Annals of Nuclear Medicine

, Volume 20, Issue 7, pp 449–456 | Cite as

Quantification of left ventricular regional functions using ECG-gated myocardial perfusion SPECT —validation of left ventricular systolic functions—

  • Akira Yamamoto
  • Tetsuo Hosoya
  • Naoto Takahashi
  • Shin-ichiro Iwahara
  • Kazuo Munakata
Original Article



We have developed a program to quantify regional left ventricular (LV) function and wall motion synchrony using ECG-gated myocardial perfusion SPECT (MPS). This preliminary study was undertaken to validate the use of this program for estimating regional LV systolic function.


Patients were subjected to MPS by99mTc-sestamibi at rest. The study included 20 patients who were confirmed to have a low probability of coronary artery disease (LPG; low probability group), 19 heart disease patients who were examined by MPS and equilibrium radionuclide angiography (ERNA) (ERG; ERNA group), and 24 patients who were examined by MPS and 2-dimensional echocardiography (2DE) (2DEG; 2DE group). The values of the ejection fraction (EF) and peak ejection rate (PER) were estimated. The global functions evaluated by this program were compared with those obtained by ERNA in the ERG. For regional assessment, the reference values of the functional indices were obtained for 17 LV segments in LPG. The Z score, (reference average value of the segment — patient’s value of the segment)/reference standard deviation of the segment, was used for the evaluation of regional functions; a score equal to or greater than 2 was defined as abnormal. Semiquantitative visual interpretation of 2DE was used as the standard to assess wall motion. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these criteria and the relationship between 2DE grading and Z scoring were validated in 2DEG.


The values of the global EF and PER evaluated by this program correlated with those determined by ERNA (r = 0.76 and 0.58, respectively; p < 0.005 and 0.01, respectively). The sensitivities of regional EF and PER for segmental wall motion abnormalities were 86.7% and 68.7%, respectively; their specificities were 86.7% and 95.5%, respectively; their PPVs were 64.3% and 79.2%, respectively; and their NPVs were 96.0% and 91.7%, respectively. The Z scores of these indices significantly correlated with the scores determined by 2DE (rs = 0.70 and 0.68, respectively; p < 10-10).


The potential of this program to quantify the regional systolic function was validated.

Key words

gated myocardial perfusion SPECT quantitative analysis left ventricle regional function 


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  1. 1.
    Germano G, Kavanagh P, Su HT, Mazzanti M, Kiat H, Hachamoritch R, et al. Automatic reorientation of three- dimensional, transaxial myocardial perfusion SPECT images.J Nucl Med 1995; 36: 1107–1119.PubMedGoogle Scholar
  2. 2.
    Germano G, Kiat H, Kavanagh P, Moriel M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT.J Nucl Med 1995; 36: 2138–2147.PubMedGoogle Scholar
  3. 3.
    Nakata T, Katagiri Y, Odawara Y, Eguchi M, Masatoshi K, Tsuchihashi K, et al. Two- and three-dimensional assessment of myocardial perfusion and function by using technetium- 99m sestamibi gated SPECT with a combination of count and image-based techniques.J Nucl Cardiol 2000; 7: 623–632.PubMedCrossRefGoogle Scholar
  4. 4.
    Hashimoto A, Nakata T, Wakabayashi T, Kyuma M, Takahashi T, Tsuchihashi K, et al. Validation of quantitative gated single photon emission computed tomography and an automated scoring system for the assessment of regional left ventricular systolic function.Nucl Med Commun 2002; 23: 887–898.PubMedCrossRefGoogle Scholar
  5. 5.
    Sharir T, Berman DS, Waechter PB, Areeda J, Kavanagh PB, Gerlach J, et al. Quantitative Analysis of Regional Motion and Thickening by Gated Myocardial Perfusion SPECT: Normal Heterology and Criteria for Abnormality.JNucl Med 2001; 42: 1630–1638.Google Scholar
  6. 6.
    American Heart Association Working group. Standarized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart. A Statement for Healthcare Professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.Circulation 2000; 105: 539–542.Google Scholar
  7. 7.
    Kumita S, Cho K, Nakajo H, Toba M, Uwamori M, Mizumura A, et al. Assessment of left ventricular diastolic function with electrocardiography-gated myocardial perfusion SPECT: Comparison with multigated equilibrium radionuclide angiography.J Nucl Cardiol 2001; 8: 568–574.PubMedCrossRefGoogle Scholar
  8. 8.
    Sugihara H, Yonekura Y, Matsumoto, Sasaki Y. Relationship between Asynchronous Myocardial Contraction and Left Ventricular Systolic and Diastolic Function: Assessment Using the ECG-Gated Polar Map with99mTc-Methoxy- Isobutyl-Isonitrile.Circ J 2005; 69: 183–187.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Akira Yamamoto
    • 1
  • Tetsuo Hosoya
    • 2
  • Naoto Takahashi
    • 3
  • Shin-ichiro Iwahara
    • 3
  • Kazuo Munakata
    • 3
  1. 1.Department of RadiologyNippon Medical School Musashikosugi HospitalKosugi-machi, Nakahara-ku, Kawasaki, KanagawaJAPAN
  2. 2.Department of Clinical Application TechnologyDaiichi Radioisotope Laboratories, Ltd.Japan
  3. 3.Department of Internal MedicineNippon Medical School Musashikosugi HospitalJapan

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