To determine right (RV) and left ventricular (LV) volumes, a new technique was developed using ECG-gated single-photon emission computed tomography (SPECT). RV volumes of nine patients and LV volumes of 22 patients measured by SPECT and biplane contrast cineangiography were compared. In addition, volume and ejection fraction (EF) of the RV and LV were obtained by SPECT for 10 normal controls, 21 patients with old myocardial infarction (OMI), eight patients with hypertrophic cardiomyopathy (HCM) and 12 patients with dilated cardiomyopathy (DCM), and these results were compared. The intracardiac blood pool was labeled with Tc-99m sodium pertechnetate and 32 images were recorded through 180 degrees by a rotating gamma-camera. End-diastolic and end-systolic counts during 50 msec were recorded during 50 or 60 cardiac cycles. These counting data were reconstructed as tomographic images of vertical long-axial slices with thickness of a pixel without any attenuation correction. The numbers of voxels within the % cut-off level were summed, and the sum was multiplied by the one voxel volume. The cut-off level for ventricular delineation was determined as 45% by phantom studies. 1. The values obtained from SPECT and contrast angiography correlated well. 2. In normal controls, LV end-diastolic and end-systolic volumes were significantly less than those of the RV (p less than 0.05, p less than 0.001) and LVEF was significantly greater than the RVEF (p less than 0.001). 3. In OMI (single vessel disease), both end-diastolic and end-systolic volumes of the LV were significantly greater than those of normals (p less than 0.01, p less than 0.001) and LVEF was significantly less. In HCM end-systolic volumes of the RV were significantly less (p less than 0.05) than those of the normals. 4. LV volume was greater and LVEF was extremely low both in DCM and in OMI (multivessel disease) compared to that of the normals. In DCM, RV end-systolic volumes was greater and RVEF was lower than that of OMI (multi-vessel disease), indicating the deterioration of RV contractility , primarily in DCM. From these findings, it was concluded that this noninvasive technique may be useful for estimating left and right ventricular volumes.