News | April 01, 2009

Gated SPECT Found as More Accurate Predictor of IHD, Study Says

April 1, 2009 - In a study comparing the ability of various medical techniques to accurately determine the extent of heart disease and stratify patients according to disease severity, researchers found that myocardial perfusion testing with gated single photon emission computed tomography (gated SPECT) was a more accurate predictor of prognosis in chronic ischemic heart disease (IHD)—a painful condition caused by a temporary reduction of oxygen-rich blood to the heart.

The research was published in the April issue of The Journal of Nuclear Medicine.

For the study, researchers selected a group of patients with known or suspected—albeit stable—IHD. Those with previous coronary artery bypass surgery, chronic kidney failure and hyperthyroidism were excluded, leaving 492 study subjects between the ages of 55 and 75. Each of these underwent a complete diagnostic work-up that included a medical history, physical examination, blood tests, electrocardiography at rest, two-dimensional echocardiography and myocardial perfusion imaging (gated SPECT) after stress and at rest.

Patients also underwent coronary angiography, which is currently the standard clinical procedure for diagnosing IHD, according to the American Heart Association. This invasive test is performed by inserting a catheter into the femoral artery of the leg and threading it into the aorta. A contrast dye is then injected, and X-rays record areas where narrowing or blockage in one or more coronary arteries has occurred.

During the next 37 months, patients returned for periodic examinations in an outpatient setting. Armed with the resulting data, the researchers determined that of the techniques investigated—including coronary angiography—gated SPECT is the best predictor of future cardiac events.

“The prognostic value of stress testing with myocardial perfusion imaging has been investigated for several years,” said Alessia Gimelli, M.D., at the Clinical Physiology Institute CNR, G. Monasterio Foundation in Pisa, Italy. “However, substantial changes in nuclear cardiology have occurred over the past two decades that have led to improved techniques. The clinical profile of patients with IHD has also changed, with patients often being older and affected by more diseases than in the past. We were therefore surprised to see that gated SPECT remains the best predictor of future cardiac events in patients with IHD.”

Furthermore, although left ventricular ejection fraction (the heart’s action of pumping blood into the body) is more commonly used in clinical practice to predict patient outcome, this study revealed that the extent of damage to the heart muscle—as shown in the SPECT images—is a better prognosticator of how patients will fare. This ability to identify individuals at risk for future cardiac events, such as heart attacks, has considerable appeal because the early initiation of preventive therapies may alter the course of the disease, noted the researchers.

“Risk stratification allows us to categorize patients according to the severity of their disease and risk of future cardiac events,” said Dr. Gimelli. “As a result, we are able to allocate resources where needed and treat the sickest patients more aggressively.”

Gated SPECT is a noninvasive nuclear medicine procedure involving an injection of a small amount of radioactive material that circulates in the bloodstream to show if the heart muscle is receiving adequate blood supply under stress and/or rest conditions, explained the researchers. SPECT imaging performed after stress reveals the distribution of the radiopharmaceutical and therefore the relative myocardial perfusion (blood flow in the heart) to the different regions of the heart muscle. The resulting set of SPECT images provides quantitative information regarding myocardial perfusion after stress and at rest, as well as the heart as it contracts.

Myocardial perfusion imaging stress testing is sensitive to even the most modest changes in blood flow and can determine whether the heart is receiving enough blood and oxygen. In this way, gated SPECT provides information regarding the presence of myocardial infarction and myocardial ischemia, explained Dr. Gimelli.

Co-authors of “Stress/Rest Myocardial Perfusion Abnormalities by Gated SPECT: Still the Best Predictor of Cardiac Events in Stable Ischemic Heart Disease” include Alessia Gimelli, Patrizia Landi, Paolo Marzullo, Giorgio Iervasi, and Daniele Rovai, CNR Clinical Physiology Institute, G. Monasterio Foundation, Pisa, Italy; Giuseppe Rossi, Unit of Biostatistics and Epidemiology, CNR Clinical Physiology Institute, G. Monasterio Foundation, Massa, Italy; and Antonio L’Abbate, CNR Clinical Physiology Institute, G. Monasterio Foundation and Scuola Superiore Sant’Anna, Pisa, Italy.

For more information:

Related Content

MIM Software Inc. Receives FDA 510(k) Clearance for Molecular Radiotherapy Dosimetry
Technology | Nuclear Imaging | January 16, 2019
MIM Software Inc. received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for molecular radiotherapy...
Videos | SPECT-CT | December 12, 2018
This is a walk around of the new Spectrum Dynamics Veriton SPECT-CT nuclear imaging system introduced at the 2018 ...
Spectrum Dynamics Sues GE for Theft, Misappropriation of Trade Secrets and Unfair Competition
News | SPECT Imaging | December 06, 2018
Single-photon emission computed tomography (SPECT) cardiac imaging company Spectrum Dynamics filed a lawsuit Dec. 6,...
A PET/CT head and neck cancer scan.

A PET/CT head and neck cancer scan.

Feature | Nuclear Imaging | November 05, 2018 | By Sabyasachi Ghosh
“Experimental validation implemented in real-life situations and not theoretical claims exaggerating small advantages
Technology and Radionucleotide Development Will Fuel Mobile Gamma Camera Adoption
News | Nuclear Imaging | September 27, 2018
Advancements in healthcare technology, particularly in the surgery category, have led to an increasing adoption of...
Brain Study of 62,454 Scans Identifies Drives of Brain Aging
News | SPECT Imaging | August 27, 2018
In the largest known brain imaging study, scientists from five institutions evaluated 62,454 brain single photon...
Siemens Healthineers Announces FDA Clearance of syngo.via VB30 Molecular Imaging Software
Technology | Nuclear Imaging | July 16, 2018
At the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), June 23-26 in Philadelphia...
MILabs Introduces Futuristic PET Capabilities on New VECTor6 System
Technology | PET Imaging | June 28, 2018
At the 2018 Society of Nuclear Medicine and Molecular Imaging (SNMMI) annual meeting, June 23-26, in Philadelphia,...
New ASNC SPECT Imaging Guideline Addresses Advances in Myocardial Perfusion Imaging
News | SPECT Imaging | June 21, 2018
The American Society of Nuclear Cardiology (ASNC) has published an update to its 2010 guidelines for single photon...