1. Department of Nuclear Medicine Asan Medical Center, Seoul, Korea
The correlation analysis of
Stress / Rest Ejection Fraction of 201Tl
gated myocardial perfusion SPECT
Department of Nuclear Medicine Asan Medical Center, Seoul, Korea
Dong Seok Kim

2. Contents Introduction Purpose Materials and Method Results Conclusion1
Purpose 2
Materials and Method 3
Results 4
Conclusion 5

3. Introduction Gated myocardial perfusion SPECT
Important diagnostic and prognostic information
- ventricular wall motion thickening information
Achieve additional information from patients without additional scan

4. Possibility of stress induced
Introduction
Inacurracy of heart function - underestimation of heart volume - overestimation of Ejection fraction
Possibility of stress induced
myocardial stunning
The problem of gated SPECT

5. Purpose 1 2 3 Insufficiency of investigation of 201Tl Gated SPECT
Determination of Stress/Rest data correlation 1
Insufficiency of investigation of 201Tl Gated SPECT 2
Determination of EF variation predictors

6. Materials and method Term Object Equipment Feb. 2008 ~ Feb. 2009
Nuclear Medicine of ASAN Medical Center
Object
144 patients with Tl-201 myocardial perfusion SPECT
Equipment
INFINIA(GE)

7. Materials and method 1. Radionuclide : 201Tl 3mCi 2. Collimator : LEGP
3. 201Tl Gamma Spectrum : keV, 167keV photo peak %,10% window level
4. Acquisition time : per 6° 50sec

8. Materials and method
EDV ml[8] ESV ml[4] EF %

9. Stress functional data
Analysis
The comparison of Stress/Rest functional data
Stress functional data
Rest functional data
Text
Matched Paired t-test
Bland-Altman analysis

10. Stress/Rest matched pairs (p)
Results
Functional data of Stress and Rest studies
EF(%)
EDV(mL)
ESV(mL)
Stress mean
60.9 ( )
79.2 ( )
33 ( )
Rest mean
61.5 ( )
71.4 ( )
29.6 ( )
Stress/Rest matched pairs (p)
0.11
<0.01
Values in parentheses represent 95% CI

11. Results The comparison of Stress/Rest functional data EF (r= 0.92)
EDV (r= 0.95)
ESV (r= 0.96)

12. Results
Bland-Altman analysis of mean of stress/rest matched pairs versus ΔEF
There was no statistically significant difference(p=0.10)

13. Reversible perfusion defect
Results
Independent predictors of statistically ΔEF difference
Mean ΔEF(%)
P value
Stress EF < 55%
-2.02
0.01
Rest ESV < 28mL
-0.96
0.04
Reversible perfusion defect
-2.16

14. Phamarcologic method - Only use adenosine
Limitation 1
Disregard of other factor
Arrythmia
exam time interval ` 2
Phamarcologic method - Only use adenosine

15. Conclusion 1 2 Like 99mTc-MIBI studies,
there was no statistically significant difference mostly.
The clinical application of predictors of EF variability.
- useful to expect statistically significant EF variation.

16. Thank You !