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Validation of 4D-MSPECT and QGS for quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPET: comparison with cardiac magnetic resonance imaging

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Abstract

The main aim of this study was to validate the accuracy of 4D-MSPECT in the assessment of left ventricular (LV) end-diastolic/end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) from gated technetium-99m methoxyisobutylisonitrile single-photon emission tomography (99mTc-MIBI SPET), using cardiac magnetic resonance imaging (cMRI) as the reference method. By further comparing 4D-MSPECT and QGS with cMRI, the software-specific characteristics were analysed to elucidate clinical applicability. Fifty-four patients with suspected or proven coronary artery disease (CAD) were examined with gated 99mTc-MIBI SPET (8 gates/cardiac cycle) about 60 min after tracer injection at rest. LV EDV, ESV and LVEF were calculated from gated 99mTc-MIBI SPET using 4D-MSPECT and QGS. On the same day, cMRI (20 gates/cardiac cycle) was performed, with LV EDV, ESV and LVEF calculated using Simpson’s rule. Both algorithms worked with all data sets. Correlation between the results of gated 99mTc-MIBI SPET and cMRI was high for EDV [R=0.89 (4D-MSPECT), R=0.92 (QGS)], ESV [R=0.96 (4D-MSPECT), R=0.96 (QGS)] and LVEF [R=0.89 (4D-MSPECT), R=0.90 (QGS)]. In contrast to ESV, EDV was significantly underestimated by 4D-MSPECT and QGS compared to cMRI [130±45 ml (4D-MSPECT), 122±41 ml (QGS), 139±36 ml (cMRI)]. For LVEF, 4D-MSPECT and cMRI revealed no significant differences, whereas QGS yielded significantly lower values than cMRI [57.5%±13.7% (4D-MSPECT), 52.2%±12.4% (QGS), 60.0%±15.8% (cMRI)]. In conclusion, agreement between gated 99mTc-MIBI SPET and cMRI is good across a wide range of clinically relevant LV volume and LVEF values assessed by 4D-MSPECT and QGS. However, algorithm-varying underestimation of LVEF should be accounted for in the clinical context and limits interchangeable use of software.

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Acknowledgements

This project was funded by a grant from the IZKF BIOMAT (TV20/21, BMBF project No. 01 KS 9503/9), Germany.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital, Aachen University of Technology, Pauwelsstrasse 30, 52074, Aachen, Germany

    Claudia S. A. Lipke, Bernd Nowak, Hans-Juergen Kaiser, Patrick Reinartz, Udalrich Buell & Wolfgang M. Schaefer

  2. Medical Clinic I (Cardiology), University Hospital, Aachen University of Technology, Pauwelsstrasse 30, 52074, Aachen, Germany

    Harald P. Kühl & Karl-Christian Koch

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  1. Claudia S. A. Lipke
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Correspondence to Wolfgang M. Schaefer.

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Lipke, C.S.A., Kühl, H.P., Nowak, B. et al. Validation of 4D-MSPECT and QGS for quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPET: comparison with cardiac magnetic resonance imaging. Eur J Nucl Med Mol Imaging 31, 482–490 (2004). https://doi.org/10.1007/s00259-003-1411-y

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  • DOI: https://doi.org/10.1007/s00259-003-1411-y

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