scholarly journals Diagnostic value of simultaneous 99mTc-sestamibi/123I-BMIPP imaging parameters for predicting the improvement of left ventricular wall motion after acute myocardial infarction using CZT SPECT system

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Hida ◽  
Y Fujita ◽  
T Hatano ◽  
T Morishima ◽  
J Yamashita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Wall Motion ◽  
Chronic Phase ◽  
Chi Square ◽  
Dual Isotope ◽  
Czt Spect ◽  
Spect System ◽  
99Mtc Sestamibi

Abstract Background Although the presence of 99mTc-sestamibi/123I-BMIPP-mismatch, the reverse redistribution (RR) of 99mTc-sestamibi and RR of 123I-BMIPP in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of LV wall motion in the infarcted territory in chronic phase, few studies were performed to analyze them by simultaneous dual-isotope imaging using cadmium-zinc-telluride (CZT) SPECT system. Purpose The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP-mismatch or RR of 99mTc-sestamibi, RR of 123I-BMIPP make better prediction of the improvement of LV wall motion in the infarcted territory. Methods We evaluated 42 consecutive patients with AMI who had undergone both dual-isotope SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS. Results Of 42 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 29 patients. The presence of 99mTc-sestamibi/123I-BMIPP-mismatch and RR of 99mTc-sestamibi and RR of 123I-BMIPP were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.0001 and p=0.002, respectively). To predict the improvement of LV wall motion in the infarcted territory in chronic phase, the presence of 99mTc-sestamibi/123I-BMIPP-mismatch showed sensitivity of 93%, specificity of 85% and accuracy of 91%, while RR of 99mTc-sestamibi and RR of 123I-BMIPP had sensitivities of 72%, 48%, specificities of 85%, 100% and accuracies of 76%, 64%, respectively. The multivariate discriminant analysis revealed that the combination of 99mTc-sestamibi/123I-BMIPP-mismatch, RR of 99mTc-sestamibi and RR of 123I-BMIPP best predicted the improvement of LV wall motion in the infarcted territory in chronic phase with sensitivity of 93%, specificity of 85% and accuracy of 91% (chi-square=40.6), compared with RR of 99mTc-sestamibi and RR of 123I-BMIPP only (sensitivity 79%, specificity 85% and accuracy of 81%, chi-square=16.9). Conclusions The addition of 99mTc-sestamibi/123I-BMIPP-mismatch on RR of 99mTc-sestamibi and RR of 123I-BMIPP in patients with AMI, help better predict the improvement of LV wall motion in the infarcted territory in chronic phase. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Prediction of the improvement of left ventricular wall motion after acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP using cadmium-zinc-telluride SPECT

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Hida ◽  
Y Fujita ◽  
Y Igarashi ◽  
T Hatano ◽  
T Morishima ◽  
...  
Keyword(s):  
Acute Phase ◽  
Wall Motion ◽  
Chronic Phase ◽  
Left Ventricular ◽  
Reverse Redistribution ◽  
Dual Isotope ◽  
Czt Spect ◽  
Spect System ◽  
Cadmium Zinc ◽  
99Mtc Sestamibi

Abstract Background/Introduction Although both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in patients with acute myocardial infarction (AMI) are known to significant markers for predicting the improvement of left ventricular (LV) wall motion in the infarcted territory in chronic phase, few studies evaluated them by simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) imaging using cadmium-zinc-telluride (CZT) SPECT system. Purpose The purpose of this study was to evaluate whether the presence of 99mTc-sestamibi/123I-BMIPP mismatch or the reverse redistribution of 99mTc-sestamibi make better prediction of the improvement of LV wall motion in the infarcted territory. Methods We evaluated 30 consecutive patients with AMI who had undergone both dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Both 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were determined using traditional definition. The improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was assessed using QGS. Results Of 30 patients, the improvement of LV wall motion in the infarcted territory from acute phase to chronic phase was found in 20 patients. Both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and reverse redistribution of 99mTc-sestamibi were significantly linked to predict the improvement of LV wall motion (p=0.0001, p=0.011, respectively). The respective sensitivities, specificities and accuracies in the prediction of the improvement of LV wall motion in the infarcted territory were 90%, 90% and 90% with 99mTc-sestamibi/123I-BMIPP mismatch, and 60%, 90%, 70% with reverse redistribution of 99mTc-sestamibi. Conclusions In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging using CZT SPECT system, both the presence of 99mTc-sestamibi/123I-BMIPP mismatch and the reverse redistribution of 99mTc-sestamibi in acute phase are useful for predicting the improvement of LV wall motion in chronic phase, but the presence of 99mTc-sestamibi/123I-BMIPP mismatch is superior to the reverse redistribution of 99mTc-sestamibi for it. Funding Acknowledgement Type of funding source: None

Prediction of myocardial viability in chronic phase in patients with acute myocardial infarction by simultaneous dual-isotope imaging with 99mTc-sestamibi/123I-BMIPP SPECT using CZT camera system

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Fujita ◽  
S Hida ◽  
Y Igarashi ◽  
T Hatano ◽  
T Morishima ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Phase ◽  
Myocardial Viability ◽  
Chronic Phase ◽  
Optimal Cutoff ◽  
Dual Isotope ◽  
Cutoff Values ◽  
Coronary Territory ◽  
99Mtc Sestamibi

Abstract Objectives The objective of this study was to determine the optimal cut-off value of % uptake of simultaneous dual-isotope (99mTc-sestamibi/123I-BMIPP) SPECT in patients with acute myocardial infarction (AMI) for prediction of myocardial viability in chronic phase. Methods We evaluated 30 consecutive patients with AMI who had undergone both dual-SPECT in acute phase and stress myocardial SPECT using 99mTc-tracers in chronic phase by Discovery NM530c. Regional % uptake with a 17-segment model was obtained using QPS software. The presence of myocardial viability was defined when regional % uptake ≥50% in 99mTc SPECT at rest in chronic phase was observed. Receiver operating characteristic (ROC) curves were analyzed to determine the optimal cutoff values of regional % uptake in both left anterior descending artery (LAD) territory and non-LAD coronary territory in acute phase to predict the myocardial viability in chronic phase. Results The cutoff values for prediction of viable myocardium were %uptake ≥47% for 99mTc-sestamibi, %uptake ≥31% for 123I-BMIPP in acute phase in LAD territory and %uptake ≥52% for 99mTc-sestamibi, %uptake ≥48% for 123I-BMIPP in non-LAD territory. The respective sensitivities, specificities and the area under the ROC curve (AUC) values in the prediction of myocardial viability were 92%, 92% and 0.94 with 99mTc-sestamibi, 90%, 85%, 0.92 with 123I-BMIPP in LAD territory, and 81%, 93% and 0.92 with 99mTc-sestamibi, 81%, 90%, 0.92 with 123I-BMIPP in non-LAD territory. There were no significant differences in AUC values between 99mTc-sestamibi and 123I-BMIPP in both LAD territory and non-LAD coronary territory. Conclusions In the simultaneous 99mTc-sestamibi/123I-BMIPP dual-isotope imaging in patients with AMI, these results suggest that not only 99mTc-sestamibi SPECT, but also 123I-BMIPP SPECT may be possible to predict the presence of myocardial viability in chronic phase. But it should be noted that the optimal cutoff values of regional % uptake in acute phase to predict the myocardial viability may differ for LAD territory and non-LAD coronary territory. Funding Acknowledgement Type of funding source: None

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