Referral pattern and findings following planar equilibrium radionuclide angiocardiography in a tertiary hospital

Abstract

Planar Equilibrium Radionuclide Angiocardiography (ERNA) is a non-invasive, reproducible and non-operator dependent Nuclear Medicine gamma camera-based technique of assessing cardiac function. Aim: To determine the common indications and findings from ERNA in a tertiary hospital in Cape Town, South Africa. Methods: The use of this database was approved by the Human Research Ethics Committee of the faculty of Health Sciences, University of Cape Town. All ERNAs conducted within a six-month period (January to June 2014), processed and reported by the authors were reviewed. The ERNAs were performed on an e.Cam dual head gamma camera (Siemens Medical Solutions, Erlangen, Germany) fitted with Low Energy High Resolution (LEHR) collimators 99m after intravenous administration of stannous pyrophosphate and Tc-pertechnetate. ECG-gated cardiac blood pool images were acquired. Images were reviewed and processed on a Siemens workstation. Cardiac morphology, size, contraction pattern, left ventricular wall motion and ejection fraction were assessed. Results: Of the 351 ERNAs of patients reviewed, 283 (80.6%) were females while 68 (19.4%) were males with a mean age of 48.3 ± 12.6 years and age range of 29 to 71 years. Indications for ERNA requests were chemotherapy 303 (86.3%), pre-operative evaluation 37 (10.5%) and ischaemic heart disease 9 (2.6%). LV size was dilated in 24 (6.8%) of the patients. Normal LV wall motion was recorded in 303 (86.3%) patients, while hypokinesia, akinesia and dyskinesia were recorded in 12.8%, 0.3% and 0.6% of the LVs respectively. Normal LVEF was recorded in 301 (85.8%)
of the patients while mild, moderate and severe LV dysfunction were recorded in 12.8%, 0.8% and 0.6% of the patients respectively. Conclusion: ERNA is a frequently requested nuclear medicine examination for assessment of cardiac function in patients undergoing cardiotoxic chemotherapy.