Technically suboptimal first-pass radionuclide angiographic studies.

First-pass radionuclide angiography (FPRNA) has proven to correctly assess left ventricular function, however, technical difficulties do occur. One hundred and thirty one patients had contrast angiography and resting radionuclide angiography within 24 h. Of the 131 patients, 86 (66%) had adequate studies and 45 (34%) were technically suboptimal studies. In the latter group, low counts affected the quality of the images but did not change the left ventricular ejection fraction (LVEF) or regional wall motion (RWM) scores. Patients with high background activity showed overestimation of LVEF, however, by using a formula that was derived from the linear regression the LVEF could be calculated accurately in most cases. Multiple technical problems were noted in 14 patients in whom the best correlation was between contrast LVEF and background uncorrected LVEF from FPRNA (r = 0.87). In the latter group, FPRNA showed overestimation of RWM in 8 patients (57%), mainly in the inferior wall. We conclude that for most technically compromised first-pass radionuclide angiographic data, accurate LVEF values can be achieved but errors in regional wall motion interpretation will occur, especially when multiple technical problems exist.