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Comparative Study
. 2013 Mar;34(3):229-32.
doi: 10.1097/MNM.0b013e32835c91b9.

Left-ventricular dyssynchrony evaluated by Tl-201 gated SPECT myocardial perfusion imaging: a comparison with Tc-99m sestamibi

Chien-Cheng Chen  1 , Wen-Sheng Huang, Guang-Uei Hung, Wan-Chen Chen, Chia-Hung Kao, Ji Chen
Affiliations
Comparative Study

Left-ventricular dyssynchrony evaluated by Tl-201 gated SPECT myocardial perfusion imaging: a comparison with Tc-99m sestamibi

Chien-Cheng Chen et al. Nucl Med Commun. 2013 Mar.

Abstract

Background and purpose: Phase analysis of gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) has been validated as a reliable tool to assess left-ventricular (LV) mechanical dyssynchrony. The initial results were all confirmed from studies using technetium-99m (Tc-99m) sestamibi or tetrofosmin as the radiotracers. The purpose of this study was to evaluate the feasibility of phase analysis in thallium-201 (Tl-201) gated SPECT MPI.

Materials and methods: Seventeen patients referred from a cardiology clinic for evaluation of coronary artery disease were studied. All patients underwent both Tl-201 and Tc-99m sestamibi gated SPECT MPI within 1 week. An additional 34 patients with Tl-201 gated SPECT and 22 patients with Tc-99m sestamibi gated SPECT, who had a low likelihood of coronary artery disease, normal LV function, and normal perfusion on MPI, were used as normal controls. LV dyssynchrony parameters, including phase standard deviation (PSD) and phase histogram bandwidth (PHB), were measured using a standard phase analysis tool and compared between Tl-201 and Tc-99m sestamibi images.

Results: The LV dyssynchrony parameters correlated well (r=0.93 for PSD and r=0.84 for PHB) between Tl-201 and Tc-99m sestamibi images. The dyssynchrony parameters of Tl-201 were significantly larger than those of Tc-99m sestamibi (PSD: 24.5±12.0 vs. 17.4±9.7, P<0.001; PHB: 74.7±35.5 vs. 50.6±25.0, P<0.001). In comparison with normal controls, Tl-201 and Tc-99m sestamibi images showed concordant results.

Conclusion: LV dyssynchrony parameters correlated well between Tl-201 and Tc-99m sestamibi images, even though the values were significantly larger for Tl-201 than for Tc-99m sestamibi. Tl-201 images showed results similar to those of Tc-99m sestamibi in the diagnosis of LV dyssynchrony.

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Conflict of interest statement

Conflicts of interest

Dr Ji Chen receives royalties from the sale of Emory Cardiac Toolbox with SyncTool. For the remaining authors there are no conflicts of interest.

Figures

Fig 1
Fig 1
The correlations of left-ventricular dyssynchrony, as represented by phase standard deviation (a) and phase histogram bandwidth (b), between Tl-201 and Tc-99m MIBI SPECT MPI. MIBI, Tc-99m sestamibi; MPI, myocardial perfusion imaging; SPECT, single-photon emission computed tomography; Tc-99m, technetium-99m; Tl-201, thallium-201.
See this image and copyright information in PMC

References

    1. Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, et al. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol. 2005;12:687–695. - PubMed
    1. Henneman MM, Chen J, Ypenburg C, Dibbets P, Stokkel M, van der Wall EE, et al. Phase analysis of gated myocardial perfusion SPECT compared to tissue Doppler imaging for the assessment of left ventricular dyssynchrony. J Am Coll Cardiol. 2007;49:1708–1714. - PubMed
    1. Marsan NA, Henneman MM, Chen J, Ypenburg C, Dibbets P, Ghio S, et al. Real-time 3-dimensional echocardiography as a novel approach to quantify left ventricular dyssynchrony: a comparison study with phase analysis of gated myocardial perfusion single photon emission computed tomography. J Am Soc Echocardiogr. 2008;21:801–807. - PMC - PubMed
    1. Marsan NA, Henneman MM, Chen J, Ypenburg C, Dibbets P, Ghio S, et al. Left ventricular dyssynchrony assessed by two 3-dimensional imaging modalities: phase analysis of gated myocardial perfusion SPECT and tri-plane tissue Doppler imaging. Eur J Nucl Med Mol Imaging. 2008;35:166–173. - PMC - PubMed
    1. Henneman MM, Chen J, Dibbets P, Stokkel M, Bleeker GB, Ypenburg C, et al. Can LV dyssynchrony as assessed with phase analysis on gated myocardial perfusion SPECT predict response to CRT? J Nucl Med. 2007;48:1104–1111. - PubMed

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