Reproducibility of gated myocardial perfusion SPECT for the assessment of myocardial function: comparison with thallium-201 and technetium-99m-MIBI

초록

Objectives: We compared the reproducibility of 201Tl and 99mTc-sestamibi (MIBI) gated SPECT (g-SPECT) for the assessment of myocardial function. Methods: G-SPECT acquisition for the assessment of myocardial function was repeated in the same position in 34 patients who received 201Tl and in 31 who received 99mTc-MIBI. The quantification of enddiastolic volume (EDV), endsystolic volume (ESV) and ejection fraction(EF) on 201Tl and 99mTc-MIBI g-SPECT were processed independently using Cedars quantitative g-SPECT software. The reproducibility of the assessment of myocardial function on 201Tl g-SPECT was compared to that of 99mTc-MIBI g-SPECT. results: Correlation between the two measurements for volumes and EF was excellent by the repeated g-SPECT studies of 201Tl (r=0.928 to 0.986; p<0.05) and 99mTc-MIBI (r=0.979 to 0.997; p<0.05). However, Bland Altman analysis revealed the 95% limits of agreement (2 SD) for volumes and EF was tighter by repeated 99mTc-MIBI g-SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5%) than by repeated 201Tl g-SPECT (EDV: 24.1 ml, ESV : 18.6 ml and EF : 10.3 %). The root mean square (RMS) values of the coefficient of variation(CV) for volumes and EFs were smaller by repeated 99mTc-MIBI g-SPECT (EDV : 2.1 ml, ESV : 2.7 ml and EF : 2.3%) than by repeated 201Tl g-SPECT (EDV : 3.2 ml, ESV: 3.5 ml and EF : 5.2%). Conclusion: 99mTc-MIBI provides more reproducible volumes and EF than 201Tl on repeated acquisition g-SPECT. 99mTc-MIBi g-SPECT is the preferable method for the clinical monitoring of myocardial function.