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

초록

Objectives: We compared reproducibility of 201Tl(Tl) and 99mTc MIBI (MIBI) gated SPECT (g-SPECT) used to quantify left ventricular volume and ejection fraction. Methods: Twently-six patients underwent two Tl g-SPECT studies in the same position; 25 patients underwent two MIBI g-SPECT studies in the same position. The quantification of enddiastolic volume (EDV), endsystolic volume (ESV) and ejection fraction (EF) with Tl and MIBI was provessed independently by the use of Cedars quantitative g-SPECT software. Results: There was no significant difference of EDV (Tl:118±39ml, MIBI: 109±40ml), ESV (Tl: 71±40 ml, MIBI : 65±35ml) and EF (Tl: 43±15%, MIBI: 42±12%) between Tl and MIBI g-SPECT (p=NS). There was excellent correlation of EDV, ESV and EF between two repeat g-SPECT with Tl(EDV: r=0.98, ESV: r=0.98, EF:r=0.92) (p<.05) as well as MIBi (EDV:r=0.98, ESV: r=0.99, EF: r=0.98) (p<.05). Bland Altman analysis showed no significant bias of EDV, ESV and EF between two repeat g-SPECT with Tl as well as MIBI. Ninety-five % limits of agreement were 25 ml, 19 ml and 11% for EDV, ESV and EF between two repeat Tl g-SPECT; 95% limits of agreement was 16 ml, 10ml and 6% for EDV, ESV and EF between two repeat MIBI g-SPECT. The geometric mean of SD was 3.3 ml, 3.5 ml and 5.4% for EDV, ESV and EF between two repeat Tl g-SPECT; the geomatric mean of SD was 2.5ml, 2.8ml and 2.6% for EDV, ESV and EF between two repeat MIBI g-SPECT. Conclusion: MIBI g-SPECT had fairly tight 95% limits of agreement and smaller geometric mean of SD for EDV, ESV and EF between two repeat g-SPECT studies compared with Tl g-SPECT. we conclude that MIBI g-SPECT is preferable to Tl g-SPECT for the assessment of left ventricular function