Accuracy of left ventricular ejection fraction determined by gated myocardial perfusion SPECT with Tl-201 and Tc-99m sestamibi: Comparison with first-pass radionuclide angiography

Research paper by Zuo-Xiang He, Eduardo Cwajg, Janice S. Preslar, John J. Mahmarian, Mario S. Verani

Indexed on: 01 Jul '99Published on: 01 Jul '99Published in: Journal of Nuclear Cardiology


We compared estimates of left ventricular ejection fraction (LVEF) assessed by gated single photon emission computed tomography (SPECT), using both technetium-99m sestamibi and thallium-201, with those obtained by first-pass radionuclide angiography (FPRNA) in patients with a broad spectrum of LVEF and perfusion abnormalities.Sixty-three patients were randomly selected to undergo a dual isotope gated SPECT study (rest Tl-201 followed by adenosine Tc-99m sestamibi scintigraphy). Studies were processed by use of the Cedars quantitative gated SPECT software. FPRNA was acquired during an intravenous bolus injection of Tc-99m sestamibi and processed with a commercially available software.The estimates of LVEF were similar (P=NS) with Tl-201 gated SPECT (54%±15%), Tc-99m gated SPECT (54%±16%), and FPRNA (54%±12%). There was an excellent correlation between Tc-99m and Tl-201 gated SPECT (Pearson’s r=0.92, P<.0001). There were also good linear correlations between Tc-99m sestamibi gated SPECT and FPRNA (Pearson’s r =0.85, P<.0001), as well as between Tl-201 gated SPECT and FPRNA (Pearson’s r=0.84, P<.0001). In the 16 patients with LVEF<50%, Tc-99m sestamibi gated SPECT and FPRNA (Pearson’s r=0.84, P<.0001) and Tl-201 gated SPECT and FPRNA (Pearson’s r=0.92, P<.0001) correlated well.LVEF can be accurately assessed by gated SPECT with either Tc-99m sestamibi or Tl-201 in properly selected patients with normal or depressed left ventricular function.