The assessment of left ventricular mechanical dyssynchrony from gated 99m Tc-tetrofosmin SPECT and gated 18 F-FDG PET by QGS: a comparative study

J Nucl Cardiol. 2021 Jul 19. doi: 10.1007/s12350-021-02737-0. Online ahead of print.

Abstract

Background: Due to partly conflicting studies, further research is warranted with the QGS software package, with regard to the performance of gated FDG PET phase analysis as compared to gated MPS as well as the establishment of possible cut-off values for FDG PET to define dyssynchrony.

Methods: Gated MPS and gated FDG PET datasets of 93 patients were analyzed with the QGS software. BW, Phase SD, and Entropy were calculated and compared between the methods. The performance of gated PET to identify dyssynchrony was measured against SPECT as reference standard. ROC analysis was performed to identify the best discriminator of dyssynchrony and to define cut-off values.

Results: BW and Phase SD differed significantly between the SPECT and PET. There was no significant difference in Entropy with a high linear correlation between methods. There was only moderate agreement between SPECT and PET to identify dyssynchrony. Entropy was the best single PET parameter to predict dyssynchrony with a cut-off point at 62%.

Conclusion: Gated MPS and gated FDG PET can assess LVMD. The methods cannot be used interchangeably. Establishing reference ranges and cut-off values is difficult due to the lack of an external gold standard. Further prospective research is necessary.

Keywords: Gated SPECT; QGS; gated PET; left ventricular dyssynchrony; phase analysis.