Nuclear myocardial perfusion imaging (MPI) by single-photon emission
computed tomography (SPECT) is a non-invasive method of evaluating left ventricular
(LV) perfusion and viability that is widely used in clinical practice.
Electrocardiographically (ECG)-gated SPECT (G-SPECT) is a state-of-the-art
technique combining the evaluation of myocardial perfusion and LV function within a
single study. It is among the most commonly performed cardiologic diagnostic
procedures in nuclear medicine departments. Advances in γ-camera instrumentation
and the software used for data acquisition, image processing and quantification have
rendered this technique user-friendly, practical and highly reproducible in everyday
practice. In patients with coronary artery disease, the introduction of ECG-gating
enhances the diagnostic and prognostic capability of MPI, provides incremental
functional information over the perfusion data alone and also bears potential for
assessing myocardial viability and following-up LV function after revascularization.
This chapter discusses the general principles of G-SPECT image acquisition, analysis
and quantification, followed by a discussion on the additive diagnostic and prognostic
value that is associated with the functional parameters obtained by G-SPECT.
Keywords: Cardiomyopathy, Coronary artery disease, Electrocardiographic
gating, Gated-SPECT, Image quantification, Left ventricular function, Myocardial
infarction, Myocardial perfusion imaging, Radiotracers, Single-photon emission
computed tomography.