The aim of this study was to evaluate the reproducibility of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurement in patients referred for dynamic SPECT. Methods: We retrospectively analyzed patients referred for myocardial perfusion imaging. SPECT data were acquired on a cadmium zinc telluride–based pinhole cardiac camera in list mode using a stress (251 ± 15 MBq)/rest (512 ± 26 MBq) 1-d ^99mTc-tetrofosmin protocol. Kinetic analyses were done with software using a 1-tissue-compartment model and converted to MBF using a previously determined extraction fraction correction. MFR was analyzed and compared globally and regionally. Motion detection was applied, but not attenuation correction. Results: In total, 124 patients (64 male, 60 female) were included, and SPECT acquisitions were twice reconstructed by the same nuclear medicine board-certified physician for 50 patients and by 2 different physicians for 74. Both intra- and interobserver measurements of global MFR had no significant bias (–0.01 [P = 0.94] and 0.01 [P = 0.67], respectively). However, rest MBF and stress MBF were significantly different in global left ventricular evaluation (P = 0.001 and P = 0.002, respectively) and in the anterior territory (P < 0.0001) on interuser analysis. The average coefficient of variation was 15%–30% of the mean stress MBF if the analysis was performed by the same physician or 2 different physicians and was around 20% of the mean MFR independently of the processing physician. Using the MFR threshold of 2, we noticed good intrauser agreement, whereas it was moderate when the users were different ( = 0.75 [95% CI, 0.56–0.94] vs. 0.56 [95% CI, 0.36–0.75], respectively). Conclusion: Repeated measurements of global MFR by the same physician or 2 different physicians were similar, with an average coefficient of variation of 20%. Better reproducibility was achieved for intrauser MBF evaluation. Automation of processing is needed to improve reproducibility.

本研究的目的是评估动态 SPECT 患者的心肌血流量 (MBF) 和心肌血流储备 (MFR) 测量的可重复性。方法：我们回顾性分析了转诊进行心肌灌注显像的患者。^{SPECT 数据是使用应力 (251 ± 15 MBq)/静息 (512 ± 26 MBq) 1-d 99m} Tc-tetrofosmin 协议以列表模式在基于镉锌碲的针孔心脏相机上采集的。动力学分析是通过软件使用 1 组织隔室模型完成的，并使用先前确定的提取分数校正转换为 MBF。在全球和区域范围内对 MFR 进行了分析和比较。应用了运动检测，但未应用衰减校正。结果：总共包括 124 名患者（64 名男性，60 名女性），SPECT 采集由同一位核医学委员会认证的医生对 50 名患者和 2 名不同的医生对 74 名患者进行了两次重建。全球 MFR 的观察者内和观察者间测量没有显着偏差（分别为 –0.01 [ P = 0.94] 和 0.01 [ P = 0.67]）。然而，静息 MBF 和负荷 MBF 在整体左心室评估（分别为P = 0.001 和P = 0.002）和前区（P< 0.0001) 用户间分析。如果由同一位医生或 2 位不同的医生进行分析，则平均变异系数为平均应力 MBF 的 15%–30%，并且独立于加工医生，平均变异系数约为平均 MFR 的 20%。使用 2 的 MFR 阈值，我们注意到良好的用户内部一致性，而当用户不同时它是温和的（分别为 = 0.75 [95% CI，0.56-0.94] 和 0.56 [95% CI，0.36-0.75]）。结论：同一位医生或 2 位不同医生对全球 MFR 的重复测量结果相似，平均变异系数为 20%。intrauser MBF 评估实现了更好的重现性。需要处理自动化以提高再现性。