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Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin: a multicentre study involving 106 hospitals

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Inter-institution reproducibility of gated SPECT quantification based on institutional preferences was evaluated. This sort of variability is crucial for a multicentre study when many hospitals are involved.

Methods

A total of 106 institutes participated in this study and were grouped according to their use of five workstation types. Fifteen sets of 99mTc-tetrofosmin gated projection images with normal ejection fraction (EF) (∼70%, group A, n=5), borderline low EF (∼50%, group B, n=5) and low EF with large perfusion defects (∼30%, group C, n=5) were prepared. The projection images were processed by QGS software in each institute based on its own routine settings. Based on 318 QGS results, the reproducibility of EF and volumes was analysed for each group and workstation.

Results

The reproducibility of EF was good in 14 of 15 cases, showing a standard deviation (SD) of <3.6%, and the coefficient of variance of the end-diastolic volume (EDV) was <9.3% in all cases. When the deviation from the average value was analysed, the difference between EF at each institute and the average EF of the workstation (dEF) showed an SD of 2.2–3.7% for each group. The ratio of the EDV divided by the average EDV (rEDV) showed an SD of 0.061–0.069 for each group. One case in group C that had a large anterior defect with low EF showed bimodal EF distribution in one of the five workstations. The SD of EF was workstation dependent, owing to the SPECT reconstruction conditions.

Conclusion

The reproducibility in EF and volumes within a workstation was good, even though the gated SPECT preferences varied. This reproducibility study supports the use of gated SPECT as a standard of ventricular function in multicentre studies.

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Acknowledgements

The authors appreciate the kind assistance offered by five companies, Toshiba Medical Systems Co, Ltd. (Tokyo, Japan), Shimadzu Corporation (Kyoto, Japan), GE Yokogawa Medical Systems, Ltd (Tokyo, Japan), Hitachi Medical Corporation (Tokyo, Japan) and Siemens-Asahi Medical Technologies Ltd (Tokyo, Japan), in preparing the projection data sets for their computer systems. We also thank the many physicians and technologists in 117 institutes for their collaboration. This work was financially supported by Japan Cardiovascular Research Foundation.

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Correspondence to Kenichi Nakajima.

Additional information

Organisation of JACCESS and committee members participating in this study: Principal Investigator: Tsunehiko Nishimura, MD, Department of Radiology, Kyoto Prefectural University of Medicine. Committee of Image Analysis: Kenichi Nakajima, MD (Chief), Department of Nuclear Medicine, Kanazawa University Hospital; Shinichiro Kumita, MD, Department of Radiology, Nippon Medical School; Kazuki Fukuchi, MD, Department of Radiology, National Cardiovascular Center; Hideki Kobayashi, MD, Department of Radiology, Tokyo Women’s Medical University; Shinji Hasegawa, MD, Division of Tracer Kinetics, Osaka University Graduate School of Medicine; Hirotaka Maruno, MD, Department of Radiology, Toranomon Hospital; Junichi Taki, MD, Department of Biotracer Medicine, Kanazawa University Graduate School of Medicine; Susumu Nakagawa, MD, Department of Internal Medicine, Tokyo Saiseikai Central Hospital; Yasuchika Takeishi, MD, First Department of Internal Medicine, Yamagata University School of Medicine. JACCESS office: Kanji Kato, Kenji Ichioka

J-ACCESS has no conflict of interest with any computer companies. This study is not intended to show the superiority of a specific workstation.

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Nakajima, K., Nishimura, T. Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin: a multicentre study involving 106 hospitals. Eur J Nucl Med Mol Imaging 33, 127–133 (2006). https://doi.org/10.1007/s00259-005-1916-7

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  • DOI: https://doi.org/10.1007/s00259-005-1916-7

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