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Clinical Investigations: CARDIOLOGY |

ECG-Gated 99mTc Single-Photon Emission CT for Assessment of Right Ventricular Structure and Function*: Is the Information Provided Similar to Echocardiography?

Franz C. Aepfelbacher; Susan B. Yeon; Kalon K. L. Ho; J. Anthony Parker; Peter G. Danias
Author and Funding Information

*From the Departments of Medicine, Cardiovascular Division (Drs. Aepfelbacher, Yeon, Ho, and Danias), and Radiology, Nuclear Medicine Division (Dr. Parker), Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA.

Correspondence to: Peter G. Danias, MD, PhD, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215; e-mail: pdanias@caregroup.harvard.edu



Chest. 2003;124(1):227-232. doi:10.1378/chest.124.1.227
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Study objective:99mTc single-photon emission CT (SPECT) and ECG-gated SPECT can visualize well the right ventricle (RV) in most patients, but their utility for assessment of the RV has not been formally evaluated. We examined whether 99mTc SPECT/ECG-gated SPECT provide similar information to transthoracic two-dimensional Doppler echocardiography (2D-ECHO) regarding RV cavity size, wall thickness, and systolic function.

Design: Retrospective analysis.

Setting: A major university teaching hospital.

Patients: A consecutive series of 194 patients with good quality stress SPECT and 2D-ECHO studies performed within 1 day of each other and no significant interim cardiac events.

Measurements and results: RV size and function were visually assessed by SPECT/ECG-gated SPECT and 2D-ECHO. RV wall thickness was visually assessed by SPECT and measured in mm in end-diastole by 2D-ECHO. Of 142 patients with normal RV cavity size by SPECT, 134 patients (94%) had normal RV cavity size by 2D-ECHO. However, of 52 patients with RV dilation by SPECT, only 9 patients (17%) had RV dilation by 2D-ECHO. A perfusion abnormality in the right coronary artery territory was significantly associated with RV dilation by SPECT (p < 0.005) and 2D-ECHO (p < 0.05). Among 150 patients with ECG-gated SPECT, only 2 patients had abnormal RV systolic function, as compared with 18 patients by 2D-ECHO. RV wall thickness measurements by SPECT and 2D-ECHO did not correlate.

Conclusions: For normal interpretations regarding RV cavity size, wall thickness, and systolic function, there is good agreement between 99mTc stress SPECT/ECG-gated SPECT and 2D-ECHO. However, there is poor overall agreement between gated SPECT/ECG-gated SPECT and 2D-ECHO regarding the presence of RV dilation, hypertrophy, and systolic dysfunction.

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