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Variability of left ventricular ejection fraction and volumes with quantitative gated SPECT: influence of algorithm, pixel size and reconstruction parameters in small and normal-sized hearts

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Abstract

Purpose

Several software packages are commercially available for quantification of left ventricular ejection fraction (LVEF) and volumes from myocardial gated single-photon emission computed tomography (SPECT), all of which display a high reproducibility. However, their accuracy has been questioned in patients with a small heart. This study aimed to evaluate the performances of different software and the influence of modifications in acquisition or reconstruction parameters on LVEF and volume measurements, depending on the heart size.

Methods

In 31 patients referred for gated SPECT, 642 and 1282 matrix acquisitions were consecutively obtained. After reconstruction by filtered back-projection (Butterworth, 0.4, 0.5 or 0.6 cycles/cm cut-off, order 6), LVEF and volumes were computed with different software [three versions of Quantitative Gated SPECT (QGS), the Emory Cardiac Toolbox (ECT) and the Stanford University (SU-Segami) Medical School algorithm] and processing workstations. Depending upon their end-systolic volume (ESV), patients were classified into two groups: group I (ESV>30 ml, n=14) and group II (ESV<30 ml, n=17). Agreement between the different software packages and the influence of matrix size and sharpness of the filter on LVEF and volumes were evaluated in both groups.

Results

In group I, the correlation coefficients between the different methods ranged from 0.82 to 0.94 except for SU-Segami (r=0.77), and were slightly lower for volumes than for LVEF. Mean differences between the methods were not significant, except for ECT, with which LVEF values were systematically higher by more than 10%. Changes in matrix size had no significant influence on LVEF or volumes. On the other hand, a sharper filter was associated with significantly larger volume values though this did not usually result in significant changes in LVEF. In group II, many patients had an LVEF in the higher range. The correlation coefficients between the different methods ranged between 0.80 and 0.96 except for SU-Segami (r=0.49), and were slightly worse for volumes than for LVEF values. In contrast to group I, however, inter-method variability was quite large and most mean LVEF differences were significant. LVEF was systematically highest with ECT and lowest with SU-Segami. With QGS, changes in matrix size from 642 to 1282 were associated with significantly larger volumes as well as lower LVEF values. Increasing the filter cut-off frequency had the same effect. With SU-Segami, a larger matrix was associated with larger end-diastolic volumes and smaller ESVs, resulting in a highly significant increase in LVEF. Increasing the filter sharpness, on the other hand, had no influence on LVEF though the measured volumes were significantly larger.

Conclusion

In patients with a normal-sized heart, LVEF and volume estimates computed from different commercially available software packages for quantitative gated SPECT are well correlated. LVEF and volumes are only slightly sensitive to changes in matrix size. Smoothing, by contrast, is associated with significant changes in volumes but usually not in LVEF values. However, owing to the specific characteristics of each algorithm, software should not be interchanged for follow-up in an individual patient. In small hearts, on the other hand, both the used software and the matrix size or smoothing significantly influence the results of quantitative gated SPECT. LVEF values in the higher range are frequently observed with all the studied software except for SU-Segami. A larger matrix or a sharper filter could be suggested to enhance the accuracy of most commercial software, more particularly in patients with a small heart.

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References

  1. Germano G, Kiat H, Kavanagh PB, Moriel M, Mazzanti M, Su H, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995;36:2138–47.

    CAS  PubMed  Google Scholar 

  2. Germano G, Kavanagh PB, Kavanagh JT, Wishner SH, Berman DS, Kavanagh GJ. Repeatability of automatic left ventricular cavity volume measurements from myocardial perfusion SPECT. J Nucl Cardiol 1998;5:477–83.

    Article  CAS  PubMed  Google Scholar 

  3. Goris ML, Thompson C, Malone L, Franken PR. Modeling the integration of myocardial regional perfusion and function. Nucl Med Commun 1994;15:9–20.

    CAS  PubMed  Google Scholar 

  4. Faber TL, Akers MS, Peshock RM, Corbett JR. Three dimensional motion and perfusion quantification in gated single-photon emission computed tomograms. J Nucl Med 1991;32:2311–7.

