Left ventricular dyssynchrony assessment by phase analysis from gated PET-FDG scans

• Published in: Journal of nuclear cardiology Vol. 18; no. 5; pp. 920 - 925
• Main Authors: Pazhenkottil, Aju P., Buechel, Ronny R., Nkoulou, Rene, Ghadri, Jelena-Rima, Herzog, Bernhard A., Husmann, Lars, Wolfrum, Mathias, Küest, Silke M., Fiechter, Michael, Gaemperli, Oliver, Kaufmann, Philipp A.
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 01.10.2011; Springer-Verlag; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Cardiac Resynchronization Therapy; Cardiology; Coronary Artery Bypass; Female; Fluorodeoxyglucose F18; Humans; Imaging; Left ventricular dyssynchrony; Male; Medicine; Medicine & Public Health; Middle Aged; myocardial perfusion imaging; Myocardial Perfusion Imaging - methods; myocardial viability; Nuclear Medicine; Original Article; phase analysis; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals; Ventricular Dysfunction, Left - diagnostic imaging; Left ventricular dyssynchrony; myocardial perfusion imaging; myocardial viability; phase analysis
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-011-9411-y

The outcome of patients with severe ischaemic left ventricular (LV) dysfunction is determined by the extent of myocardial viability and the presence of LV dyssynchrony. We aimed at assessing both parameters from the same imaging method, i.e. gated positron emission tomography (PET) F18-fluorodeoxyglucose (FDG) scans. Phase analysis from Emory Cardiac Toolbox was applied on gated PET-FDG scans to assess histogram bandwidth and standard deviation (SD) as a measure of LV dyssynchrony in 30 heart failure patients (mean ejection fraction: 30.2% ± 13.8%) referred for the evaluation of myocardial viability. Cut-off values from single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) best predicting cardiac resynchronization therapy (CRT) response served as standard of reference (bandwidth < 135°; phase SD < 43°). Severe LV dyssynchrony was diagnosed if both SPECT-MPI values were above these limits. Intraclass correlation and clinical agreement in detection of severe LV dyssynchrony by PET vs SPECT were assessed. There was a significant correlation between PET-FDG and SPECT-MPI for bandwidth (r = 0.88, P < .001) and phase SD (r = 0.88, P < .001) resulting in an excellent clinical agreement between the two methods of 93%. Accurate LV dyssynchrony assessment by phase analysis of gated PET-FDG scans is feasible, allowing assessing myocardial viability and severe LV dyssynchrony in one scan.