Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167, Bei Li Shi Lu, Beijing, 100037, People's Republic of China.
Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
J Nucl Cardiol. 2021 Apr;28(2):560-574. doi: 10.1007/s12350-019-01709-9. Epub 2019 Apr 16.
This study aimed to compare the accuracy of gated-SPECT (GSPECT) and gated-PET (GPET) in the assessment of left ventricular (LV) end-diastolic volumes (EDVs), end-systolic volumes (ESVs) and LV ejection fractions (LVEFs) among patients with prior myocardial infarction (MI).
One hundred and sixty-eight consecutive patients with MI who underwent GSPECT and GPET were included. Of them, 76 patients underwent CMR in addition to the two imaging modalities. The measurements of LV volumes and LVEF were performed using Quantitative Gated SPECT (QGS), Emory Cardiac Toolbox (ECTB), and 4D-MSPECT (4DM).
The correlation between GPET, GSPECT, and CMR were excellent for LV EDV (r = 0.855 to 0.914), ESV (r = 0.852 to 0.949), and LVEF (r = 0.618 to 0.820), as calculated from QGS, ECTB, and 4DM. In addition, subgroup analysis revealed that EDV, ESV, and LVEF measured by GPET were accurate in patients with different extents of total perfusion defect (TPD), viable myocardium, and perfusion/metabolic mismatch. Furthermore, multivariate regression analysis identified that mismatch score was associated with the difference in EDV (P < 0.05) measurements between GPET and CMR.
In patients with MI, LV volumes and LVEF scores measured by both GSPECT and GPET imaging were comparable to those determined by CMR, but should not be interchangeable in individual patients.
本研究旨在比较门控 SPECT（GSPECT）和门控 PET（GPET）在评估既往心肌梗死（MI）患者左心室（LV）舒张末期容积（EDV）、收缩末期容积（ESV）和 LV 射血分数（LVEF）方面的准确性。
共纳入 168 例接受 GSPECT 和 GPET 检查的 MI 连续患者。其中，76 例患者除两种影像学方法外还接受了 CMR 检查。LV 容积和 LVEF 的测量使用定量门控 SPECT（QGS）、Emory 心脏工具包（ECTB）和 4D-MSPECT（4DM）进行。
GPET、GSPECT 和 CMR 之间的 LV EDV（r=0.855 至 0.914）、ESV（r=0.852 至 0.949）和 LVEF（r=0.618 至 0.820）的相关性均非常好，如通过 QGS、ECTB 和 4DM 计算得出。此外，亚组分析显示，在不同程度总灌注缺陷（TPD）、存活心肌和灌注/代谢不匹配的患者中，GPET 测量的 EDV、ESV 和 LVEF 准确。此外，多元回归分析发现，不匹配评分与 GPET 和 CMR 之间 EDV 测量值的差异有关（P<0.05）。
在 MI 患者中，GSPECT 和 GPET 成像测量的 LV 容积和 LVEF 评分与 CMR 测定值相当，但在个体患者中不能互换。
