RT Journal Article
SR Electronic
T1 Accuracy of 4 Different Algorithms for the Analysis of Tomographic Radionuclide Ventriculography Using a Physical, Dynamic 4-Chamber Cardiac Phantom
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 165
OP 171
VO 46
IS 1
A1 De Bondt, Pieter
A1 Claessens, Tom
A1 Rys, Bart
A1 De Winter, Olivier
A1 Vandenberghe, Stijn
A1 Segers, Patrick
A1 Verdonck, Pascal
A1 Dierckx, Rudi Andre
YR 2005
UL http://jnm.snmjournals.org/content/46/1/165.abstract
AB Various automatic algorithms are now being developed to calculate left ventricular (LV) and right ventricular (RV) ejection fraction from tomographic radionuclide ventriculography. We tested the performance of 4 of these algorithms in estimating LV and RV volume and ejection fraction using a dynamic 4-chamber cardiac phantom. Methods: We developed a realistic physical, dynamic 4-chamber cardiac phantom and acquired 25 tomographic radionuclide ventriculography images within a wide range of end-diastolic volumes, end-systolic volumes, and stroke volumes. We assessed the ability of 4 algorithms (QBS, QUBE, 4D-MSPECT, and BP-SPECT) to calculate LV and RV volume and ejection fraction. Results: For the left ventricle, the correlations between reference and estimated volumes (0.93, 0.93, 0.96, and 0.93 for QBS, QUBE, 4D-MSPECT, and BP-SPECT, respectively; all with P < 0.001) and ejection fractions (0.90, 0.93, 0.88, and 0.92, respectively; all with P < 0.001) were good, although all algorithms underestimated the volumes (mean difference [±2 SDs] from Bland–Altman analysis: −39.83 ± 43.12 mL, −33.39 ± 38.12 mL, −33.29 ± 40.70 mL, and −16.61 ± 39.64 mL, respectively). The underestimation by QBS, QUBE, and 4D-MSPECT was greater for higher volumes. QBS, QUBE, and BP-SPECT could also be tested for the right ventricle. Correlations were good for the volumes (0.93, 0.95, and 0.97 for QBS, QUBE, and BP-SPECT, respectively; all with P < 0.001). In terms of absolute volume estimation, the mean differences (±2 SDs) from Bland–Altman analysis were −41.28 ± 43.66 mL, 11.13 ± 49.26 mL, and −13.11 ± 28.20 mL, respectively. Calculation of RV ejection fraction correlated well with true values (0.84, 0.92, and 0.94, respectively; all with P < 0.001), although an overestimation was seen for higher ejection fractions. Conclusion: Calculation of LV and RV ejection fraction based on tomographic radionuclide ventriculography was accurate for all tested algorithms. All algorithms underestimated LV volume; estimation of RV volume seemed more difficult, with different results for each algorithm. The more irregular shape and inclusion of a relatively hypokinetic RV outflow tract in the right ventricle seemed to cause the greater difficulty with delineation of the right ventricle, compared with the left ventricle.