Comparison of post-stress ejection fraction and relative left ventricular volumes by automatic analysis of gated myocardial perfusion single-photon emission computed tomography acquired in the supine and prone positions.

BACKGROUND

We have previously described an automatic method for measuring left ventricular ejection fraction (LVEF) for myocardial perfusion single-photon emission computed tomography (SPECT). The repeatability of this method has not been previously described.

METHODS AND RESULTS

This study compares LVEF and relative end-systolic and end-diastolic volumes assessed from myocardial perfusion SPECT by our automatic method in 180 consecutive patients undergoing gated myocardial perfusion SPECT with injection of 99mTc-labeled sestamibi in whom the acquisitions were performed sequentially in supine and prone positions. The algorithm operated completely automatically in the prone and supine positions in 178 of the 180 patients. Very high correlations were observed for LVEF (r = 0.93), relative left ventricular end-systolic volume (r = 0.98), and relative left ventricular end-diastolic volume (r = 0.97). The mean paired absolute difference between LVEFs in the prone and supine position was 3.8+/-3.2, for left ventricular end-systolic volume was 4.9+/-4.8 ml, and for left ventricular end-diastolic volume was 7.4+/-6.7 ml. When patients were classified by the extent and severity of stress perfusion defect, there was no significant difference in repeatability for the measurements in any category.

CONCLUSIONS

Our algorithm for automatic quantification of LVEF and relative end-systolic and end-diastolic volumes from gated 99mTc sestamibi myocardial perfusion SPECT is repeatable. When performed in the prone position, values of ejection fractions and ventricular volumes are essentially identical to those obtained in the supine position.