Inubushi M, Tadamura E, Kudoh T, Hattori N, Kubo S, Koshiji T, Nishimura K, Komeda M, Tamaki N, Konishi J
Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Faculty of Medicine, Japan.
J Nucl Med. 1999 Nov;40(11):1840-7.
This study was designed to evaluate the methodological feasibility of 123I-labeled beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP)-gated SPECT to assess regional and global left ventricular (LV) function in comparison with 99mTc-sestamibi (methoxyisobutyl isonitrile [MIBI])-gated SPECT and first-pass radionuclide angiography (FPRNA).
Forty-four patients with stable coronary artery disease underwent rest BMIPP-gated SPECT (111 MBq, 60 s/step) and rest MIBI-gated SPECT (600 MBq, 40 s/step) within a week. From both gated SPECT studies, regional defect scores (DS), wall motion scores (WMS) and wall-thickening scores (WTS) were evaluated visually using 4-point scales for nine segments, and LV ejection fraction (EF) (%) was automatically calculated using Quantitative Gated SPECT (QGS) software. FPRNA was also performed on injection of MIBI.
Exact agreement between the two gated SPECT studies was 84.1% (kappa = 0.706, r = 0.907, P < 0.0001) in WMS and 87.1% (kappa = 0.662, r = 0.884, P < 0.0001) in WTS. LVEF obtained from BMIPP-gated SPECT linearly correlated with those from MIBI-gated SPECT (y = -0.27 + 0.944x, r = 0.948, SEE = 5.00, P < 0.0001) and FPRNA (y = -7.32 + 1.042x, r = 0.919, SEE = 6.19, P < 0.0001). Even in 21 patients with mismatch segments (BMIPP DS > MIBI DS), agreement was considered to be acceptable in WMS (81.5%, kappa = 0.707, r = 0.853, P < 0.0001) and in WTS (76.7%, kappa = 0.526, r = 0.754, P < 0.0001), and correlation in LVEF remained good between BMIPP-gated SPECT and MIBI-gated SPECT (y = -1.24 + 0.955x, r = 0.938, SEE = 6.25, P < 0.0001) or FPRNA (y = -6.03 + 1.024x, r = 0.913, SEE = 7.38, P < 0.0001).
BMIPP-gated SPECT can evaluate regional and global LV function with the QGS software. Therefore, BMIPP-gated SPECT offers the opportunity for simultaneous assessment of myocardial free fatty acid utilization and LV function.
本研究旨在评估123I标记的β-甲基-对碘苯基-十五烷酸（BMIPP）门控单光子发射计算机断层显像（SPECT）与99mTc-甲氧基异丁基异腈（MIBI）门控SPECT及首次通过放射性核素血管造影（FPRNA）相比，评估左心室（LV）局部和整体功能的方法学可行性。
44例稳定型冠状动脉疾病患者在一周内接受静息状态下的BMIPP门控SPECT（111MBq，每步60秒）和静息状态下的MIBI门控SPECT（600MBq，每步40秒）检查。从这两项门控SPECT研究中，使用4分制对九个节段进行视觉评估，得出局部缺损评分（DS）、壁运动评分（WMS）和壁增厚评分（WTS），并使用定量门控SPECT（QGS）软件自动计算左心室射血分数（EF）（%）。在注射MIBI时也进行FPRNA检查。
两项门控SPECT研究在WMS方面的完全一致性为84.1%（kappa = 0.706，r = 0.907，P < 0.0001），在WTS方面为87.1%（kappa = 0.662，r = 0.884，P < 0.0001）。从BMIPP门控SPECT获得的左心室射血分数与从MIBI门控SPECT获得的左心室射血分数呈线性相关（y = -0.27 + 0.944x，r = 0.948，标准误 = 5.00，P < 0.0001），与FPRNA获得的左心室射血分数也呈线性相关（y = -7.32 + 1.042x，r = 0.919，标准误 = 6.19，P < 0.0001）。即使在21例存在节段不匹配（BMIPP DS > MIBI DS）的患者中，WMS方面的一致性也被认为是可接受的（81.5%，kappa = 0.707，r = 0.853，P < 0.0001），WTS方面的一致性为76.7%（kappa = 0.526，r = 0.754，P < 0.0001），并且BMIPP门控SPECT与MIBI门控SPECT之间左心室射血分数的相关性仍然良好（y = -1.24 + 0.955x，r = 0.938，标准误 = 6.25，P < 0.0001），与FPRNA之间的相关性也良好（y = -6.03 + 1.024x，r = 0.913，标准误 = 7.38，P < 0.0001）。
BMIPP门控SPECT可通过QGS软件评估左心室局部和整体功能。因此，BMIPP门控SPECT为同时评估心肌游离脂肪酸利用情况和左心室功能提供了机会。
