Abstract
Background
Differences in spatial resolution and image filtering between the solid-state DSPECT and traditional Anger SPECT (ASPECT) cameras are likely to result in differences in LV measurements. However, DSPECT-specific normal values are not available. The traditional approach of using patients deemed to have a low (< 5%) probability of coronary artery disease for the derivation of normative values has a number of limitations. We used healthy organ-donor subjects without known disease or medication use for derivation of normal values.
Methods
Subjects were 92 consecutive kidney or liver donors who underwent single-day rest (5 mCi)-stress (15 mCi) Tc-99m sestamibi-gated SPECT myocardial perfusion imaging (MPI) on the DSPECT camera for pre-operative evaluation and had normal perfusion and LV function. Exclusion criteria included any known cardiac disease or medications. LV measurements were made on the post-stress supine stress images using QGS®.
Results
Of 92 subjects (mean age 54.4 ± 15.0 and 39% men), mean EF ± 2SD for women and men was 77.2% ± 14.1% and 70.0 % ± 14.7%, respectively. Mean end-diastolic volume ± 2SD for women and men was 67.0 ± 32.2 mL and 99.6 ± 51.6 mL (indexed 38.3 ± 17.2 mL/m2 and 48.1 ± 25.9 mL/m2), respectively. Mean end-systolic volume ± 2SD for women and men was 16.1 ± 15.7 mL and 31.2 ± 29.2 mL (indexed 9.2 ± 8.8 mL/m2 and 15.0 ± 14.2 mL/m2), respectively. Mean LV wall volume ± 2SD for women and men was 95.9 ± 26.0 mL and 112.0 ± 48.8 mL (indexed 55.0 ± 13.8 mL/m2 and 54.1 ± 24.6 mL/m2), respectively.
Conclusion
We report DSPECT-specific LV measurements from normal subjects from which limits of normality can be derived for clinic use. Organ donors who undergo pre-operative MPI are a suitable cohort for the derivation of normal values.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- ASPECT:
-
Anger single-photon emission computed tomography
- gSPECT:
-
Gated single-photon emission computed tomography
- Tc-99m:
-
Technetium-99m
- MPI:
-
Myocardial perfusion imaging
- LVEF:
-
Left ventricular ejection fraction
- LVEDV:
-
Left ventricular end-diastolic volume
- LVEDVi:
-
Indexed left ventricular end-diastolic volume
- LVESV:
-
Left ventricular end-systolic volume
- LVESVi:
-
Indexed left ventricular end-systolic volume
References
Sharir T, Kang X, Germano G, et al. Prognostic value of poststress left ventricular volume and ejection fraction by gated myocardial perfusion SPECT in women and men: gender-related differences in normal limits and outcomes. J Nucl Cardiol 2006;13:495‐506.
Gambhir SS, Berman DS, Ziffer J, et al. A novel high-sensitivity rapid-acquisition single-photon cardiac imaging camera. J Nucl Med 2009;50:635‐43.
Pfisterer ME, Battler A, Zaret BL. Range of normal values for left and right ventricular ejection fraction at rest and during exercise assessed by radionuclide angiocardiography. Eur Heart J 1985;6:647‐55.
Ababneh AA, Sciacca RR, Kim B, Bergmann SR. Normal limits for left ventricular ejection fraction and volumes estimated with gated myocardial perfusion imaging in patients with normal exercise test results: influence of tracer, gender, and acquisition camera. J Nucl Cardiol 2000;7:661‐8.
Rozanski A, Nichols K, Yao SS, Malholtra S, Cohen R, DePuey EG. Development and application of normal limits for left ventricular ejection fraction and volume measurements from 99mTc-sestamibi myocardial perfusion gates SPECT. J Nucl Med 2000;41:1445‐50.
Toft J, Lindahl D, Ohlsson M, et al. The optimal reference population for cardiac normality in myocardial SPET in the detection of coronary artery stenoses: patients with normal coronary angiography or subjects with low likelihood of coronary artery disease? Eur J Nucl Med 2001;28:831‐5.
