Author + information
- Received December 29, 1994
- Revision received July 27, 1995
- Accepted August 1, 1995
- Published online January 1, 1996.
- Kim A. Williams, MD** and
- Linda A. Taillon, MS
- ↵**Address for correspondence: Dr. Kim A. Williams, Nuclear Cardiology, The University of Chicago, 5841 South Maryland Avenue MC4057, Chicago, Illinois 60637.
Objectives. This study evaluated the use of gated single-photon emission computed tomographic (SPECT) myocardial perfusion images for determination of left ventricular ejection fraction.
Background. Gated SPECT has expanded the applications of myocardial perfusion imaging to include the evaluation of left ventricular size, regional wall motion and regional systolic thickening. Accurate automated or semi-automated methods for quantitation of left ventricular ejection fraction from tomographic perfusion images would provide additional valuable clinical information.
Methods. Rest gated SPECT was performed on the stress distribution of technetium-99m sestamibi, using eight frames per cardiac cycle. Mid-horizontal long-axis and vertical long-axis gated tomographic perfusion images were analyzed after digital matrix inversion, which enhances edge detection, for ejection fraction determination. These ejection fractions were compared with those determined by contrast ventriculography (n = 54, including 45 biplane and 9 single plane) and first-pass radionuclide angiography (n = 38) in patients with coronary artery disease.
Results. Myocardial perfusion SPECT image inversion-derived ejection fractions were slightly lower (2.7 ejection fraction units, p < 0.01), and first-pass ejection fractions were much lower (8.0 ejection fraction units, p < 0.001) than those obtained with contrast ventriculography. There was excellent correlation between SPECT and contrast ventriculographic ejection fractions (r = 0.93) over a wide range of ejection fractions (14% to 89%). Good correlation was also observed between first-pass radionuclide angiography and both contrast ventriculography (r = 0.83) and SPECT (r = 0.87). Reproducibility of SPECT image inversion ejection fractions was excellent (intraobserver r = 0.99, interobserver r = 0.93).
Conclusions. Semiautomated ejection fractions can be obtained from gated SPECT technetium-99m sestamibi perfusion images using the image inversion technique. These results are reproducible and correlate well with results of first-pass radionuclide angiography but are closer in value to those obtained with contrast ventriculography.
This work was supported by the Ralph S. Zitnik, MD Award (a grant from the American Heart Association of Metropolitan Chicago). This study was presented in part at the 42nd Annual Scientific Session of the American College of Cardiology, Anaheim, California, March 1993 and at the 67th Annual Scientific Sessions of the American Heart Association, Dallas, Texas, November 1994.
- Received December 29, 1994.
- Revision received July 27, 1995.
- Accepted August 1, 1995.
- American College of Cardiology