Are nuclear medicine images quantified in 2D and 3D equally functional? (original) (raw)
Related papers
Echocardiography, 2007
Patient selection, often restricted to those with ideal image quality, and timing of studies in relation to reference methods may limit clinical applicability of cardiac volumes derived from 3D echocardiography. To test the influence of image quality on LV volumes by real time 3DE (RT3DE), we compared results obtained by RT3DE to those from gated-SPECT imaging in 64 consecutive patients referred for clinically indicated nuclear perfusion imaging. To minimize hemodynamic effects, RT3DE was performed immediately following G-SPECT. LV volumes by RT3DE were calculated using at least three orthogonal plane pairs. Image quality was rated as good if 75-100% of the endocardial border was visualized, fair if 60-74% was visualized, and poor if 50-60% was visualized. Image quality was good in 25 (39%), fair in 20 (31%), and poor in 13 (20%) patients. Six patients (9%) were excluded for uninterpretable echo images. For the entire cohort, EDV and ESV agreed closely (all P = NS). When stratified by image quality, the EDV and ESV of those with good and fair image quality agreed closely with minimal bias (average 1 +/- 9 mL and 2 +/- 7 mL, respectively). Poor image was associated with less strong agreement and much greater bias for EDV and ESV (7 +/- 25 mL and 7 +/- 20 mL, respectively). When applied to patients studied in routine clinical practice, LV volumes by RT3DE compare favorably to G-SPECT. RT3DE results are more reliable when >60% of endocardium is visualized.
2001
Gated blood-pool SPECT (GBPS), inherently 3-dimensional (3D), has the potential to replace planar equilibrium radionuclide angiography (ERNA) for computation of left ventricular ejection fraction (LVEF), analysis of regional wall motion (RWM), and analysis of right heart function. The purpose of this study was to compare GBPS and ERNA for the assessment of ventricular function in a large, multicenter cohort of patients. Methods: One hundred seventy-eight patients referred in the usual manner for nuclear medicine studies underwent ERNA followed by GBPS. Each clinical site followed a GBPS acquisition protocol that included 180°rotation, a 64 by 64 matrix, and 64 or 32 views using single-or double-head cameras. Transverse GBPS images were reconstructed with a Butterworth filter (cutoff frequency, 0.45-0.55 Nyquist; order, 7), and short-axis images were created. All GBPS studies were processed with a new GBPS program, and LVEF was computed from the isolated left ventricular chamber and compared with standard ERNA LVEF. Reproducibility of GBPS LVEF was evaluated, and right ventricular ejection fraction (RVEF) was computed in a subset of patients (n ϭ 33). Using GBPS, RWM and image quality from 3D surface-shaded and volume-rendered cine displays were evaluated qualitatively in a subset of patients (n ϭ 30). Results: The correlation between GBPS LVEF and planar LVEF was excellent (r ϭ 0.92). Mean LVEF was 62.2% for GBPS and 54.1% for ERNA. The line of linear regression was GBPS LVEF ϭ (1.04 ϫ ERNA LVEF) ϩ 6.1. Bland-Altman plotting revealed an increasing bias in GBPS LVEF with increasing LVEF (Y ϭ 0.13x ϩ 0.61; r ϭ 0.30; mean difference ϭ 8.1% Ϯ 7.0%). Interoperator reproducibility of GBPS LVEF was good (r ϭ 0.92). RVEF values averaged 59.8%. RWM assessment using 3D cine display was enhanced in 27% of the studies, equivalent in 67%, and inferior in 7%. Conclusion: GBPS LVEF was reproducible and correlated well with planar ERNA. GBPS LVEF values were somewhat higher than planar ERNA, likely because of the exclusion of the left atrium.
European journal of nuclear medicine and molecular imaging, 2016
Bellevre et al. used D-SPECT (Spectrum Dynamics, Israel) with a cadmium zinc telluridebased camera for the determination of the heart-to-mediastinum ratio (HMR) of myocardial 123 I-metaiodobenzylguanidine (MIBG) uptake [1]. Since some institutions have changed their SPECT equipment from Anger SPECT to D-SPECT for cardiac studies, conventional planar images are not available in the routine clinical setting. Although the European Association of Nuclear Medicine (EANM) Cardiovascular Committee and the European Council of Nuclear Cardiology have recommended the use of medium-energy (ME) collimators for 123 I-MIBG studies [2], a number of hospitals still use low-energy (LE) collimators, and SPECT MIBG HMRs have been added recently.
