J Korean Med Assoc.  2003 Nov;46(11):981-986. 10.5124/jkma.2003.46.11.981.

Gated Myocardial SPECT

Affiliations
  • 1Department of Nuclear Medicine, Seoul National University College of Medicine & Hospital, Korea. dsi@plaza.snu.ac.kr

Abstract

The advent of gated myocardial SPECT has achieved onestop imaging in coronary artery diseases. Perfusion at rest and stress is measured and quantified using software. Myocardial contractility can be determined by quantifying the global function or regional contractility markers such as wall motion or systolic thickening. Excellent reproducibility was shown for ejection fraction and left ventricular volumes and mass. Improvement of the ejection fraction by 5% or a decrease of volumes by 10 ml can be used as criteria on a postoperative or followup scan. To achieve postoperative global improvements, an increase of systolic thickening > 15% of regional segments is needed. Even the prolonged transient stunning can be detected on gated myocardial SPECT as one gated SPECT indicates the perfusion and corn tractility of each segment. Lowdose dobutaminechallenged gated SPECT is feasible and is believed to parallel lowdose dobutamine echocardiography for determination of myocardial viability. Gated SPECT was also helpful to differentiate artifacts and for risk stratification of diabetic patients ; normal perfusion with abnormal function means a worse prognosis. Gated myocardial SPECT is mandatory if SPECT cameras have the capability of gating because it provides clinicians with information not only on diagnosis but also on prognosis, treatment strategy and risk stratification.

Keyword

Gated myocardial SPECT; Myocardial contractility; Myocardial perfusion

MeSH Terms

Artifacts
Coronary Artery Disease
Diagnosis
Dobutamine
Echocardiography
Follow-Up Studies
Humans
Perfusion
Prognosis
Tomography, Emission-Computed, Single-Photon*
Zea mays
Dobutamine

Reference

2. Sharir T, Germano G, Waechter PB, Kavanagh PB, Areeda JS, Berman DS, et al. A new algorithm for the quantitation of myocardial perfusion SPECT. II : validation and diagnostic yield. J Nucl Med. 2000. 41:720–727.
3. Berman DS, Hachamovitch R, Kiat H, Cohen I, Cabico JA, Diamond GA, et al. Incremental value of prognostic testing in patients with known or suspected ischemic heart disease : a basis for optimal utilization of exercise technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography. J Am Coll Cardiol. 1995. 26:639–647.
Article
4. Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Diamond GA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death:differential stratification for risk of cardiac death and myocardial infarction. Circulation. 1998. 97:535–543.
Article
6. Lee DS, Cheon GJ, Ahn JY, Chung JK, Lee MC. Reproducibility of assessment of myocardial function using gated 99 Tc(m)-MIBI SPECT and quantitative software. Nucl Med Commun. 2000. 21:1127–1134.
Article
7. Paeng JC, Lee DS, Cheon GJ, Lee MM, Chung JK, Lee MC. Reproducibility of an automatic quantitation of regional myocardial wall motion and systolic thickening on gated 99mTc-sestamibi myocardial SPECT. J Nucl Med. 2001. 42:695–700.
8. Lee DS, Cheon GJ, Paeng JC, Kim KB, Chung JK, Lee MC. Criteria for definition of regional functional improvement on quantitative post-stress gated myocardial SPET after bypass surgery in patients with ischaemic cardiomyopathy. Eur J Nucl Med Mol Imaging. 2002. 29:1078–1082.
Article
9. DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med. 1995. 36:952–955.
10. Lee DS, Yeo JS, Chung JK, Lee MM, Lee MC. Transient prolonged stunning induced by dipyridamole and shown on 1- and 24-hour poststress 99mTc-MIBI gated SPECT. J Nucl Med. 2000. 41:27–35.
11. Jeong HJ, Lee DS, Lee HY, Jang MJ, Paeng JC, Lee MC, et al. prognostic value of normal perfusion but impaired left ventricular wall motion in diabetic heart : quantitative gated myocardial perfusion SPECT. J Nucl Med. 2002. 43:141P. (Abstract).
13. Leoncini M, Sciagra R, Bellandi F, Maioli M, Sestini S, Dabizzi RP, et al. Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy. J Nucl Cardiol. 2002. 9:402–406.
Article
14. Lee DS, Kim KM, Kim SK, Cheon GJ, Kim YK, Lee MC, et al. Development of a method for measuring myocardial contractility with gated myocardial SPECT and arterial tonometry. J Nucl Cardiol. 1999. 6:657–663.
Article
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr