Quantitative Tools in Nuclear Cardiology: SPECT
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Quantitative Tools in Nuclear Cardiology: SPECT Dr. Erick Alexánderson Rosas
Transcript of Quantitative Tools in Nuclear Cardiology: SPECT
Quantitative Tools in Nuclear Cardiology: SPECTDr. Erick Alexánderson Rosas
• Myocardial perfusion» Visual evaluation» Semiquantitative» Quantative
• Infarct Size» Transmurality » Viability» Percent of myocardial burden
• Gated SPECT» Wall thickness - Wall motion» Left Ventricular Ejection Fraction» Ventricular Volumes
How do we do it?First point
3 axis orientation
Visual asessmentSecond point
Severity of ischemia
E
R
E
R
E
R
E
RNormal
Moderately abnormal
Severelyabnormal
Mildlyabnormal
Infarction
Stress
Rest
Stress
Rest
Rest
Stress
SPECT
Author, year (reference) Number of pts Tracer Stress Sensitivity% Specificity%
Iskandrian, 1989 (4) 193 Thalium 201 Physical 86 62Maddahi, 1989 (5) 110 Thalium 201 Physical 95 56Mahmarian, 1990 (6) 296 Thalium 201 Physical 87 87Cramer, 1994 (11) 38 Thalium 201 Dipiridamol 90 71Kapur, 2002 (14) 2560 MIBI Adenosine 91 87
SENSITIVITY: 90 %SPECIFICITY: 73%
Semiquantitative asessmentThird point
Perfusion defectNormalMild ModerateSevereAbsent
Score01234
Perfusion defects scale
Wall motionMotion defect
NormalMild hipokinesisModerate hipokinesisSevere hipokinesisAkinesisDyskinesis
Score012345
Quantitative asessmentFourth point
SPECTSPECT
Generalidades
ViabilidadPerfusión
Miocárdica
Función ventricular
SPECT / CT
Fifth point
Case 1
• 56 yo male• Hypertension 3 years• Dyslipidemia 7 years before• Actual symptoms
– Effort angina– Dyspnea to minimal exercise, ocassionally
orthopnea
In the very near future . . .