    CAS  PubMed  Google Scholar 

  5. Faber Tl, Cooke CD, Folks RD, Vansant JP, Nichols KJ, DePuey EG, et al. Left ventricular function and perfusion from gated perfusion images: an integrated method. J Nucl Med 1999;40:650–9

    CAS  PubMed  Google Scholar 

  6. Nichols K, DePuey RG, Rozanski A. Automation of gated tomography left ventricular ejection fraction. J Nucl Cardiol 1996;3:475–82

    Article  CAS  PubMed  Google Scholar 

  7. Everaert H, Bossuyt A, Franken P. Left ventricular ejection fraction and volumes from gated single photon emission tomographic myocardial perfusion images: comparison between two algorithms working in three-dimensional space. J Nucl Cardiol 1997;4:472–6

    Article  CAS  PubMed  Google Scholar 

  8. Nichols K, Lefkowitz D, Faber T, Folks R, Cooke D, Garcia EV, et al. Echocardiographic validation of gated SPECT ventricular function measurements. J Nucl Med 2000;41:1308–14

    CAS  PubMed  Google Scholar 

  9. Nakajima J, Higuchi T, Taki J, Kawano M, Tonami N. Accuracy of ventricular volume and ejection fraction measured by gated myocardial SPECT: comparison of 4 software programs. J Nucl Med 2001;42:1571–8

    CAS  PubMed  Google Scholar 

  10. Vourvouri E, Poldermans D, Bax JJ, Sianos G, Sozzi FB, Schinkel AF, et al. Evaluation of left ventricular function and volumes in patients with ischaemic cardiomyopathy: gated single-photon emission computed tomography versus two-dimensional echocardiography. Eur J Nucl Med 2001;28:1610–5

    Article  CAS  PubMed  Google Scholar 

  11. Lum DP, Coel MN. Comparison of automatic quantification software for the measurement of ventricular volume and ejection fraction in gated myocardial perfusion SPECT. Nucl Med Commun 2003;24:259–66

    Article  CAS  PubMed  Google Scholar 

  12. Vallejo E, Dione DP, Bruni WL, Constable RT, Borek PP, Soares JP, et al. Reproducibility and accuracy of gated SPECT for determination of left ventricular volume and ejection fraction: experimental validation using MRI. J Nucl Med 2000;41:874–82

    CAS  PubMed  Google Scholar 

  13. Nakajima K, Taki J, Higuchi T, Kawano M, Taniguchi M, Maruhashi K, et al. Gated SPET quantification of small hearts: mathematical simulation and clinical application. Eur J Nucl Med 2000;27:1372–9

    Article  CAS  PubMed  Google Scholar 

  14. Ford P, Chatziioannou S, Moore H, Dhekne R. Overestimation of the LVEF by quantitative gated SPECT in simulated left ventricles. J Nucl Med 2001;42:454–9

    CAS  PubMed  Google Scholar 

  15. Manrique A, Hitzel A, Gardin I, Dacher JN, Vera P. Influence of Wiener filter in determining the left ventricle volume and ejection fraction using thallium-201 gated SPECT. Nucl Med Commun 2003;24:907–14

    Article  CAS  PubMed  Google Scholar 

  16. De Bondt P, Van de Wiele C, De Sutter J, De Winter F, De Backer G, Dierckx RA. Age- and gender-specific differences in left ventricular cardiac function and volumes determined by gated SPET. Eur J Nucl Med 2001;28:620–4

    Article  PubMed  Google Scholar 

  17. Achtert AD, King MA, Dahlberg ST, Pretorius PH, LaCroix KJ, Tsui BM. An investigation of the estimation of ejection fractions and cardiac volumes by a quantitative gated SPECT software package in simulated gated SPECT images. J Nucl Cardiol 1998;5:144–52

    Article  CAS  PubMed  Google Scholar 

  18. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurements. Lancet 1986;1:307–10

    CAS  PubMed  Google Scholar 

  19. Nichols K, Santana CA, Folks R, Krawczynska E, Cooke CD, Faber TL, et al. Comparison between ECT and QGS for assessment of left ventricular function from gated myocardial perfusion SPECT. J Nucl Cardiol 2002;9:285–93

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank H. Ham, MD, PhD, for his friendly comments and criticisms in the review of this manuscript. None of the authors has a financial interest in any software package. This study did not receive any vendor support.

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Correspondence to Anne-Sophie Hambye.

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Hambye, AS., Vervaet, A. & Dobbeleir, A. Variability of left ventricular ejection fraction and volumes with quantitative gated SPECT: influence of algorithm, pixel size and reconstruction parameters in small and normal-sized hearts. Eur J Nucl Med Mol Imaging 31, 1606–1613 (2004). https://doi.org/10.1007/s00259-004-1601-2

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  • DOI: https://doi.org/10.1007/s00259-004-1601-2

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