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Automatic Determination of Left Ventricular Ejection Fraction from Gated Blood-Pool Tomography

Division of Nuclear Medicine, University Hospital, Free University of Brussels, Brussels, Belgium

View larger version (43K): [in a new window]   FIGURE 1. Horizontal long-axis slice at end-diastole (A) and end-systole (B). Subtracting end-systolic image from end-diastolic image (C) results in positive values around ventricles (dark gray) and negative values around auricles (light gray).

View larger version (51K): [in a new window]   FIGURE 2. Detecting septum is done on best septal view at end-diastole. By summing all voxels along x-axis, profile is generated. Maximum (A) is selected, and another profile along this location is created. Local minimum (B) is selected as septum, and local maximum on left side of septum (C) is selected as center of left ventricle.

View larger version (88K): [in a new window]   FIGURE 3. Summary of algorithm. Initially, end-diastolic image (A) is segmented (B) and segments are identified (C) as left and right ventricle. Optimal threshold is found when corresponding ventricular wall (D) best fits first derivative of end-diastolic count distribution (E).

View larger version (15K): [in a new window]   FIGURE 4. Linear regression analysis (A) and Bland-Altman plot (B) between LVEF determined by GBPT and LVEF determined by PRNA.

View larger version (14K): [in a new window]   FIGURE 5. Intraobserver reproducibility. Linear regression (A) and Bland-Altman analysis (B) between original LVEFs measured (LVEF 1) and ejection fraction measured 3 mo later (LVEF 2).

View larger version (14K): [in a new window]   FIGURE 6. Agreement between LVEFs measured by two independent observers.