Poyraz, Nilüfer Yıldırım Ankara Atatürk Training and Research Hospital, - Department of Nuclear Medicine, Turkey , Akdemir, Ümit Özgür Gazi Üniversitesi - Faculty of Medicine - Department of Nuclear Medicine, Turkey , Özdemir, Elif Ankara Atatürk Training and Research Hospital - Department of Nuclear Medicine, Turkey , Ünlü, Mustafa Gazi Üniversitesi - Faculty of Medicine - Department of Nuclear Medicine, Turkey

COMPARISON OF BLOOD POOL GATED SPECT WITH THREE DIFFERENT GATED MYOCARDIAL PERFUSION SPECT PROGRAMS FOR LEFT VENTRICULAR FUNCTIONAL PARAMETERS IN PATIENTS WITH LOW LIKELIHOOD FOR CAD

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Purpose: To compare several gated myocardial perfusion SPECT (gMPS) programs with blood pool gated SPECT (BPGS) for the evaluation of left ventricular (LV) functional parameters and further investigate the effect of heart size in a population with low coronary artery disease (CAD) risk. Materials and Methods: Forty patients whose gMPS were seen to be normal were included. Rest blood pool studies were performed in patients 3 days after the evaluation of gMPS, and the data were processed with 3 different programs: Emory Cardiac Toolbox (ECT), Quantitative Gated SPECT (QGS), and 4D-MSPECT. The results of each program were evaluated using BPGS as the reference method and all programs were compared with each other. Patients were also grouped according to their end systolic volumes (ESV) with BPGS; the ESV 30 ml (small heart) group was compared to group 2 (ESV 30 ml) for functional parameters. Repeated measures ANOVA, linear regression, and Bland-Altman analysis were used to compare the methods. Results: All gMPS programs were well correlated with BPGS, while 4D-MSPECT had the best correlation. Mean differences in EF between gMPS programs and BPGS were not significant, except for ECTb, with which EF values were significantly higher from BPGS. No statistically significant differences were observed between BPGS and gMPS programs for mean end diastolic volume (EDV) values. However, ESV values from ECT and 4D MSPECT programs were significantly lower than those from BPGS. EF values were significantly higher in patients with small hearts for all methods. The closest EF values to the reference method values were calculated with 4D MSPECT in group 1 and with QGS in group 2. Conclusion: gMPS programs yield accurate and reliable results in the assessment of myocardial function in addition to myocardial perfusion. In all patient groups and the small heart group, the closest LVEF values to those of the reference method were calculated with 4D-MSPECT. Overestimation of LVEF in small hearts is the major problem of gMPS methods and also ERNA and BPGS. In this study the lowest overestimations of LVEF values were obtained with QGS in small hearts.

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EF , Blood , Pool Gated SPECT , Gated MPS

Fırat Medical Journal

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