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Research ArticleCLINICAL INVESTIGATIONS

Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements

Kenneth J. Nichols, Andrew Van Tosh, Yi Wang, Christopher J. Palestro and Nathaniel Reichek
Journal of Nuclear Medicine January 2009, 50 (1) 53-60; DOI: https://doi.org/10.2967/jnumed.108.056085
Kenneth J. Nichols
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Andrew Van Tosh
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Yi Wang
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Christopher J. Palestro
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Nathaniel Reichek
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  • FIGURE 1. 
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    FIGURE 1. 

    MR images of 75-y-old male patient with history of congestive heart failure and hypertension with severe LV and RV dysfunction and abnormal LV EF (23%) at ED (A) and ES (B). Manually drawn epicardial and endocardial outlines are superimposed on images.

  • FIGURE 2. 
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    FIGURE 2. 

    Screens of cines used to visually analyze BP-gated SPECT regional WM abnormalities for same patient in Figure 1 at ED (A) and ES (B).

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    FIGURE 3. 

    Polar map of BP-gated SPECT LV regional EF (percentage) for patient in Figure 1.

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    FIGURE 4. 

    BP measurement of global LV EF vs. cardiac MRI–quantified global LV EF. CMR = cardiac MRI.

  • FIGURE 5. 
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    FIGURE 5. 

    Receiver-operating-characteristic curves to predict LV segments with abnormal WM as seen on cardiac MRI, for AQ BP-gated SPECT EF, initial visual assessment (V1), and second visual assessment (V2) for all territories (A) and for LCX (B), LAD (C), and RCA (D) territories only.

Tables

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    TABLE 1

    Strength of Agreement and Significance of Differences of BP AQ with Cardiac MRI in Identifying Patients with Abnormally Low Global EF

    Discrimination thresholdκAgreement (14)McNemar differenceMcNemar P
    Global EF < 35%0.94“Very good”3.0%1.00
    Global EF < 50%0.94“Very good”3.0%1.00
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    TABLE 2

    Accuracy (Receiver-Operating-Characteristic Curve Area) of Segment-by-Segment Identification, Grouped by Coronary Territory

    TerritoryAllLCXLADRCA
    WM
     AQ88% ± 2%95% ± 2%86% ± 2%88% ± 2%
     VA180% ± 2%*78% ± 6%*84% ± 3%74% ± 4%*
     VA281% ± 2%*82% ± 5%*80% ± 3%80% ± 3%*
    WT
     AQ80% ± 2%84% ± 4%79% ± 3%78% ± 3%
     VA173% ± 2%66% ± 5%*75% ± 4%76% ± 3%
     VA274% ± 2%71% ± 5%*75% ± 4%77% ± 3%
    WV
     AQ87% ± 2%94% ± 3%84% ± 3%88% ± 2%
     VA179% ± 3%*74% ± 6%*84% ± 4%74% ± 4%*
     WV VA279% ± 2%*81% ± 5%*79% ± 4%78% ± 4%*
    • ↵* P < 0.05 versus AQ.

    • All = all coronary artery territories; VA1 = initial visual assessment; VA2 = second visual assessment.

    • View popup
    TABLE 3

    Strength of Agreement and Significance of Differences Between BP AQ and BP Visual Assessment with Cardiac MRI in Identifying Territories with Abnormal WM

    Territory showing abnormal WMκAgreement (14)McNemar differenceMcNemar P
    AQ
     LCX0.71“Good”5.6%0.15
     LAD0.50“Moderate”5.0%0.16
     RCA0.65“Good”5.9%0.08
    Visual assessment
     LCX0.58“Moderate”6.9%0.12
     LAD0.59“Moderate”1.8%0.75
     RCA0.45“Moderate”9.6%0.0006
    • View popup
    TABLE 4

    Strength of Agreement and Significance of Differences Between BP Initial Visual Assessment and BP Second Visual Assessment in Identifying Territories with Abnormal WM

    Territory showing abnormal WMκAgreement (14)McNemar differenceMcNemar P
    LCX0.55“Moderate”7.8%0.07
    LAD0.72“Good”5.1%0.06
    RCA0.58“Moderate”3.9%0.20
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Journal of Nuclear Medicine: 50 (1)
Journal of Nuclear Medicine
Vol. 50, Issue 1
January 2009
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Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements
Kenneth J. Nichols, Andrew Van Tosh, Yi Wang, Christopher J. Palestro, Nathaniel Reichek
Journal of Nuclear Medicine Jan 2009, 50 (1) 53-60; DOI: 10.2967/jnumed.108.056085

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Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements
Kenneth J. Nichols, Andrew Van Tosh, Yi Wang, Christopher J. Palestro, Nathaniel Reichek
Journal of Nuclear Medicine Jan 2009, 50 (1) 53-60; DOI: 10.2967/jnumed.108.056085
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