Original articlesNew hybrid count- and geometry-based method for quantification of left ventricular volumes and ejection fraction from ECG-gated SPECT: Methodology and validation
Section snippets
Definition of LV region and exclusion of background on nongated horizontal long-axis slice
The GSCQ method starts with the identification of a central nongated horizontal long-axis slice (Figure 1A)—that is, the slice with maximal LV cavity diameter. An initial binary image was generated from the central horizontal long-axis slice by use of a simple thresholding scheme, in which the 50% maximal intensity obtained from the upper half of nongated short-axis images was used as a cutoff.2 The K-means cluster classification algorithm14 was adapted to divide the initial binary image into 2
Normal phantoms
Figure 4A shows the correlation between quantified SPECT volumes and actual volumes for normal phantoms (r = 0.97). Figure 4B shows the Bland-Altman plot and limits of agreement. There was overestimation in large phantom volumes and underestimation in small volumes. The mean difference for normal phantoms was −1.67 mL.
Phantoms with defect inserts
Figure 4C shows the correlation between quantified volumes and actual phantom volumes for phantoms with defect inserts. The correlation with actual volumes was slightly better (r
Discussion
We have presented the methodology of GSCQ for quantifying LV volumes and LVEF from gated SPECT imaging. The method was based on a combination of count density information and geometry of the left ventricle. Endocardial and epicardial boundaries of the LV myocardium were detected with incorporation of an integrated count strategy. LV volumes and LVEF were calculated based on mathematically derived endocardial boundaries. GSCQ was validated in phantoms and in patients. The GSCQ method showed good
Acknowledgment
We thank Oleg Drozhinin, MD, for an initial drawing of the phantom design; Enrique Vallejo, MD, Peter Lam, MD, Mary Jo Zito, and Vera Tsatkin for data collection and technical assistance; and Barry L. Zaret, MD, for reviewing the manuscript. Through an arrangement with Yale University School of Medicine (New Haven, Conn), Drs Liu, Sinusas, and Wackers receive royalties from the sale of Wackers-Liu CQ software.
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2009, American Journal of CardiologyCitation Excerpt :Infarct size, the LV ejection fraction (LVEF), and cardiac volumes were determined from the reconstructed SPECT images by core laboratory (Yale University Radionuclide Core Laboratory, New Haven, Connecticut) using Wackers-Liu CQ software (GE Healthcare, Waukesha, Wisconsin).7 Myocardial perfusion defects (infarct size) were quantified and expressed as a percentage of the left ventricle relative to a normal reference database, and the LVEF was determined using a validated method.7,8 Standard image acquisition was performed at all clinical sites and submitted to an independent angiographic core laboratory.
This study was funded in part by Eclipse Systems Inc, Branford, Conn, and GE Medical Systems, Waukesha, Wis.