Korean J Nucl Med.
2005 Apr;39(2):94-99.
Accuracy of Ventricular Volume and Ejection Fraction Measured by Gated Tl-201 Perfusion Single Photon Emission Tomography
- Affiliations
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- 1Department of Nuclear Medicine, University of Ulsan College of Medicine, Seoul, Korea. dhmoon@amc.seoul.kr
- 2Division of Nuclear Medicine, Department of Radiology, Ewha Womans University College of Medicine, Seoul, Korea.
- 3Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea.
Abstract
- Electrocardiogram-gated single photon emission computed tomography (SPECT) provides valuable information in the assessment of both myocardial perfusion and ventricular function. Tl-201 is a suboptimal isotope for gating. Tl-201 images are more blurred compared with Tc-99m tracers due to the increased amount of scattered photons and use of a smooth filter. The average myocardial count densities are approximately one-half those of conventional technetium tracers. However, Tl-201 is still widely used because of its well-established utility for assessing myocardial perfusion, viability and risk stratification. Gated SPECT with Tl-201 enables us to assess both post-stress and rest left ventricular volume and function. Previous studies with gated Tl-201 SPECT measurements of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) have shown high correlation with first-pass radionuclide angiography, gated blood pool scan, Tc-99m-MIBI gated SPECT, contrast ventriculography, echocardiography, and 3-dimensional magnetic resonance imaging. However, problems related to these studies include few agreement data of EDV and ESV, use of a reference method that is likely to have the same systemic errors (gated Tc-99m-MIBI SPECT), and other technical factors related to the count density of gated SPECT. With optimization of gated imaging protocols and more validation studies, gated Tl-201 SPECT would be an accurate method to provide perfusion and function information in patients with coronary artery disease.
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