SpringerLink
Log in

Assessment of Left Ventricular Ejection Fraction by Thallium-201 Myocardial SPECT-CT in Patients with Angina Pectoris: Comparison with 2D Echocardiography

  • Original Article
  • Published:
Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Left ventricular (LV) ejection fraction (EF) is an important parameter for assessing cardiac systolic function and predicting prognosis in patients with cardiovascular disease. The aim of this study was to evaluate the feasibility of assessing LVEF by Tl-201 hybrid myocardial single-photon emission computed tomography (SPECT)/CT using two attenuation correction methods in patients with angina pectoris.

Methods

A total of 339 patients with angina pectoris (62.8 ± 12.9 years, male:female = 206:133) were analyzed. All patients underwent Tl-201 myocardial SPECT/CT and transthoracic two-dimensional (2D) echocardiograph. We compared LVEF assessed by SPECT/CT using two attenuation correction methods: CT-based attenuation correction (CTAC) and non-attenuation correction (non-AC) methods and 2D echocardiography.

Results

LVEF assessed by either of the two attenuation correction techniques and 2D echocardiography showed moderate correlation in all patients with angina pectoris (r = 0.487 for CTAC and r = 0.473 for non-AC, p < 0.001). Results were similar in the subgroup of patients with perfusion abnormalities on myocardial SPECT/CT images. Overall diagnostic performances were similar for the CTAC and non-AC methods for evaluating normal and decreased LVEF by myocardial SPECT/CT.

Conclusion

LVEF measured by the CTAC method of Tl-201-gated myocardial SPECT/CT was comparable with the conventional non-AC method in patients with angina pectoris and in the subgroup of patients with perfusion abnormality. Tl-201-gated myocardial hybrid SPECT/CT can be a reliable tool in the assessment of LVEF in clinic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mitra D, Basu S. Equilibrium radionuclide angiocardiography: its usefulness in current practice and potential future applications. World J Radiol. 2012;4:421–30.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Rizvi A, Deano RC, Bachman DP, **ong G, Min JK, Truong QA. Analysis of ventricular function by CT. J Cardiovasc Comput Tomogr. 2015;9:1–12.

    Article  PubMed  Google Scholar 

  3. Greupner J, Zimmermann E, Grohmann A, Dubel HP, Althoff TF, Borges AC, et al. Head-to-head comparison of left ventricular function assessment with 64-row computed tomography, biplane left cineventriculography, and both 2- and 3-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging as the reference standard. J Am Coll Cardiol. 2012;59:1897–907.

    Article  PubMed  Google Scholar 

  4. Citro R, Rigo F, D'Andrea A, Ciampi Q, Parodi G, Provenza G, et al. Echocardiographic correlates of acute heart failure, cardiogenic shock, and in-hospital mortality in tako-tsubo cardiomyopathy. JACC Cardiovasc Imaging. 2014;7:119–29.

    Article  PubMed  Google Scholar 

  5. Chin BB, Bloomgarden DC, **a W, Kim HJ, Fayad ZA, Ferrari VA, et al. Right and left ventricular volume and ejection fraction by tomographic gated blood-pool scintigraphy. J Nucl Med. 1997;38:942–8.

    CAS  PubMed  Google Scholar 

  6. Chua T, Yin LC, Thiang TH, Choo TB, ** DZ, Leng LY. Accuracy of the automated assessment of left ventricular function with gated perfusion SPECT in the presence of perfusion defects and left ventricular dysfunction: correlation with equilibrium radionuclide ventriculography and echocardiography. J Nucl Cardiol. 2000;7:301–11.

    Article  CAS  PubMed  Google Scholar 

  7. Yamagishi H, Shirai N, Yoshiyama M, Teragaki M, Akioka K, Takeuchi K, et al. Incremental value of left ventricular ejection fraction for detection of multivessel coronary artery disease in exercise (201) Tl gated myocardial perfusion imaging. J Nucl Med. 2002;43:131–9.

    PubMed  Google Scholar 

  8. Maunoury C, Chen CC, Chua KB, Thompson CJ. Quantification of left ventricular function with thallium-201 and technetium-99m-sestamibi myocardial gated SPECT. J Nucl Med. 1997;38:958–61.

    CAS  PubMed  Google Scholar 

  9. He ZX, Cwajg E, Preslar JS, Mahmarian JJ, Verani MS. Accuracy of left ventricular ejection fraction determined by gated myocardial perfusion SPECT with Tl-201 and Tc-99m sestamibi: comparison with first-pass radionuclide angiography. J Nucl Cardiol. 1999;6:412–7.

