Gated SPECT is a
nuclear medicine
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitting ...
imaging technique, typically for the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
in
myocardial perfusion imagery. An
electrocardiogram (ECG) guides the image acquisition, and the resulting set of
single-photon emission computed tomography
Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, ...
(SPECT) images shows the heart as it contracts over the interval from one
R wave
The QRS complex is the combination of three of the graphical deflections seen on a typical electrocardiogram (ECG or EKG). It is usually the central and most visually obvious part of the tracing. It corresponds to the depolarization of the ri ...
to the next. Gated myocardial perfusion imaging has been shown to have high
prognostic
Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stable ...
value and
sensitivity for critical
stenosis
A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture).
''Stricture'' ...
.
The acquisition computer defines the number of time bins or frames to divide the R to R interval of the patient's electrocardiogram. A "window" may be set which discards data from R to R intervals which deviate from some amount from the patient's average R to R wave duration. This discards
preventricular contractions and
arrhythmia
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
s from the acquisition and improves the quality of the resulting study.
The
gamma camera
A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development ...
will take a series of pictures around the patient, dividing each 'step' of the camera head's motion into the predetermined number of 'frames.' The details of this acquisition vary with single-headed, double-headed, or triple-headed cameras — but a single-headed camera typically acquires 32 'steps' over an arc of 180 degrees around the patient.
When the acquisition is completed, the technician must process the images to create a data set which represents the volume of tracer as seen by the camera during the study acquisition. In gated SPECT, this process is performed for each of the time bins defined by the acquisition protocol. When viewed by the physician for interpretation, the heart can be watched as it contracts and expands from
diastole
Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventric ...
to
systole
Systole ( ) is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. The term originates, via New Latin, from Ancient Greek (''sustolē''), from (''sustéllein'' 'to contract'; from ''sun ...
.
The computer can calculate the patient's
ejection fraction
An ejection fraction (EF) is the volumetric fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or heartbeat). It can refer to the cardiac atrium, ventricle, gall bladder, ...
, end diastolic volume, wall motion, end systolic volume, myocardial thickening, shortening, and contractility. However, one is viewing an average of all collected heart beats over the image acquisition.
Noise
Noise is unwanted sound considered unpleasant, loud or disruptive to hearing. From a physics standpoint, there is no distinction between noise and desired sound, as both are vibrations through a medium, such as air or water. The difference arise ...
on the ECG, patient motion,
artefacts, or a change in the heart rate during acquisition can degrade the quality of the resulting gated image dataset.
References
Further reading
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3D nuclear medical imaging
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