Evaluation of global and regional left ventricular function using technetium-99m sestamibi ECG-gated single-photon emission tomography.

We evaluated a method for the assessment of left ventricular (LV) function with technetium-99m sestamibi ECG-gated single-photon emission tomography (GSPET). GSPET was performed at rest in 21 patients. Images were reconstructed to obtain end-diastolic (ED) and end-systolic (ES) images. Endocardial and epicardial edges of the left ventricle for the ED and ES images were defined using the gradient images and the algorithm developed. LV wall thickness was measured for the mid-ventricular slices of ED and ES images at 10 degrees intervals. The systolic thickening (ST) and the LV ejection fraction [LVEF(GSPECT)] could be determined. These values were compared with the LV ejection fraction (LVEF) estimated using the gated blood pool method. There was a linear correlation between LVEF and ST (r=0.79), and LVEF and LVEF(GSPET) (r=0.87). Histograms of LV thicknesses were generated. Agreement for evaluation of regional wall motion between the method using histograms of LV thicknesses and the gated blood pool study was 92.8% (kappa=0.75). It is concluded that with an appropriate method for LV edge detection, GSPET with 99mTc-labelled perfusion agents is of use for simultaneous evaluation of myocardial perfusion and assessment of LV function.