Evaluation of left ventricular function by 99Tcm-MIBI/18F-FDG gated myocardial tomography with dual isotope simultaneous acquisition

Objective: To evaluate the accuracy of left ventricular ejection fraction (LVEF) and regional wall motion measured by gated SPECT with dual isotope [99Tcm-methoxyisobutylisonitrile (MIBI) and 18F-fluorodeoxyglucose (FDG)] simultaneous acquisition (DISA). Methods: Seventy-seven patients with coronary artery disease (CAD) underwent 99Tcm-MIBI/18F-FDG myocardial gated SPECT with DISA using a dual-head SPECT system equipped with ultra-high-energy collimators. LVEF obtained by gated SPECT was measured using a commercially available software. Contrast left ventriculography (LVG) was performed as well in 53 patients separately from myocardial SPECT within (6.0+-8.6) d apart from each other. Results: LVEF was (38.3 +- 13.6)% obtained by 99Tcm-MIBI, (39.5 +- 13.5)% by 18F-FDG, respectively. Correlation between LVEF measured by 99Tcm-MIBI and 18F-FDG gated SPECT was excellent (r=0.90, P<0.001). Both LVEFs determined by 99Tcm-MIBI (r=0.86, P<0.001) and 18F-FDG (r=0.85, P<0.001) gated SPECT correlated well to that determined by contrast ventriculography. Correlation of regional wall motion measured by LVG with that come from gated SPECT of both isotopes was good with the Kappa value being 0.765 (99Tcm-MIBI) and 0.742 (18F-FDG), respectively. Conclusions: Left ventricular global and regional function can be accurately measured using 99Tcm-MIBI/18F-FDG myocardial gated SPECT with DISA. It is thus feasible to obtain the information about left ventricular myocardial perfusion, metabolism and function simultaneously