Quantitative gated myocardial perfusion single photon emission computed tomography improves the prediction of regional functional recovery in akinetic areas after coronary bypass surgery: useful tool for evaluation of myocardial viability

Abstract

The regional functional index calculated by electrocardiogram-gated SPECT indicated that wall thickening was well correlated with functional recovery compared with wall motion or perfusion uptake. This suggests that the wall thickening calculated by electrocardiogram-gated SPECT may be more useful to predict functional recovery than regional myocardial perfusion. Or, it could suggest that in addition to perfusion uptake, wall thickening could enhance the objective assessment of myocardial viability.

Evaluation of myocardial perfusion and viability in coronary artery disease in view of the new revascularization guidelines

“…During GSPECT acquisi tion a viable myocardium shows at least 50% of the maximal marker accumulation compared to the reference best bloodsupplied myocardial region (assuming that it is nondamaged myocardium) and systolic increase in the myocardial thickness of at least 10% in ECGgated SPECT registration. These SPECT parameters show that the myocardial functions are likely to improve in more than 70% of postrevascularisation patients [17]. In other studies, the level of marker accumulation during SPECT registration below 30% of the maximal reference value shows that there is an 80% probability of myocardial nonviability, i.e.…”

“…It is the cheapest and most widely available viability imaging method among 99mTcMIBIbased functional SPECT proce dures -only a viable myocardium shows an appropriate level of perfusion at rest and systolic increase in the myocardial thick ness during GSPECT registration [16,17]. During GSPECT acquisi tion a viable myocardium shows at least 50% of the maximal marker accumulation compared to the reference best bloodsupplied myocardial region (assuming that it is nondamaged myocardium) and systolic increase in the myocardial thickness of at least 10% in ECGgated SPECT registration.…”

Long-Term Survival of Patients with Viable and Nonviable Aneurysms Assessed by 99mTc-MIBI SPECT and 18F-FDG PET: A Comparative Study of Medical and Surgical Treatment

“…A third limitation was that a 9-segment rather than the standard 17-segment model was used for image-based analysis of regional radiotracer activity concentrations and wall motion. The same segmentation approach had been used in our prior studies (7,16), as well as by another group (17), and afforded adequate evaluation and grading of perfusion and metabolism and of wall motion in LV aneurysms. A fourth limitation was that our study had the intrinsic technical limitation of SPECT perfusion imaging.…”

“…1). A 9-segment model was used rather than the standard 17-segment model of our prior study (7,16) and another study (17) because the 9-segment model better separated aneurysmal from nonaneurysmal regions and better corresponded to echocardiography. The LV contained the aneurysmal and nonaneurysmal regions (perianeurysmal plus remote aneurysmal).…”

Co-Registration of Cardiac MRI and Rest Gated SPECT in the Assessment of Myocardial Perfusion, Function and Viability

“…The SPECT perfusion study is an established procedure used for diagnosing myocardial perfusion and viability, but it may miss small or subendocardial necrosis due to its spatial resolution comparable to myocardial wall thickness (27)(28)(29)(30)(31). On the other hand, perfusion SPECT produces sum up 3-D images of stress and rest myocardial perfusion covering the whole left ventricle myocardium and with higher signal to background contrast in comparison to perfusion MRI.…”