K. Nakajima et al., Accuracy of ventricular volume and ejection fraction measured by gated myocardial SPECT: Comparison of 4 software programs, J NUCL MED, 42(10), 2001, pp. 1571-1578
Citations number
22
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Gated myocardial perfusion SPECT has been used to calculate ejection fracti
on (EF) and end-diastolic volume (EDV) and has correlated well with convent
ional methods. However, the comparative accuracy of and correlations across
various types of gated SPECT software are not well understood. Methods: Ma
thematic phantoms of cylindric-hemispheric hybrid models, ranging in volume
from 34 to 266 mL, were generated. The clinical cases consisted of 30 pati
ents who participated in a radionuclide angiography and gated blood-pool (G
BP) study in addition to undergoing Tc-99m-sestamibi gated SPECT. Four kind
s of software, Quantitative Gated SPECT (QGS), the Emory Cardiac Toolbox (E
CT), 4D-MSPECT, and Perfusion and Functional Analysis for Gated SPECT (pFAS
T) were used to compute EF and EDV, and the results were analyzed by multip
le comparisons tests. Patients were classified into 4 groups (i.e., no defe
ct, small defect, large defect, and small heart) so that factors affecting
variation could be analyzed. Results: In mathematic models greater than or
equal to 74 mL, volume error was within +/- 15%, whereas for a small volume
(34 mL), QGS and 4D-MSPECT underestimated the volume and pFAST overestimat
ed it. The respective intra- and interobserver reproducibility of the resul
ts was good for QGS (r = 0.99 and 1.00), ECT (r = 0.98 and 0.98), and 4D-MS
PECT (r = 0.98 and 0.98) and fair for pFAST (r = 0.88 and 0.85). The correl
ation coefficient for EF between gated SPECT and the GBP study was 0.82, 0.
78, 0.69, and 0.84 for QGS, ECT, 4D-MSPECT, and pFAST, respectively. The co
rrelation coefficient for EDV between gated SPECT and the GBP study was 0.8
8, 0.89, 0.85, and 0.90, respectively. Although good correlation was observ
ed among the 4 software packages, QGS, ECT, and 4D-MSPECT overestimated EF
in patients with small hearts, and pFAST overestimated the true volume in p
atients with large perfusion defects. Correlation coefficients among the 4
kinds of software were 0.80-0.95 for EF and 0.89-0.98 for EDV. Conclusion:
All 4 software programs showed good correlation between EF or EDV and the G
BP study. Good correlation was observed also between each pair of quantific
ation methods. However, because each method has unique characteristics that
depend on its specific algorithm and thus behaves differently in the vario
us patient subgroups, the methods should not be used interchangeably.