Comparison of 99mTc-sestamibi/18FDG DISA SPECT with PET for the detection of viability in patients with coronary artery disease and left ventricular dysfunction
Comparison of 99mTc-sestamibi/18FDG DISA SPECT with PET for the detection of viability in patients with coronary artery disease and left ventricular dysfunction
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DOI：
10.1007/s00259-005-1785-0
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发表时间：
2005-04
影响因子：
9.1
通讯作者：
R. Slart;Jeroen J. Bax;J. Boer;A. Willemsen;P. Mook;M. Oudkerk;E. Wall;D. J. Veldhuisen;P. L. Jager
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文献类型：
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作者：
R. Slart;Jeroen J. Bax;J. Boer;A. Willemsen;P. Mook;M. Oudkerk;E. Wall;D. J. Veldhuisen;P. L. Jager
目的双同位素同步采集（DISA）单光子发射计算机断层扫描（SPECT）是一种有吸引力的技术，因为它可以在一个会话中评估心肌葡萄糖代谢和灌注，但很少有关于其评估存活率的准确性的数据。在本研究中，DISA SPECT与正电子发射断层扫描（PET）检测正常和功能障碍的左心室（LV）myocardial.Methods58例慢性冠状动脉疾病和左心室功能障碍（LV射血分数33±12%）的心肌活力进行了研究。患者接受了为期1天的双嘧达莫负荷99 mTc-Sestamibi/18 F-氟脱氧葡萄糖（18 FDG）DISA SPECT和13 N-氨/18 FDG PET方案。在1周内，进行静息MRI以评估收缩功能。PET和SPECT数据进行比较，使用视觉和定量analysis.ResultsThe相关性的标准化活动的流动示踪剂99 mTc-sestamibi和13 N-氨是好的（r=0.82;P<0.001）。两种18FDG检查之间的相关性也很好（r=0.83;p< 0.001）。DISA SPECT和PET之间所有节段存活率评估的一致性为82%，κ统计量为0.59（95% CI 0.53-0.64），无显著差异;仅在功能障碍节段中，一致性为82%，κ统计量为0.63（95% CI 0.56-0.70），无显著差异。当对DISA SPECT数据进行目视分析时，DISA SPECT和PET之间的一致性为83%，κ统计量为0.58（95% CI 0.52-0.63），无显著差异。此外，有没有视觉和定量DISA SPECT分析检测violence.ConclusionThis研究显示了一个整体良好的协议之间的99 mTc-sestamibi/18 FDG DISA SPECT和PET心肌活力的评估严重左心室功能障碍的患者之间的显着差异。SPECT数据的定量或目视分析不影响与PET的一致性，表明目视评估可能足以用于临床目的。
PurposeDual-isotope simultaneous acquisition (DISA) single-photon emission computed tomography (SPECT) is an attractive technique as it permits assessment of both myocardial glucose metabolism and perfusion within a single session, but few data on its accuracy for the assessment of viability are available as yet. In the present study, DISA SPECT was compared with positron emission tomography (PET) for the detection of myocardial viability in normal and dysfunctional left ventricular (LV) myocardium.MethodsFifty-eight patients with chronic coronary artery disease and LV dysfunction (LV ejection fraction 33±12%) were studied. Patients underwent a 1-day dipyridamole stress99mTc-sestamibi/18F-fluorodeoxyglucose (18FDG) DISA SPECT and13N-ammonia/18FDG PET protocol. Within 1 week, resting MRI was performed to assess contractile function. Comparison of PET and SPECT data was performed using both visual and quantitative analysis.ResultsThe correlation of normalised activities of the flow tracers99mTc-sestamibi and13N-ammonia was good (r=0.82;p<0.001). The correlation between the two18FDG studies was also good (r=0.83;p< 0.001). The agreement for the assessment of viability for all segments between DISA SPECT and PET was 82%, with a κ-statistic of 0.59 (95% CI 0.53–0.64), without a significant difference; in dysfunctional segments only, the agreement was 82%, with a κ-statistic of 0.63 (95% CI 0.56–0.70), without a significant difference. When the DISA SPECT data were analysed visually, the agreement between DISA SPECT and PET was 83%, with a κ-statistic of 0.58 (95% CI 0.52–0.63), without a significant difference. Moreover, there was no significant difference between visual and quantitative DISA SPECT analysis for the detection of viability.ConclusionThis study shows an overall good agreement between99mTc-sestamibi/18FDG DISA SPECT and PET for the assessment of myocardial viability in patients with severe LV dysfunction. Quantitative or visual analysis of the SPECT data did not influence the agreement with PET, suggesting that visual assessment may be sufficient for clinical purposes.