Open Access Research article

Late gadolinium uptake demonstrated with magnetic resonance in patients where automated PERFIT analysis of myocardial SPECT suggests irreversible perfusion defect

Lene Rosendahl12*, Peter Blomstrand1, Jan L Ohlsson1, Per-Gunnar Björklund1, Britt-Marie Ahlander3, Sven-Åke Starck4 and Jan E Engvall25

Author Affiliations

1 Dept. of Clinical Physiology, County Hospital Ryhov, SE-55185 Jönköping, Sweden

2 Center for Medical Image Science and Visualization, CMIV, Linköping University Hospital, SE-58185 Linköping, Sweden

3 Radiology, County Hospital Ryhov, SE-55185 Jönköping, Sweden

4 Hospital Physics Unit, Dept. Of Oncology, County Hospital Ryhov, SE-55185 Jönköping, Sweden

5 Dept. of Clinical Physiology, Linköping University Hospital, SE-58185 Linköping, Sweden

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BMC Medical Imaging 2008, 8:17  doi:10.1186/1471-2342-8-17

Published: 12 December 2008



Myocardial perfusion single photon emission computed tomography (MPS) is frequently used as the reference method for the determination of myocardial infarct size. PERFIT® is a software utilizing a three-dimensional gender specific, averaged heart model for the automatic evaluation of myocardial perfusion. The purpose of this study was to compare the perfusion defect size on MPS, assessed with PERFIT, with the hyperenhanced volume assessed by late gadolinium enhancement magnetic resonance imaging (LGE) and to relate their effect on the wall motion score index (WMSI) assessed with cine magnetic resonance imaging (cine-MRI) and echocardiography (echo).


LGE was performed in 40 patients where clinical MPS showed an irreversible uptake reduction suggesting a myocardial scar. Infarct volume, extent and major coronary supply were compared between MPS and LGE as well as the relationship between infarct size from both methods and WMSI.


MPS showed a slightly larger infarct volume than LGE (MPS 29.6 ± 23.2 ml, LGE 22.1 ± 16.9 ml, p = 0.01), while no significant difference was found in infarct extent (MPS 11.7 ± 9.4%, LGE 13.0 ± 9.6%). The correlation coefficients between methods in respect to infarct size and infarct extent were 0.71 and 0.63 respectively. WMSI determined with cine-MRI correlated moderately with infarct volume and infarct extent (cine-MRI vs MPS volume r = 0.71, extent r = 0.71, cine-MRI vs LGE volume r = 0.62, extent r = 0.60). Similar results were achieved when wall motion was determined with echo. Both MPS and LGE showed the same major coronary supply to the infarct area in a majority of patients, Kappa = 0.84.


MPS and LGE agree moderately in the determination of infarct size in both absolute and relative terms, although infarct volume is slightly larger with MPS. The correlation between WMSI and infarct size is moderate.