Abstract
This review described the diagnostic efficacy of gated myocardial SPECT and its cost-effectiveness. Normal findings on myocardial stress SPECT predict negligible hard cardiac events. This prognostic value of myocardial SPECT influences cost-effectiveness of the strategy of the diagnosis of coronary artery disease. Despite the cost of the SPECT itself, the strategy of angiography following myocardial SPECT was the most cost-effective. Gated SPECT yields information regarding myocardial contractility and help differentiate attenuation artefact. Using gated SPECT, perfusion and contraction coupling can be interpreted. The test-retest reproducibility of global and regional contractile function of gated myocardial SPECT was excellent. Gated myocardial SPECT could be used to Predict functional improvement of myocardial dysfunction and to acknowledge improvement of myocardial function. Performance of rest-24 hour delay Tl-201 SPECT for viability study was good. Rest Tl-201/ gated stress Tc-99m MIBI SPECT and 24-hour delay Tl-201 SPECT is a convenient method to diagnose coronary artery disease and myocardial viability.
References
1. Lee DS, Lee MC. Bahk Y-W, Kim EE, Isawa T, editors. Heart scan. Nuclear imaging of the chest. 1997. Berlin: Springer;239–284.
3. Lee DS, Yeo JS, Chung JK, Lee MM, Lee MC. Transient prolonged stunning induced by dipyridamole and shown on 1- and 24-hour poststress 99mTc-MIBI gated SPECT. J Nucl Med. 2000. 41:27–35.
4. Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Diamond GA, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation. 1998. 97:535–543.
5. Fleischmann KE, Hunink MG, Kuntz KM, Douglas PS. Exercise echocardiography or exercise SPECT imaging? A meta-analysis of diagnostic test performance. J Nucl Cardiol. 2002. 9:133–134.
6. Patterson RE, Eisner RL, Horowitz SF. Comparison of cost-effectiveness and utility of exercise ECG, single photon emission computed tomography, positron emission tomography, and coronary angiography for diagnosis of coronary artery disease. Circulation. 1995. 91:54–65.
7. Lee DS, kang KW, Jang MJ, Cheon GJ, Lee MM, Lee MC, et al. Cost-effectiveness of myocardial perfusion SPECT for diagnosis of coronary artery disease in Korea: comparison with exercise ECG and coronary angiography. Korean J Nucl Med. 2000. 34:207–221.
8. Lee DS, Jang MJ, Cheon GJ, Chung JK, Lee MC. Comparison of the cost-effectiveness of stress myocardial SPECT and stress echocardiography in suspected coronary artery disease considering the prognostic value of false-negative results. J Nucl Cardiol. 2002. 9:515–522.
9. Canty JM Jr, Fallavollita JA. Chronic hibernation and chronic stunning: a continuum. J Nucl Cardiol. 2000. 7:509–527.
10. Lee DS, Cheon GJ, Ahn JY, Chung JK, Lee MC. Reproducibility of assessment of myocardial function using gated 99Tc(m)-MIBI SPECT and quantitative software. Nucl Med Commun. 2000. 21:1127–1134.
11. Paeng JC, Lee DS, Cheon GJ, Lee MM, Chung JK, Lee MC. Reproducibility of an automatic quantitation of regional myocardial wall motion and systolic thickening on gated 99mTc-sestamibi myocardial SPECT. J Nucl Med. 2001. 42:695–700.
12. Lee DS, Cheon GJ, Paeng JC, Kim KB, Chung JK, Lee MC. Criteria for definition of regional functional improvement on quantitative post-stress gated myocardial SPET after bypass surgery in patients with ischaemic cardiomyopathy. Eur J Nucl Med Mol Imaging. 2002. 29:1078–1082.
13. Bax JJ, Visser FC, Poldermans D, Elhendy A, Cornel JH, Visser CA, et al. Time course of functional recovery of stunned and hibernating segments after surgical revascularization. Circulation. 2001. 104:I314–I318.
14. Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol. 2002. 39:1151–1158.
15. Bax JJ, Wijns W, Cornel JH, Visser FC, Boersma E, Fioretti PM. Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease: comparison of pooled data. J Am Coll Cardiol. 1997. 30:1451–1460.