Detection of Radiation-Induced Heart Disease by Gated Myocardial Perfusion Imaging in Patients With Esophageal Cancer During RT
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Gated SPECT
Psoriasis is a chronic inflammatory disorder with an increased risk for coronary artery disease (CAD). This retrospective study aimed to evaluate the rate of myocardial ischaemia in patients with psoriasis subjected to myocardial perfusion imaging (MPI).Twelve patients with moderate to severe psoriasis that had MPI were compared to 395 MPIs randomly retrieved from our MPIs pool data. All patients had a [99mTc]tetrofosmin stress - rest single-photon emission computer tomography ([99mTc]SPECT). Summed difference scores (SDS) were calculated for stress (SSS), rest (SRS) and their difference (SDS = SSS - SRS).There was no significant difference in the frequency of abnormal MPI SPECT outcomes between patients with vs. without psoriasis (6/12 vs 214/395 respectively; p = 0.778). From the evaluation of SSS, SRS and SDS, only the SDS scores of inadequately compensated resting perfusion defects were significantly lower in patients with psoriasis (p = 0.012).Patients with moderate-to-severe psoriasis had a similar rate of abnormal SSS scans compared to control patients. However, the SDS scans were significantly lower in patients with psoriasis indicating compromised reversibility of resting perfusion defects. Larger controlled studies are needed to verify these observations.
SSS*
Emission computed tomography
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Left-ventricular ejection fraction (LVEF) can be computed from gated myocardial perfusion SPECT studies using quantitative algorithms. The purpose of this study was to compare the LVEF obtained using the conventional high-resolution parallel-hole collimator (HRC) to the Cardiofocal collimator (CFC) (Siemens Medical Systems, Hoffman Estates, IL) using a quantitative LVEF program.Thirty-four patients (15 men, 19 women; mean age = 62 y) had either treadmill or pharmacological stress testing with 25-30 mCi 99mTc sestamibi injected at peak stress. Conventional gated SPECT imaging was performed approximately 30 min poststress, first with the HRC collimator, then with the CFC, using the same acquisition parameters on a single-head gamma camera. Traditional (TRAD) determination of LVEF using planar gated blood pool and/or cardiac catherization also was obtained for each patient.The correlation in LVEF between the CFC and HRC acquisitions was excellent, r = 0.99. The correlation between CFC and TRAD LVEF was good, r = 0.95, as was the HRC and TRAD correlation, r = 0.97. The mean LVEF value for HRC was slightly less than TRAD (54% vs. 55.4%), while the CFC mean LVEF was higher (62% vs. 55.4%). Although CFC LVEF correlated well with HRC, mean LVEF value using CFC was higher than HRC.The choice of collimator may alter the LVEF obtained from gated SPECT perfusion studies.
Collimator
Gated SPECT
Collimated light
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Few studies including only a limited number of patients have compared left ventricular ejection fraction (LVEF) assessed by 2-dimensional echocardiography (2-DE) and electrocardiography-gated Tl-201 single-photon emission computed tomography (SPECT).LVEF assessment by Tl-201 gated spect is comparable with LVEF assessed by 2-DE in two different echocardiographic laboratories.Patients (n = 402) underwent Tl-201 gated SPECT in the same laboratory and 2-DE in 2 different laboratories. Patients were divided into 2 groups according to the study laboratory: group 1, at the tertiary hospital and group 2, at a community laboratory.LVEF evaluations were similar (mean LVEF: 50.73% +/- 11.67% by 2-DE vs 50.11% +/- 11.41% by SPECT in group 1 and 57.27% +/- 7.44% by 2-DE vs 57.41% +/- 8.37% by SPECT in group 2). All LVEF measurements were highly correlated (r = 0.7, P<.001). Baseline characteristics differed between the groups, with a higher prevalence of past myocardial infarction in the in-hospital vs the community echo group (46.7% vs 22.2%, P<.01), resulting in a higher LVEF in the latter, both by 2-DE (mean 50.7% +/- 11.7% vs 57.3% +/- 7.4%, P<.01) and SPECT (50.1% +/- 11.4% vs 57.4% +/- 8.4%, P<.01).The Tl-201 gated SPECT is a reliable clinical tool for LVEF assessment, with good correlation when compared to 2-DE. It may be routinely used as an alternative for patients with poor acoustic visualization and should be performed systematically in patients undergoing myocardial perfusion imaging with Tl-201.
