  7. Shigeyuki Nishimura
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  8. Akira Yamashina
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  9. Yoshio Ishida
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Corresponding author

Correspondence to Kenichi Nakajima.

Appendix

Appendix

List of the hospitals for MIBI myocardial viability research group follows.

Sapporo Medical University Hospital, Hokkaido University Hospital, Wakkanai City Hospital, Hokko Memorial Hospital, Kushiro City Medical Association Hospital, Yamagata University Hospital, Hoshi General Hospital, Toho University Omori Hospital Center, Toranomon Hospital, Sakakibara Commemoration Hospital, Shonan Kamakura General Hospital, Tomioka General Hospital, Nagoya Daini Red Cross Hospital, Social Insurance Hamamatsu Hospital, Kansai Medical University Takii Hospital, National Cardiovascular Center, Kyoto University Hospital, Kyoto University Hospital, Kanazawa University Hospital, Koseiren Takaoka Hospital, Fukui Prefectural Hospital, Hokuriku Central Hospital of Japan Mutual Aid Association of Public School Teachers, Kanazawa Cardiovascular Hospital, Saiseikai Saijo Hospital, National Hospital Organization Ehime National Hospital, Saiseikai Kumamoto Hospital

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Nakajima, K., Tamaki, N., Kuwabara, Y. et al. Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan. Eur J Nucl Med Mol Imaging 35, 2038–2048 (2008). https://doi.org/10.1007/s00259-008-0838-6

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  • DOI: https://doi.org/10.1007/s00259-008-0838-6

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