Quantitative gated blood pool SPECT for the assessment of coronary artery disease at rest

Background. Planar gated blood pool imaging (GBPI) has long proven to be us eful for the noninvasive assessment of ventricular function. From a practic al viewpoint, gated blood pool single photon emission computed tomography ( GBPS) acquisition can be accomplished in the same time as a three-view plan ar series, with the benefit of a tomographic perspective that avoids chambe r overlap. Methods and Results. Quantitative gated blood pool SPECT was applied to 10 patients who underwent coronary arteriography, contrast ventriculography, a nd planar gated blood pool imaging. For each patient, the mid-short axis ob lique slice was divided into 4 discrete segments using 4 different referenc e models and 2 forms of segmentation. A center of mass (counts) fixed in th e end-diastolic frame and segmentation that bisected the ventricular septum proved to have the highest sensitivity and specificity for determining reg ional wall motion abnormalities at rest in myocardium supplied by severely diseased coronary arteries (>75%). GBPS correctly identified 19 of 21 abnor mal segments (90%), with good specificity (95%), whereas ventriculography i dentified 12 (57%) and planar GBPI identified 9 (43%) of the segments suppl ied by diseased coronaries. Conclusion, Quantitative GBPS appears to be a sensitive method for assessin g coronary artery disease at rest in myocardium perfused by severely diseas ed coronary arteries.