Value of low-dose dobutamine addition to routine dual isotope gated SPECT myocardial imaging in patients with healed myocardial infarction or abnormal wall thickening by echocardiogram

Heiba, Sherif; Abdel‐Dayem, Hussein M.; Gould, Randy B.; Bernaski, Edward; Morlote, Manuel; El-Zeftawy, Hossam; Ambrose, John A.

doi:10.1016/j.amjcard.2003.10.008

Cited by 14 publications

(8 citation statements)

References 17 publications

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“…incorporating WT with other imaging information may add additional clinically useful information for directing patient management [3], and for predicting the likelihood of LV remodeling [5]. Although good agreement has been reported between visual assessment of WT by SPECT and visual assessment of WT by CMR, agreement in hypoperfused segments is less robust [12].…”

Section: Discussionmentioning

confidence: 99%

“…This includes assessment of regional wall thickening (WT), quantification of which is based on measuring regional systolic count changes [1,2]. For patients following myocardial infarction (MI), WT has been used to assess cardiac status and predict the likelihood of functional recovery [3][4][5]. In addition, visual analysis of WT has long been incorporated into assessment of LV contractility, as it significantly improves diagnostic accuracy in identifying MP defects through recognition of attenuation artifacts [6].…”

Section: Introductionmentioning

confidence: 99%

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Correspondence between gated SPECT and cardiac magnetic resonance quantified myocardial wall thickening

Nichols

Tosh

Wang

et al. 2010

Int J Cardiovasc Imaging

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Left ventricular (LV) wall thickening (WT) assessed from myocardial perfusion (MP) gated SPECT data has been reported to be a marker of functional recovery following myocardial damage. However, the accuracy of WT measurements obtained in the clinical setting rarely has been validated against an independent quantitative reference standard. The purpose of this investigation was to assess the degree to which quantified MP WT agrees with cardiac magnetic resonance (CMR) WT measurements, and to determine whether quantitation is as accurate as visual analysis in detecting abnormal regional WT. MP and ECG-gated True-FISP CMR data were analyzed for 20 patients evaluated after myocardial infarction (age 60 ± 11 years; 95% males). An experienced observer visually graded MP WT on a 5-point scale while viewing MP cines. MP WT was quantified using "Emory Cardiac Toolbox" (ECTb) algorithms. MP algorithms isolated myocardial counts and generated polar maps of WT. CMR data were analyzed by Medis "MASS" software. Manually drawn endocardial and epicardial contours were used to compute WT on CMR. CMR data also were processed for 10 age-matched normal volunteers to define the CMR WT threshold of abnormality. All computations were sampled into conventional 17 ACC/AHA LV wall segments. Receiver operating characteristics (ROC) curve analysis provided discrimination thresholds for optimal accuracy, which subsequently were used to dichotomize the MP methods. WT abnormalities also were assessed for the 3 major arterial territories, and for total numbers of abnormal segments per patient. 25% of all segments had abnormally low WT by CMR. While MP quantitation underestimated CMR WT values for segments with normal WT (26 ± 13% vs. 56 ± 28%, P < 0.0001), measurements were similar for segments with abnormal WT (4 ± 12% vs. 5 ± 9%, P = 0.45). On a segment-by-segment basis, detection of abnormal WT was more accurate by quantitative than visual analysis both for continuous variables (ROC area = 88 ± 2% vs. 80 ± 3%, P < 0.0001) and for dichotomized methods (83% vs. 76%, P = 0.04). Agreement of MP versus CMR for discriminating segments with normal from abnormal WT was significantly better for quantitative than visual analysis (κ = 0.59 vs. 0.40, P < 0.0001), with strongest agreement for left anterior descending artery territories (κ = 0.72). Total numbers of segments with abnormal WT per patient demonstrated significant correlation with CMR (r = 0.83, P < 0.0001). MP quantified LV ejection fractions and volumes also correlated well with CMR (r = 0.87 and 0.90, respectively). Quantified MP WT measurements correlated significantly with CMR values, and discriminated segments with abnormal WT from segments with normal WT more accurately than visual analysis. Therefore, quantification should be performed when analyzing regional WT by scintigraphy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correspondence between gated SPECT and cardiac magnetic resonance quantified myocardial wall thickening

Nichols

Tosh

Wang

et al. 2010

Int J Cardiovasc Imaging

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“…However, we could demonstrate that a combined approach that defines viability of hypokinetic segments according to their contractile reserve (assessed using gated SPECT under dobutamine infusion) and of a/dyskinetic segments according to their tracer activity was significantly more specific (83%) and accurate (81%) than perfusion imaging alone [106]. Other groups have confirmed the value of combining perfusion threshold and inotropic and/or ischaemic response with low-dose dobutamine, even when using 201 Tl as the perfusion tracer or with a dual-isotope imaging protocol [107][108][109]. Another most recent use of dobutamine gated SPECT is that reported by Kumita et al [110], who demonstrated a relationship between the type of contractile response, the stress-rest perfusion pattern and the fatty acid metabolic status assessed by 123 I-beta-methyl-iodophenylpentadecanoic acid.…”

Section: Gated Spect For the Assessment Of Contractile Reservementioning

confidence: 95%

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

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Background Gating of single-photon emission computed tomography (SPECT) has significantly improved the reliability and diagnostic accuracy of myocardial perfusion imaging. The functional parameters derived from this technique, mainly left ventricular volumes and ejection fraction, have been demonstrated to be accurate and reproducible. They are able to increase the detection of severe and extensive coronary artery disease and show a significant incremental prognostic power over perfusion abnormalities. Therefore, the importance given to gated SPECT functional data has progressively grown. Discussion This circumstance has further expanded the indications for myocardial perfusion imaging and strengthened its position among the different imaging modalities. Moreover, several studies show that the evaluation of ventricular function may have a leading part in justifying the execution of perfusion scintigraphy in various clinical conditions. Aim Aim of this review is to describe this evolution of gated SPECT functional assessment from a supporting rank with respect to perfusion, to a main actor position in the field of cardiac imaging.

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“…Thus, LDD MPI SPECT is a practical protocol that improves the detection of viability by simultaneous myocardial perfusion and motion analysis in addition to coronary flow reserve assessment in one study. Moreover no extra imaging time or radioactivity is required compared with the routine protocol [17,18].…”

Section: Discussionmentioning

confidence: 99%

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

Asl¹,

Mandegar²,

Roshanali³

et al. 2014

Nucl. Med. Rev.

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Value of low-dose dobutamine addition to routine dual isotope gated SPECT myocardial imaging in patients with healed myocardial infarction or abnormal wall thickening by echocardiogram

Cited by 14 publications

References 17 publications

Correspondence between gated SPECT and cardiac magnetic resonance quantified myocardial wall thickening

Correspondence between gated SPECT and cardiac magnetic resonance quantified myocardial wall thickening

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Comparison of stress dobutamine echocardiography and stress dobutamine gated myocardial SPECT for the detection of viable myocardium

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