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The Journal of Nuclear Medicine Vol. 36 No. 11 2138-2147
© 1995 by Society of Nuclear Medicine
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Automatic Quantification of Ejection Fraction from Gated Myocardial Perfusion SPECT

Guido Germano, Hosen Kiat, Paul B. Kavanagh, Mady Moriel, Marco Mazzanti, Hsiao-Te Su, Kenneth F. Van Train and Daniel S. Berman

Department of Medical Physics and Imaging, Division of Nuclear Medicine, Department of Imaging and Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
Department of Radiological Sciences and Department of Medicine, UCLA School of Medicine, Los Angeles, California

Correspondence: For correspondence or reprints contact: Guido Germano, PhD, Director, Nuclear Medicine Physics, Cedars-Sinai Medical Center A047 N, 8700 Beverly Blvd., Los Angeles, CA 90048.

ABSTRACT

We have developed a completely automatic algorithm to quantitatively measure left ventricular ejection fraction (LVEF) from gated 99mTc-sestamibi myocardial perfusion SPECT images. Methods: The algorithm operates in the three-dimensional space and uses gated short-axis image volumes. It segments the left ventricle (LV), estimates and displays endocardial and epicardial surfaces for all gating intervals in the cardiac cycle, calculates the relative left ventricular cavity volumes and derives the global EF from the end-diastolic and end-systolic volume, all without operator interaction. The algorithm for measuring LVEF was tested in 65 clinical patients undergoing 16-interval and 8-interval rest-gated SPECT and validated against first-pass radionuclide ventriculography. Results: Automatic segmentation and contouring of the LV was successful in 65/65 (100%) of the studies. Agreement between EFs measured from 8-interval gated SPECT and EF scalculated from first-pass data was high (y = 2.44 + 1.03x, r = 0.909, p < 0.001, s.e.e. = 6.87). Agree ment between EF values measured from 16-interval and 8-interval gated SPECT was excellent (y = –2.7 + 0.97x, r = 0.988, p < 0.001,s.e.e. = 2.65), the latter being on average lower by 3.71 percentage points. Conclusion: Our automatic method is rapid and highly agrees with conventional radionuclide measurements of EF, thus providing clinically useful additional information to complement myocardial perfusion studies.

Key Words: automatic ejection fraction quantitation • technetium-99m-sestamibi • myocardial perfusion imaging • single-photon emission computed tomography




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