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Left Ventricular Function and Perfusion from Gated SPECT Perfusion Images: An Integrated Method

Division of Nuclear Medicine, Emory University School of Medicine, Atlanta, Georgia
Division of Cardiology, St. Luke's-Roosevelt Hospital of Columbia University, New York, New York

Correspondence: For correspondence or reprints contact: Tracy L. Faber, PhD, Division of Nuclear Medicine, Emory University Hospital, 1364 Clifton Rd., NE, Atlanta, GA 30322.

ABSTRACT

A new technique for computing left ventricular function, including left ventricular volumes, mass and ejection fraction, has been developed. This method is a logical extension of the results of a standard perfusion quantification technique; thus, it allows integration of perfusion and functional information. Methods: Anatomically based models of the endocardial and epicardial surfaces are generated using the myocardial samples for which perfusion values are quantified, for all frames in the cardiac cycle. With these surface points, left ventricular chamber volume and myocardial volume can be computed. A computer simulation was used to determine the sensitivity of the approach to the assumptions of the model. Validation of volume, mass and ejection fraction was performed with correlative MR studies, and ejection fraction and left ventricular volumes were further investigated using correlative first-pass studies. Results: Automated processing was successful in 96% of the cases analyzed. End diastolic volume, end systolic volume, left ventricular mass and left ventricular ejection fraction correlated with MRI with r = 0.97, 0.99, 0.87, and 0.85, respectively. Ejection fraction from tomography correlated with first-pass values with r = 0.82, and end diastolic and end systolic volumes from tomography correlated with first-pass values with r = 0.85 and r = 0.91, respectively. Conclusion: The new integrated approach is accurate and robust for computing both perfusion and function from perfusion tomograms.

Key Words: gated SPECT • ejection fraction • myocardial perfusion imaging • left ventricular function

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