Johnson RD, Bath NK, Rinker J, et al. Introduction to the D-SPECT for technologists: workflow using a dedicated digital cardiac camera. J Nucl Med Technol 2020;48:297‐303.
Cullom SJ, Case JA, Bateman TM. Electrocardiographically gated myocardial perfusion SPECT: technical principles and quality control considerations. J Nucl Cardiol 1998;5:418‐25.
Erlandsson K, Kacperski K, van Gramberg D, Hutton BF. Performance evaluation of D-SPECT: a novel SPECT system for nuclear cardiology. Phys Med Biol 2009;54:2635‐49.
Barde MP, Barde PJ. What to use to express the variability of data: standard deviation or standard error of mean? Perspect Clin Res 2012;3:113‐6.
Miao TL, Kansal V, Glenn Wells R, Ali I, Ruddy TD, Chow BJ. Adopting new gamma cameras and reconstruction algorithms: Do we need to re-establish normal reference values? J Nucl Cardiol 2016;23:807‐17.
Jameria ZA, Abdallah M, Dwivedi A, et al. Computer derived transient ischemic dilation ratio for identifying extensive coronary artery disease using a CZT camera and imaging in the upright position. J Nucl Cardiol 2017;24:1702‐8.
Esteves FP, Raggi P, Folks RD, et al. Novel solid-state-detector dedicated cardiac camera for fast myocardial perfusion imaging: multicenter comparison with standard dual detector cameras. J Nucl Cardiol 2009;16:927‐34.
Hambye AS, Vervaet A, Dobbeleir A. Variability of left ventricular ejection fraction and volumes with quantitative gated SPECT: influence of algorithm, pixel size and reconstruction parameters in small and normal-sized hearts. Eur J Nucl Med Mol Imaging 2004;31:1606‐13.
Hu LH, Sharir T, Miller RJH, et al. Upper reference limits of transient ischemic dilation ratio for different protocols on new-generation cadmium zinc telluride cameras: a report from REFINE SPECT registry. J Nucl Cardiol 2020;27:1180‐9.
Lomsky M, Johansson L, Gjertsson P, Björk J, Edenbrandt L. Normal limits for left ventricular ejection fraction and volumes determined by gated single photon emission computed tomography—a comparison between two quantification methods. Clin Physiol Funct Imaging 2008;28:169‐73.
Akincioglu C, Berman DS, Nishina H, et al. Assessment of diastolic function using 16-frame 99mTc-sestamibi gated myocardial perfusion SPECT: normal values. J Nucl Med 2005;46:1102‐8.
Nakajima K, Kusuoka H, Nishimura S, Yamashina A, Nishimura T. Normal limits of ejection fraction and volumes determined by gated SPECT in clinically normal patients without cardiac events: a study based on the J-ACCESS database. Eur J Nucl Med Mol Imaging 2007;34:1088‐96.
Disclosures
Dr. Joseph Ibrahim has none to disclose. Dr. Ricardo A. Nieves has none to disclose. Dr. Amr F. Barakat has none to disclose. Kevin Hynal has none to disclose. Dr. Daniel Shpilsky has none to disclose. Dr. Prem Soman discloses consultancy/advisory board fees from Spectrum Dynamics, Pfizer, Alnylam, and Eidos pharma.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.
The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast.
Funding
Dr. Prem Soman discloses grant funding from Astellas and Pfizer and discloses consultancy/advisory board fees from Spectrum Dynamics, Pfizer, Alnylam, and Eidos pharma.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Ibrahim, J., Nieves, R.A., Barakat, A.F. et al. DSPECT-specific normative limits for left ventricular size and function. J. Nucl. Cardiol. 29, 3293–3299 (2022). https://doi.org/10.1007/s12350-022-02932-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12350-022-02932-7