Iranian Journal of Nuclear Medicine

Iranian Journal of Nuclear Medicine

Normal perfusion and function myocardial perfusion imaging indices in Iranian normal females

Document Type : Original Article

Authors
Ali Hosseini 1
Mohammad Reza Fattahi 1
Maryam Mehrpooya 2
Ali Khosravi 3
Saeed Farzanefar 1
Mehrshad Abbasi 1
1 Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
3 Technical Department, Tabesh Parto Negar Company, Tehran, Iran
10.22034/irjnm.2022.40036
Abstract
Introduction: Normal population data is necessary for the quantification of myocardial perfusion studies (MPS). In Iran, data embedded in the Cedars Cardiac Suite, from young Californian volunteers, is used. We generated an Iranian female dataset and compared it with the original one.  
Methods: Thirty-one females aged 20-45 years without coronary artery disease risks were recruited. They underwent two-day exercise stress (Bruce protocol) and rest gated SPECT MPS. [99mTc]Tc-MIBI was injected (15 mCi) and imaging for stress and rest phases were started 60 and 90 min later, respectively, in supine and prone positions. A dual head gamma camera was used, ProSPECT (PNP, Tehran, Iran). Polar plots were extracted and a normal database generated.
Results: Visually, none of the participants presented a reversible perfusion defect. Index for transient ischemic dilation was 1.1±0.15 and 1.1±0.14, respectively for prone and supine positions; lung heart uptake ratio 0.3±0.1 and 0.28±0.1; ejection fraction 69.8±7.8 and 70±8; peak filling rate 2.9±0.75 and 2.9±0.95 end-diastolic volume/sec; and time to peak filling rate at 178±44.5 and 203±49.5 millisecond. Compared to the original prone Californian normal database, total perfusion defect for stress and rest was 12.1±6.7 and 5.3±5.2, and for the supine position 10.1±0.5.4 and 4.0±3.4, respectively.
Conclusions: Iranian normal database for MPS was generated with a remarkable difference from the original normal data.
Keywords
Iran
Normal database
Myocardial perfusion study
Female
Subjects
  1. Dori G, Denekamp Y, Fishman S, Bitterman H. Exercise stress testing, myocardial perfusion imaging and stress echocardiography for detecting restenosis after successful percutaneous transluminal coronary angioplasty: a review of performance. J Intern Med. 2003 Mar;253(3):253-62.
  2. D Jain . Technetium-99m labeled myocardial perfusion imaging agents. Semin Nucl Med. 1999 Jul;29(3):221-36.
  3. Husain SS. Myocardial perfusion imaging protocols: is there an ideal protocol? J Nucl Med Technol. 2007 Mar;35(1):3-9.
  4. Wackers FJ. Science, art, and artifacts: how important is quantification for the practicing physician interpreting myocardial perfusion studies? J Nucl Cardiol. 1994 Sep-Oct;1(5 Pt 2):S109-17.
  5. Berman DS, Kang X, Gransar H, Gerlach J, Friedman JD, Hayes SW, Thomson LE, Hachamovitch R, Shaw LJ, Slomka PJ, Yang LD, Germano G. Quantitative assessment of myocardial perfusion abnormality on SPECT myocardial perfusion imaging is more reproducible than expert visual analysis. J Nucl Cardiol. 2009 Jan-Feb;16(1):45-53.
  6. Germano G, Kavanagh PB, Slomka PJ, Van Kriekinge SD, Pollard G, Berman DS. Quantitation in gated perfusion SPECT imaging: the Cedars-Sinai approach. J Nucl Cardiol. 2007 Jul;14(4):433-54.
  7. Garcia EV, Faber TL, Cooke CD, Folks RD, Chen J, Santana C. The increasing role of quantification in clinical nuclear cardiology: the Emory approach. J Nucl Cardiol. 2007 Jul;14(4):420-32.
  8. N Nakajima K. Normal values for nuclear cardiology: Japanese databases for myocardial perfusion, fatty acid and sympathetic imaging and left ventricular function. Ann Nucl Med. 2010 Apr;24(3):125-35.
  9. Dixon KL, Fung A, Celler A. The effect of patient, acquisition and reconstruction variables on myocardial wall thickness as measured from myocardial perfusion SPECT studies. IEEE Nucl Sci Symp Conf Rec (2004). 2004 Oct. 7: 4141-4145.
  10. Cuberas-Borrós G, Aguadé-Bruix S, Boronat-de Ferrater M, Muxí-Pradas MA, Romero-Farina G, Castell-Conesa J, Aliaga V, García-Dorado D, Candell-Riera J. Normal myocardial perfusion SPECT database for the Spanish population. Rev Esp Cardiol. 2010 Aug;63(8):934-42.
  11. Li D, Li D, Feng J, Yuan D, Cao K, Chen J. Quantification of myocardial perfusion SPECT studies in Chinese population with western normal databases. J Nucl Cardiol. 2010 Jun;17(3):486-93.
  12. Nakajima K, Kumita S, Ishida Y, Momose M, Hashimoto J, Morita K, Taki J, Yamashina S, Maruno H, Ogawa M, Kubota M, Takahashi M, Odagawa T, Yokozuka K. Creation and characterization of Japanese standards for myocardial perfusion SPECT: database from the Japanese Society of Nuclear Medicine Working Group. Ann Nucl Med. 2007 Nov;21(9):505-11.
  13. Nakazato R, Berman DS, Hayes SW, Fish M, Padgett R, Xu Y, Lemley M, Baavour R, Roth N, Slomka PJ. Myocardial perfusion imaging with a solid-state camera: simulation of a very low dose imaging protocol. J Nucl Med. 2013 Mar;54(3):373-9.
  14. Slomka P, Germano G. Factors affecting appearance of a normal myocardial perfusion scan. J Nucl Cardiol. 2018 Oct;25(5):1655-1657.
  15. Nakajima K, Matsumoto N, Kasai T, Matsuo S, Kiso K, Okuda K. Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database. Ann Nucl Med. 2016 Apr;30(3):188-99.
  16. Kumar SP, Brewington SD, O'Brien KF, Movahed A. Clinical correlation between increased lung to heart ratio of technetium-99m sestamibi and multivessel coronary artery disease. Int J Cardiol. 2005 May 25;101(2):219-22.
  17. Giubbini R, Campini R, Milan E, Zoccarato O, Orlandi C, Rossini P, Giannuzzi P, La Canna G, Galli M. Evaluation of technetium-99m-sestamibi lung uptake: correlation with left ventricular function. J Nucl Med. 1995 Jan;36(1):58-63.
  18. Jeong SY, Lee JT, Bae JH, Ahn BC, Lee KB. Lung uptake of 99mTc-sestamibi during routine gated exercise SPECT Imaging: comparison with left ventricular ejection fraction and severity of perfusion defect. Korean J Nucl Med. 2003;37(2):83-93.
  19. Ficaro EP, Lee BC, Kritzman JN, Corbett JR. Corridor4DM: the Michigan method for quantitative nuclear cardiology. J Nucl Cardiol. 2007 Jul;14(4):455-65.
  20. Muntinga HJ, van den Berg F, Knol HR, Niemeyer MG, Blanksma PK, Louwes H, van der Wall EE. Normal values and reproducibility of left ventricular filling parameters by radionuclide angiography. Int J Card Imaging. 1997 Apr;13(2):165-71.