Gated blood pool SPECT using cadmium zinc telluride (CZT) and Anger camera for the assessment of global LV and RV function and quantitative Fourier analysis of ventricular asynchrony compared to planar angiography.

Objectives The impact of differences in count sensitivity, spatial resolution and contrast-to-noise ratios between CZT and Anger cameras remains unclear on gated Blood-pool SPECT (gBP-SPECT). This study compared the differences in the assessment of global LV and RV function, and quantitative Fourier phase analysis using planar angiography (RNA) and gBP-SPECT with both CZT and Anger cameras (DNM 530c and Infinia, GE Healthcare).

Methods 20 men and 6 women (mean age: 62 ± 27 years) underwent RNA and gBP-SPECT acquisitions using both cameras. RNA and SPECT data were processed using commercially available software (XTERNA, GE Healthcare; and QBS, Cedars Sinai).

Results LV and RV volumes were significantly lower with the CZT vs. Anger camera; LVEDV (mL): 156 ± 53 vs. 180 ± 62 (P<0.001); LVESV (mL): 95 ± 49 vs. 111 ± 59 (P<0.001); RVEDV (mL): 123 ± 37 vs. 152 ± 43 (P<0.001); RVESV (mL): 63 ± 26 vs. 75 ± 29 (P<0.005). However, LVEF were similar using RNA (41.5% ± 14.9%), Anger (42.2% ± 15.2%) and CZT gBP-SPECT (42.5% ± 16.7%; all P=NS). RVEF was significantly lower (P<0.005) using RNA (42.5% ± 8.7%) compared with Anger (51% ± 8.9%) and CZT gBP-SPECT (49.5% ± 10.1%). Interventricular delay, calculated as the difference between LV and RV mean phase angles, was significantly higher using RNA (11.7° ± 20.4, P<0.01), but similar with Anger (2.5°± 23.3) and CZT gBP-SPECT(4.5° ± 22, P=NS). Bland Altman plots and Lin's concordance coefficient (CCC) showed an excellent concordance for LVEF (CCC>0.9 for all) and LV volumes (EDV: CCC=0.87 and ESV: CCC=0.92) between CZT and Anger camera, but not for RVEF and RV volumes.

Conclusions Gated blood pool SPECT yielded significantly lower LV and RV volumes but similar LVEF and RVEF, and shorter interventricular delay using both CZT and Anger camera compared to RNA. These differences should be taken into account in clinical practice.