Functional assessment of the right ventricle with gated myocardial perfusion SPECT

Full text: Evaluation of right ventricular function can provide valuable information in a variety of cardiac and non-cardiac conditions. Functional assessment of the right ventricle is difficult owing to its anatomy and geometry. We describe a method of assessing right ventricular function using gated myocardial perfusion SPECT. In 20 patients right and left ventricular ejection fractions (RVEF, LVEF) were determined using gated blood pool (GBPS) and gated myocardial perfusion SPECT (GSPECT). To avoid contamination with right atrial activity the two frame method was adopted for gated blood pool data when measuring RVEF. In 9 patients with normal right ventricles, an index of wall thickening for the right ventricle was derived from the peak systolic and diastolic counts in the free wall. There was good linear correlation between the two methods adopted for calculation of LVEF and RVEF. Bland - Airman analysis demonstrated good agreement between the two methods with no specific bias. The mean LVEF was 47.9 +/-12% (GBPS) and 47.3 +/- 12.4 (GSPECT). The mean RVEF was 43.2 +/- 9.6% (GBPS) and 44.2 +/- 8.5% (GSPECT). In both cases the values were significantly different. The mean wall motion index was 35%. There was no correlation between the wall thickness index and ejection fraction however the index was greater in patients with normal right ventricle than in those with reduced RVER Gated SPECT offers an alternative to GBPS for the functional assessment of the right ventricle. Utilising GSPECT will allow the simultaneous assessment of both the right and left ventricles. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc