FIRST-PASS RADIONUCLIDE ANGIOCARDIOGRAPHY WITH SINGLE-CRYSTAL GAMMA-CAMERAS

Both multicrystal and single-crystal detectors have been in use for mo re than 25 years for measurement of ejection fraction by analysis of i mages collected during the first-pass transit of radionuclides through the heart, Originally, multicrystal cameras were preferred, because t hey provided higher count rates than Anger cameras; however, over the years improvements in count rate capability and collimator design have enabled Anger cameras to perform equally well, This has become an imp ortant issue now that readily available Tc-99m agents, such as sestami bi, enable evaluation of both myocardial function and perfusion from a single injection, The technical abilities of a particular camera dete rmine which acquisition protocols are most likely to provide clinicall y useable images for the widest spectrum of patients, Electrocardiogra phic-gated list mode collection is highly desirable for first-pass ima ging, providing the greatest flexibility of data review, rebinning, an d analysis, Attention to quality control issues of data characterizati on and processing is important to ensure accuracy and precision of all measurements, Accurate determinations of ejection fraction of the lef t ventricle are possible routinely and, under favorable circumstances, of the right ventricle as well.