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Validation of QGS and 4D-MSPECT for Quantification of Left Ventricular Volumes and Ejection Fraction from Gated ¹⁸F-FDG PET: Comparison with Cardiac MRI

¹ Department of Nuclear Medicine, University Hospital, University of Aachen, Aachen, Germany
² Medical Clinic I, University Hospital, University of Aachen, Aachen, Germany
³ Department of Radiology, University Hospital, University of Aachen, Aachen, Germany

ABSTRACT

The aim of this study was to validate Quantitative Gated SPECT (QGS) and 4D-MSPECT for assessing left ventricular end-diastolic and systolic volumes (EDV and ESV, respectively) and left ventricular ejection fraction (LVEF) from gated ¹⁸F-FDG PET. Methods: Forty-four patients with severe coronary artery disease were examined with gated ¹⁸F-FDG PET (8 gates per cardiac cycle). EDV, ESV, and LVEF were calculated from gated ¹⁸F-FDG PET using QGS and 4D-MSPECT. Within 2 d (median), cardiovascular cine MRI (cMRI) (20 gates per cardiac cycle) was done as a reference. Results: QGS failed to accurately detect myocardial borders in 1 patient; 4D-MSPECT, in 2 patients. For the remaining 42 patients, correlation between the results of gated ¹⁸F-FDG PET and cMRI was high for EDV (R = 0.94 for QGS and 0.94 for 4D-MSPECT), ESV (R = 0.95 for QGS and 0.95 for 4D-MSPECT), and LVEF (R = 0.94 for QGS and 0.90 for 4D-MSPECT). QGS significantly (P < 0.0001) underestimated LVEF, whereas no other parameter differed significantly between gated ¹⁸F-FDG PET and cMRI for either algorithm. Conclusion: Despite small systematic differences that, among other aspects, limit interchangeability, agreement between gated ¹⁸F-FDG PET and cMRI is good across a wide range of clinically relevant volumes and LVEF values assessed by QGS and 4D-MSPECT.

Key Words: gated ¹⁸F-FDG PET • cardiovascular MRI • Quantitative Gated SPECT • 4D-MSPECT

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