Validation of global and segmental left ventricular contractile function using gated planar technetium-99m sestamibi myocardial perfusion imaging

Department of Medicine, University of Vermont, College of Medicine, Burlington 05401.

OBJECTIVES. The purpose of this study was to test the hypothesis that segmental wall motion analysis determined from gated planar technetium-99m sestamibi myocardial imaging is reproducible and agrees well with echocardiographic data. BACKGROUND. Technetium-99m sestamibi is a new radiopharmaceutical recently approved for myocardial perfusion imaging. Its advantages include a dosimetry that allows use of a dose 10 to 15 times higher than that of thallium-201. As a result, myocardial counts are markedly improved and images can be collected in a gated mode to potentially allow assessment of global and segmental ventricular function. However, the reproducibility and accuracy of technetium-99m sestamibi imaging for measurement of global and segmental left ventricular function have not been evaluated or compared with those of a standard ventricular function technique, such as echocardiography. METHODS. We studied 136 patients referred for clinical technetium-99m sestamibi imaging. One-day rest-stress planar technetium-99m sestamibi protocols were used, gating the stress images. After technetium-99m sestamibi imaging, all patients had standard rest two-dimensional echocardiography. Global and segmental technetium-99m sestamibi and echocardiographic left ventricular contraction was graded qualitatively as normal or abnormal using a four-point grading system. RESULTS. Interobserver and intraobserver agreement was extremely high for global and segmental technetium-99m sestamibi wall motion analysis, with absolute agreements ranging from 0.92 to 1.00 and corresponding kappa values of 0.74 to 1.00 (p < 0.00001). Agreement with global and segmental echocardiographic wall motion was similarly very high, with absolute agreements ranging from 0.93 to 1.00 and corresponding kappa values of 0.75 to 1.00 (p < 0.00001). CONCLUSIONS. Gated technetium-99m sestamibi cardiac imaging provides information with regard to rest global and segmental left ventricular systolic function that is highly reproducible and agrees very well with results of two-dimensional echocardiography.

This article has been cited by other articles:

				D. Patel, V. J.B. Robinson, R. B. Arteaga, and J. W. Thornton Diastolic Filling Parameters Derived from Myocardial Perfusion Imaging Can Predict Left Ventricular End-Diastolic Pressure at Subsequent Cardiac Catheterization J. Nucl. Med., May 1, 2008; 49(5): 746 - 751. [Abstract] [Full Text] [PDF]

				L. Spinelli, M. Petretta, W. Acampa, W. He, A. Petretta, D. Bonaduce, and A. Cuocolo Prognostic Value of Combined Assessment of Regional Left Ventricular Function and Myocardial Perfusion by Dobutamine and Rest Gated SPECT in Patients with Uncomplicated Acute Myocardial Infarction J. Nucl. Med., July 1, 2003; 44(7): 1023 - 1029. [Abstract] [Full Text] [PDF]