    Article  CAS  PubMed  Google Scholar 

  10. Itti E, Rosso J, Damien P, Auffret M, Thirion JP, Meignan M. Assessment of ejection fraction with Tl-201 gated SPECT in myocardial infarction: precision in a rest-redistribution study and accuracy versus planar angiography. J Nucl Cardiol. 2001;8:31–9.

    Article  CAS  PubMed  Google Scholar 

  11. Lee DS, Ahn JY, Kim SK, Oh BH, Seo JD, Chung JK, et al. Limited performance of quantitative assessment of myocardial function by thallium-201 gated myocardial single-photon emission tomography. Eur J Nucl Med. 2000;27:185–91.

    Article  CAS  PubMed  Google Scholar 

  12. Manrique A, Faraggi M, Vera P, Vilain D, Lebtahi R, Cribier A, et al. 201Tl and 99mTc-MIBI gated SPECT in patients with large perfusion defects and left ventricular dysfunction: comparison with equilibrium radionuclide angiography. J Nucl Med. 1999;40:805–9.

    CAS  PubMed  Google Scholar 

  13. Masood Y, Liu YH, Depuey G, Taillefer R, Araujo LI, Allen S, et al. Clinical validation of SPECT attenuation correction using x-ray computed tomography-derived attenuation maps: multicenter clinical trial with angiographic correlation. J Nucl Cardiol. 2005;12:676–86.

    Article  PubMed  Google Scholar 

  14. Tonge CM, Manoharan M, Lawson RS, Shields RA, Prescott MC. Attenuation correction of myocardial SPECT studies using low resolution computed tomography images. Nucl Med Commun. 2005;26:231–7.

    Article  PubMed  Google Scholar 

  15. Malkerneker D, Brenner R, Martin WH, Sampson UK, Feurer ID, Kronenberg MW, et al. CT-based attenuation correction versus prone imaging to decrease equivocal interpretations of rest/stress Tc-99m tetrofosmin SPECT MPI. J Nucl Cardiol. 2007;14:314–23.

    Article  PubMed  Google Scholar 

  16. Henry WL, DeMaria A, Gramiak R, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardiography Committee on nomenclature and standards in two-dimensional echocardiography. Circulation. 1980;62:212–7.

    Article  CAS  PubMed  Google Scholar 

  17. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Chamber quantification writing group; American Society of Echocardiography’s guidelines and standards committee; European Association of Echocardiography.: recommendations for chamber quantification: a report from the American Society of Echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.

    Article  PubMed  Google Scholar 

  18. Huang R, Li F, Zhao Z, Liu B, Ou X, Tian R, et al. Hybrid SPECT/CT for attenuation correction of stress myocardial perfusion imaging. Clin Nucl Med. 2011;36:344–9.

    Article  PubMed  Google Scholar 

  19. Kaufmann PA, Di Carli MF. Hybrid SPECT/CT and PET/CT imaging: the next step in noninvasive cardiac imaging. Semin Nucl Med. 2009;39:341–7.

    Article  PubMed  Google Scholar 

  20. Ficaro EP, Fessler JA, Shreve PD, Kritzman JN, Rose PA, Corbett JR. Simultaneous transmission/emission myocardial perfusion tomography. Diagnostic accuracy of attenuation-corrected 99mTc-sestamibi single-photon emission computed tomography. Circulation. 1996;93:463–73.

    Article  CAS  PubMed  Google Scholar 

  21. Caobelli F, Kaiser SR, Thackeray JT, Bengel FM, Chieregato M, Soffientini A, et al. IQ SPECT allows a significant reduction in administered dose and acquisition time for myocardial perfusion imaging: evidence from a phantom study. J Nucl Med. 2014;55:2064–70.

    Article  PubMed  Google Scholar 

  22. Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med. 1995;36:2138–47.

    CAS  PubMed  Google Scholar 

  23. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hedeer F, Palmer J, Arheden H, Ugander M. Gated myocardial perfusion SPECT underestimates left ventricular volumes and shows high variability compared to cardiac magnetic resonance imaging -- a comparison of four different commercial automated software packages. BMC Med Imaging. 2010;10:10.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Persson E, Carlsson M, Palmer J, Pahlm O, Arheden H. Evaluation of left ventricular volumes an ejection fraction by automated gated myocardial SPECT versus cardiovascular magnetic resonance. Clin Physiol Funct Imaging. 2005;25:135–41.

