RT Journal Article
SR Electronic
T1 Electrocardiographically Gated Blood-Pool SPECT and Left Ventricular Function: Comparative Value of 3 Methods for Ejection Fraction and Volume Estimation
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1043
OP 1049
VO 42
IS 7
A1 Daou, Doumit
A1 Harel, François
A1 Helal, Badia O.
A1 Fourme, Thierry
A1 Colin, Patrice
A1 Lebtahi, Rachida
A1 Mariano-Goulart, Denis
A1 Faraggi, Marc
A1 Slama, Michel
A1 Le Guludec, Dominique
YR 2001
UL http://jnm.snmjournals.org/content/42/7/1043.abstract
AB The current major limitation to development of electrocardiographically (ECG) gated blood-pool SPECT (GBPS) for measurement of the left ventricular (LV) ejection fraction (LVEF) and volumes is the lack of availability of clinically validated automatic processing software. Recently, 2 processing software methods for quantification of the LV function have been described. Their LVEFs have been validated separately, but no validation of the LV volume measurement has been reported. Methods: We compared 3 processing methods for evaluation of the LVEF (n = 29) and volumes (n = 58) in 29 patients: automatic geometric method (GBPSG), semiautomatic activity method (GBPSM), and 35% maximal activity manual method (GBPS35%). The LVEF provided by the ECG gated equilibrium planar left anterior oblique view (planarLAO) and the LV volumes provided by LV digital angiography (Rx) were used as gold standards. Results: Whereas the GBPSG and GBPSM methods present similar low percentage variabilities, the GBPS35% method provided the lowest percentage variabilities for the LVEF and volume measurements (P < 0.04 and P < 0.02, respectively). The LVEF and volume provided by the 3 methods were highly correlated with the gold standard methods (r > 0.98 and r > 0.83, respectively). The LVEFs provided by the GBPS35% and GBPSM methods are similar and higher than those of the GBPSG method and planarLAO method, respectively (P < 0.0001). For the LVEF, there is no correlation between the average and paired absolute difference for the 3 GBPS methods against the planarLAO method, and the limits of agreement are relatively large. LV volumes are lower when calculated with the GBPSM, GBPSG, and Rx methods (P < 0.0001). However, the GBPS35% and Rx methods provide LV volumes that are similar. There is no linear correlation between the average and the paired absolute difference of volumes calculated with the GBPSG and GBPS35% methods against Rx LV volumes. However, a moderate linear correlation was found with the GBPSM method (r = 0.6; P = 0.0001). The 95% limits of agreement between the Rx LV volumes and the 3 GBPS methods are relatively large. Conclusion: GBPS is a simple, highly reproducible, and accurate technique for the LVEF and volume measurement. The reported findings should be considered when comparing results of different methods (GBPS vs. planarLAO LVEF; GBPS vs. Rx volume) and results of different GBPS processing methods.