Why the study?
The accuracy of calculating left ventricular volumes, ejection fraction, and mass using ECG-synchronized myocardial perfusion scintigraphy on a CZT camera compared with cardiac multislice computed tomography needed assessment.
Does ECG-synchronized myocardial perfusion scintigraphy accurately calculate hemodynamic parameters and left ventricular mass compared to cardiac multislice computed tomography in patients with suspected or established coronary heart disease?
Does ECG-synchronized myocardial perfusion scintigraphy accurately calculate hemodynamic parameters and left ventricular mass compared to cardiac multislice computed tomography in patients with suspected or established coronary heart disease?
Answers are grounded in this paper and cite their sources.
ECG-MPS significantly underestimates left ventricular volumes and overestimates mass compared to MSCT, though ejection fraction measurements remain consistent between the two modalities.
Objective . To assess accuracy in calculating the values of end-diastolic and end-systolic volumes (EDV and ESV), ejection fraction (EF), and left ventricular (LV) mass, which are obtained according to ECG-synchronized myocardial perfusion scintigraphy (ECG-MPS) on a CZT camera versus those of cardiac multislice computed tomography (MSCT). Material and methods . Thirty-four patients (mean age, 62 ± 5 years) with suspected coronary heart disease or its previously established diagnosis were examined. All the patients underwent MSCT coronary angiography and myocardial perfusion scintigraphy with 99m Tc-methyxy-isobutyl-isonitrile. For a comparative analysis, the investigators used the EDV, ESV, FV and LV mass values determined by ECG-MPS at rest and cardiac MSCT. The studies were conducted on a 64-slice SPECT/CT hybrid scanner (Discovery 570c, GE Healthcare, USA). Results . The analysis of the results obtained by both methods revealed statistically significant differences in the values of EDV (MSCT: 168 (145–210) ml; ECG-MPS: 112 (94–141) ml; p < 0.05), ESV (MSCT: 72 (49–83) ml; ECG-MPS: 44 (32–66) ml; p < 0.05), and LV mass (MSCT: 123 (107–143) g; ECG-MPS: 140 (124–168) g; p < 0.05). There were no significant differences in LV EF (MSCT: 64 (54–69)%; ECG-MPS: 61 (50–66)%; p > 0.05). There was a statistically significant correlation between the values of EDV, ESV, and LV mass (r = 0.81; r = 0.78; r = 0.82, respectively, p < 0.05) and a mean correlation of LV EF (r = 0.66; p < 0.05). The Bland–Altman analysis showed that the values of EDV, ESV, and LV mass had statistically significant differences. The consistency limits for the indicators were as follows: EDV, 9–105 ml; ESV, 9–55 ml; LV mass, 51.6–20.7 g. There was a measurement consistency only for EF (consent limits, 16.9–18.4%; p < 0.05). Linear regression equations were calculated, which allow determination of exact values for the volume indices and LV mass according ECG-MPS data. Conclusion . The scintigraphic method versus MSCT yields significantly smaller volumes (EDV and ESV) and higher LV mass. The ECG-MPS values for EDV, ESV, EF, and LV mass have a statistically significant strong correlation with MSCT findings. At the same time, a good consistency of measurements was found only for LV EF.
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Саушкин et al. (2019) studied this question.
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