Accuracy of left ventricular ejection fraction determined by gated myocardial perfusion SPECT with Tl-201 and Tc-99m sestamibi: Comparison with first-pass radionuclide angiography

Background. We compared estimates of left ventricular ejection fraction (LV EF) assessed by gated single photon emission computed tomography (SPECT), u sing both technetium-99m sestamibi and thallium-201, with those obtained by first-pass radionuclide angiography (FPRNA) in patients with a broad spect rum of LVEF and perfusion abnormalities. Methods. Sixty-three patients were randomly selected to undergo a dual isot ope gated SPECT study (rest T1-201 followed by adenosine Tc-99m sestamibi s cintigraphy), Studies were processed by use of the Cedars quantitative gate d SPECT software. FPRNA was acquired during an intravenous bolus injection of Tc-99m sestamibi and processed with a commercially available software. Results. The estimates of LVEF were similar (P = NS) with T1-201 gated SPEC T (54% +/- 15%), Tc-99m gated SPECT (54% +/- 16%), and FPRNA (54% +/- 12%), There was an excellent correlation between Tc-99m and T1-201 gated SPECT ( Pearson's r = 0.92, P <.0001), There were also good linear correlations bet ween Tc-99m sestamibi gated SPECT and FPRNA (Pearson's r = 0.85, P <.0001), as well as between T1-201 gated SPECT and FPRNA (Pearson's r = 0.84, P <.0 001). In the 16 patients with LVEF < 50%, Tc-99m sestamibi gated SPECT and FPRNA (Pearson's r = 0.84, P <.0001) and T1-201 gated SPECT and FPRNA (Pear son's r = 0.92, P <.0001) correlated well. Conclusion. LVEF can be accurately assessed by gated SPECT with either Tc-9 9m sestamibi or T1-201 in properly selected patients with normal or depress ed left ventricular function.