    Article  PubMed  Google Scholar 

  26. Winz OH, Meyer PT, Knollmann D, Lipke CS, Kuhl HP, Oelve C, et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation of the EXINI heart software package. Clin Physiol Funct Imaging. 2009;29:89–94.

    Article  PubMed  Google Scholar 

  27. Lipke CS, Kuhl HP, Nowak B, Kaiser HJ, Reinartz P, Koch KC, et al. Validation of 4D-MSPECT and QGS for quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPET: comparison with cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging. 2004;31:482–90.

    Article  PubMed  Google Scholar 

  28. H. Stegger L, Lipke CS, Kies P, Nowak B, Schober O, Buell U, et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: validation of an elastic surface model approach in comparison to cardiac magnetic resonance imaging, 4D-MSPECT and QGS. Eur J Nucl Med Mol Imaging 2007;34:900–909.

  29. Gholamrezanezhad A, Mirpour S, Esfehani AF, Saghari M, Mirpour K, Beiki D, et al. A correlative study comparing current different methods of calculating left ventricular ejection fraction. Nucl Med Commun. 2007;28:41–8.

    Article  PubMed  Google Scholar 

  30. Habash-Bseiso DE, Rokey R, Berger CJ, Weier AW, Chyou PH. Accuarcy of non-invasive ejection fraction measurement in a large community-based clinic. Clin Med Res. 2005;3:75–82.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Berk F, Isgoren S, Demir H, Kozdag G, Sahin T, Ural D, et al. Assessment of left ventricular function and volumes for patients with dilated cardiomyopathy using gated myocardial perfusion SPECT and comparison with echocardiography. Nucl Med Commun. 2005;26:701–10.

    Article  PubMed  Google Scholar 

  32. Mistry N, Halvorsen S, Hoffmann P, Müller C, Bøhmer E, Kjeldsen SE, et al. Assessment of left ventricular function with magnetic resonance imaging vs. echocardiography, contrast echocardiography, and single-photon emission computed tomography in patients with recent ST-elevation myocardial infarction. Eur J Echocardiogr. 2010;11:793–800.

    PubMed  Google Scholar 

  33. Cwajg E, Cwajg J, He ZX, Hwang WS, Keng F, Nagueh SF, et al. Gated myocardial perfusion tomography for the assessment of left ventricular function and volumes: comparison with echocardiography. J Nucl Med. 1999;40:1857–65.

    CAS  PubMed  Google Scholar 

  34. Harpaz D, Asman A, Kuperstein R, Boaz M, Chouraqui P. Left ventricular ejection fraction assessment by Tl-201 gated SPECT: a comparison with echocardiography. Clin Cardiol. 2010;33:E56–62.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kajimoto K, Minami Y, Sato N, Otsubo S, Kasanuki H. Acute decompensated heart failure syndromes (ATTEND) registry. gender differences in left ventricular ejection fraction and outcomes among patients hospitalized for acute decompensated heart failure. Am J Cardiol. 2017;119:1623–30.

    Article  PubMed  Google Scholar 

  36. Sciagrà R, Parodi G, Migliorini A, Memisha G, Antoniucci D, Pupi A. Evaluation of the influence of age and gender on the relationships between infarct size, infarct severity, and left ventricular ejection fraction in patients successfully treated with primary percutaneous coronary intervention. J Nucl Cardiol. 2010;17:444–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Ji Young Kim and Hwan-Cheol Park contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea

    Ji Young Kim

  2. Department of Internal Medicine, College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea

    Hwan-Cheol Park

  3. Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea

    Soo Jeong Kim, Hyung Seok Chang & Young Hwan Kim

  4. Department of Nuclear Medicine, Hanyang University Seoul Hospital, Seoul, Republic of Korea

    Hyung ** Choi

Authors
  1. Ji Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hwan-Cheol Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Soo Jeong Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hyung Seok Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hyung ** Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Young Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Young Hwan Kim.

Ethics declarations

Conflict of Interest

Ji Young Kim, Hwan-Cheol Park, Soo Jeong Kim, Hyung Seok Chang, Hyung ** Choi, and Young Hwan Kim declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was not obtained due to retrospective review study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, J.Y., Park, HC., Kim, S.J. et al. Assessment of Left Ventricular Ejection Fraction by Thallium-201 Myocardial SPECT-CT in Patients with Angina Pectoris: Comparison with 2D Echocardiography. Nucl Med Mol Imaging 53, 136–143 (2019). https://doi.org/10.1007/s13139-019-00575-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13139-019-00575-0

Keywords

Search

Navigation