Accuracy of left ventricular ejection fraction determined by gated myocardial perfusion SPECT with Tl-201 and Tc-99m sestamibi: comparison with first-pass radionuclide angiography

J Nucl Cardiol. Jul-Aug 1999;6(4):412-7. doi: 10.1016/s1071-3581(99)90007-7.


Background: We compared estimates of left ventricular ejection fraction (LVEF) assessed by gated single photon emission computed tomography (SPECT), using both technetium-99m sestamibi and thallium-201, with those obtained by first-pass radionuclide angiography (FPRNA) in patients with a broad spectrum of LVEF and perfusion abnormalities.

Methods: Sixty-three patients were randomly selected to undergo a dual isotope gated SPECT study (rest Tl-201 followed by adenosine Tc-99m sestamibi scintigraphy). Studies were processed by use of the Cedars quantitative gated SPECT software. FPRNA was acquired during an intravenous bolus injection of Tc-99m sestamibi and processed with a commercially available software.

Results: The estimates of LVEF were similar (P = NS) with Tl-201 gated SPECT (54% +/- 15%), Tc-99m gated SPECT (54% +/- 16%), and FPRNA (54% +/- 12%). There was an excellent correlation between Tc-99m and Tl-201 gated SPECT (Pearson's r = 0.92, P < .0001). There were also good linear correlations between Tc-99m sestamibi gated SPECT and FPRNA (Pearson's r = 0.85, P < .0001), as well as between Tl-201 gated SPECT and FPRNA (Pearson's r = 0.84, P < .0001). In the 16 patients with LVEF < 50%, Tc-99m sestamibi gated SPECT and FPRNA (Pearson's r = 0.84, P < .0001) and Tl-201 gated SPECT and FPRNA (Pearson's r = 0.92, P < .0001) correlated well.

Conclusion: LVEF can be accurately assessed by gated SPECT with either Tc-99m sestamibi or Tl-201 in properly selected patients with normal or depressed left ventricular function.

Publication types

  • Comparative Study

MeSH terms

  • Adenosine
  • Aged
  • Female
  • Heart / diagnostic imaging
  • Humans
  • Male
  • Myocardial Ischemia / diagnostic imaging*
  • Random Allocation
  • Stroke Volume / physiology*
  • Technetium Tc 99m Sestamibi*
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon*
  • Ventricular Function, Left / physiology*
  • Ventriculography, First-Pass*


  • Thallium Radioisotopes
  • Technetium Tc 99m Sestamibi
  • Adenosine