Gated SPECT
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Objective To explore the correlation of automatic quantification of left ventricular ejection fraction (LVEF) from gated myocardial perfusion SPECT with 201Tl and rest equilibrium gated bloodpool imaging with 99mTc-red blood cell.Methods Rest gated myocardial perfusion SPECT with 201Tlwas performed on 72 cases.AUTOQUANT 4.21 software was used to measure LVEF.Rest equilibrium gated blood-pool imaging was also performed within 24 h.The values of LVEF measured by two methods were gated myocardial perfusion SPECT and rest equilibrium gated blood-pool imaging(r=0.554,P=0.000).There methods were(64.68±10.77)%and(62.46±8.99)%.The values of LVEF measured by gated myocardial perfusion SPECT was higher 3.55%than rest equilibrium gated blood-pool imaging.Conclusion There was good correlation between the LVEF measured with gated myocardial perfusion SPECT by AUTOQUANT 4.21 software and gated blood-pool imaging.The LVEF can be accurately evaluated using gated myocardial perfusion SPECT with 201Tl.The value of LVEF measured by gated myocardial perfusion SPECT was higher than rest equilibrium gated blood-pool imaging.
Key words:
Gated blood-pool imaging; Gated myocardial imaging; Thallium radioisotopes; Tomography,emission-computed,single photon
Gated SPECT
Emission computed tomography
Spect imaging
Thallium
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Gated SPECT
Pinhole (optics)
Emission computed tomography
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Gated SPECT
Emission computed tomography
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Gated cardiac single photon emission computed tomography (SPECT) is an important diagnostic tool for evaluating both myocardial perfusion and ventricular function. However, it often suffers from increased noise due to gating. In this paper we explore the use of Fourier harmonic basis functions to model the time activities across the different gates, aiming to exploit the periodicity of cardiac beating. The gated frames are reconstructed through estimation in the frequency domain along the gate dimension. We demonstrate this approach by simulating gated Tc-99m labeled sestamibi imaging based on the NURBS- based cardiac-torso (NCAT) phantom.
Gated SPECT
Torso
Basis function
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Gated SPECT
Ventricular dyssynchrony
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Emission computed tomography
Spect imaging
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OBJECTIVES: To assess the prognostic value of gated-SPECT myocardial perfusion imaging (MPI) in women after acute coronary syndrome (ACS), as well as to evaluate whether the intraventricular dyssynchrony shows any difference in women according to the type of ACS. METHODS: Ninety women (mean age: 58±9 years) admitted between April 2011 and April 2014 with diagnosis of ACS were included. They were divided in two groups: those with ST elevation myocardial infarction (STEMI) (group 1, 54 patients), and those with non-ST elevation myocardial infarction (NSTEMI) (group 2, 36 patients). All underwent a gated-SPECT two-day MPI with a stress - rest protocol. A one year clinical follow-up was done. RESULTS: Summed stress (SSS) and rest scores (SRS) were significantly greater in STEMI patients (11.33 vs. 4.86 for SSS, and 8.24 vs. 2.66 for SRS). Left ventricular ejection fraction was significantly higher in those with NSTEMI (both post-stress: 68.75% vs. 58.54% in STEMI, and at rest: 67.22% vs. 58.75%). Phase-derived standard deviation and histogram bandwidth were significantly different between both groups. STEMI patients showed a more asynchronous behavior. Fourteen adverse cardiac events appeared during follow-up. SSS and the percentage of maximal heart rate (MHR) achieved during maximal stress were associated with the occurrence of cardiac events in NSTEMI patients, but not in those with STEMI. CONCLUSION: A gated-SPECT MPI can be useful to risk stratifies women after ACS. SSS and percentage of MHR were the best predictors of adverse cardiac events among NSTEMI patients. STEMI patients showed a more asynchronous behavior.
SSS*
Gated SPECT
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