Elsevier

Journal of Nuclear Cardiology

Volume 11, Issue 3, May–June 2004, Pages 282-292
Journal of Nuclear Cardiology

Original article
Model dependence of gated blood pool SPECT ventricular function measurements

https://doi.org/10.1016/j.nuclcard.2004.01.007Get rights and content

Abstract

Background

Calculation differences between various gated blood pool (GBP) single photon emission computed tomography (SPECT) (GBPS) algorithms may arise as a result of different modeling assumptions. Little information has been available thus far regarding differences for right ventricular (RV) function calculations, for which GBPS may be uniquely well suited.

Methods and results

Measurements of QBS (Cedars-Sinai Medical Center, Los Angeles, Calif) and BP-SPECT (Columbia University, New York, NY) algorithms were evaluated. QBS and BP-SPECT left ventricular (LV) ejection fraction (EF) correlated strongly with conventional planar-GBP LVEF for 422 patients (r = 0.81 vs r = 0.83). QBS correlated significantly more strongly with BP-SPECT for LVEF than for RVEF (r = 0.80 vs r = 0.41). Both algorithms demonstrated significant gender differences for 31 normal subjects. BP-SPECT normal LVEF (67% ± 9%) was significantly closer to values in the magnetic resonance imaging (MRI) literature (68% ± 5%) than QBS (58% ± 9%), but both algorithms underestimated normal RVEF (52% ± 7% and 50% ± 9%) compared with the MRI literature (64% ± 9%). For 21 patients, QBS correlated similarly to MRI as BP-SPECT for LVEF (r = 0.80 vs r = 0.85) but RVEF correlation was significantly weaker (r = 0.47 vs r = 0.81). For 16 dynamic phantom simulations, QBS LVEF correlated similarly to BP-SPECT (r = 0.81 vs r = 0.91) but QBS RVEF correlation was significantly weaker (r = 0.62 vs r = 0.82). Volumes were lower by QBS than BP-SPECT for all data types.

Conclusions

Both algorithms produced LV parameters that correlated strongly with all forms of image data, but all QBS RV relationships were significantly different from BP-SPECT RV relationships. Differences between the two algorithms were attributed to differences in their underlying ventricular modeling assumptions.

Section snippets

Patient population

Between September 1, 2001, and February 1, 2003, 486 patients (mean age, 52 ± 17 years; 61% male) were referred to Columbia University, New York, NY, and St Francis Medical Center, Roslyn, NY, for measurement of LVEF by conventional planar-GBP imaging. It was necessary to eliminate 64 studies for technical reasons (given below), leaving 422 studies for subsequent analysis. Specifically, patients were referred for status evaluation after heart transplantation (28%), congestive heart failure

Software region generation

For clinical data, 64 of 486 patients (13%) showed obvious evidence of serious ventricular tracking problems for QBS, regardless of the manner in which algorithms were run (see above). This was consistent with previously reported QBS automation success rates of 70% to 85%.9 To permit a fair and realistic comparison between the two algorithms for clinical images, the questionable cases were eliminated, leaving 422 clinical studies, thereby censoring studies in the same fashion used by previous

Discussion

For clinical data, normal subjects, and MRI and phantom data, QBS and BP-SPECT LV parameters correlated strongly with one another, but all QBS RV relationships were significantly weaker than all QBS LV relationships. QBS algorithm region-generation success rates also were quite similar for all data types. Another finding in common across all data types was that QBS LVEFs and LVEDVs were significantly lower than BP-SPECT values and the other imaging modalities' LV values.

The latter finding was

Acknowledgements

Dr Nichols stands to benefit from sale of software proceeds through marketing arrangements with Syntermed, Inc (Atlanta, Ga), related to the research described in this article. The terms of this arrangement have been reviewed and approved by Columbia University in accordance with its conflict-of-interest practice. The other authors have indicated they have no financial conflicts of interest.

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  • Cited by (0)

    Supported in part by grants from Siemens Medical Solutions, Inc, Chicago, Ill.

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