Gated First Pass Radionuclide Ventriculography Methods, Validation, and Applications

Abstract

Electrocardiographic gating provides an alternative method of acquiring first pass radionuclide ventriculograms from both ventricles. This report details the methods of acquisition and analysis, provides validation and reproducibility data, and describes applications of gated first pass radionuclide ventriculography using a count-based method. Left ventricular ejection fractions measured by gated first pass were correlated quite closely with gated blood pool ventriculography (n=43; r=0.95) but less well with contrast angiography (n=23; r=0.72). The right ventricular ejection fractions measured by gated first pass compared favorably with gated blood pool ventriculography (n=32; r=0.93). When one observer processed the images two times, the reproducibilities of RVEF (n=10; r=0.99) and LVEF (n=10; r=0.88) were excellent. Similarly, when two observers processed the images independently, the reproducibilities of RVEF (n=11; r=0.99) and LVEF (n=11; r=0.98) were excellent. The first pass studies were obtained in a right anterior obliquity, which provided the best atrioventricular chamber separation and provided a different view of global ventricular function and segmental wall motion from that provided by the standard blood pool views.