European Journal of Nuclear Medicine and Molecular Imaging, 2007
Purpose Accurate assessment of ventricular function is required to optimize therapeutic management of cardiac diseases. The aim of this study was to correlate planar equilibrium multigated acquisition (MUGA) with tomographic ventriculography (SPECT) in patients with diverse volumes and wall motion abnormalities. Methods Eighty-three studies in 80 patients (56±14 years; 56% women) were classified according to ventricular dilation, wall motion abnormalities and systolic dysfunction. Left and right ventricular ejection fraction (LVEF and RVEF) and end-diastolic and end-systolic left ventricular volumes (EDV and ESV) were obtained using a commercial QBS program for SPECT. On planar acquisition, LVEF and RVEF were obtained using standard techniques and volumes were determined using the count-based method, without blood sampling. Results A. Total group: With the planar method, LVEF was 44±17%, RVEF 42±13%, left EDV 147±97 ml (range 31–487 ml) and left ESV 93±85 ml (range 15–423 ml); with SPECT the corresponding values were 40±20%, 49±16%,131±95 ml and 91±89 ml, respectively (p=NS for all but RVEF). Linear correlation was 0.845 for LVEF, 0.688 for RVEF, 0.927 for left EDV and 0.94 for left ESV, with good intra-class correlation. B. Subgroups: Global and intra-class correlations between planar imaging and SPECT were high for volumes, RVEF and LVEF in all subgroups, except in patients with normal wall motion and function, who showed smaller volumes with SPECT. The group with diffuse wall motion abnormalities had a lower EDV on SPECT. In the abnormal left ventricle, RVEF was higher with SPECT. Conclusion Good correlation and agreement exist between SPECT and planar MUGA with respect to LVEF and left ventricular volumes. SPECT is useful in patients with functional abnormalities, but less reliable in those with normal small cavities. A combined technique is still necessary, and RVEF should be interpreted cautiously.
Annals of nuclear medicine, 2016
As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created. The CT-based correction provided similar perfusion patterns between genders. In phase analysis of gated myocardial perfusion SPECT, a new approach for analyzing dyssynchrony, normal ranges of parameters for phase bandwidth, standard deviation and entropy were determined in four software programs. Although the results were not interchangeable, dependency on gender, ejection fraction and volumes were common characteristics of these parame...
Multimodality Comparison of Quantitative Volumetric Analysis of the Right Ventricle
JACC: Cardiovascular Imaging, 2010
and overcome the limitations 2D echocardiography that stem from the unique geometry of the right ventricle. We tested a new technique for volumetric analysis of the right ventricle designed for RT3DE, CMR and CCT (TomTec) on images obtained in RV-shaped phantoms and in 28 patients with a range of RV geometry who underwent RT3DE, CMR and CCT imaging on the same day. In-vitro measurements showed that: (1) volumetric analysis of CMR images yielded the most accurate measurements; (2) CCT measurements showed slight (4%) but consistent overestimation; (3) RT3DE measurements showed small underestimation, but considerably wider margins of error. In patients, both RT3DE and CCT measurements correlated highly with the CMR reference (r-values 0.79-0.89) and showed the same trends noted in-vitro. In conclusion, eliminating analysis-related inter-modality differences allowed fare comparisons and highlighted the unique limitations of each modality. Understanding these differences promises to aid in the functional assessment of the right ventricle.
Journal of Nuclear Cardiology, 2009
Background. Increased left ventricular mass (LVM) has been correlated with adverse cardiac events, such as sudden cardiac death. However, LVM quantitation with widely utilized gated SPECT myocardial perfusion imaging (MPI) software, has little validation and clinical application. Thus, we compared LVM from two commonly employed gated SPECT packages [4D-MSPECT Ò (4DM) and Quantitative Perfusion SPECT Ò (QPS)] with the 3-dimensional reference standard, CT angiography (CTA).
2010
The purpose of this study was to test the ability of reinjection thallium-201 and rest technetium-99m sestamibi ECG (electrocardiographic)-gated SPECT (i.e., reinjection-g-SPECT [single-photon emission computed tomography] and MIBI-g-SPECT) to determine regional and global functional parameters. BACKGROUND The ECG-gated perfusion SPECT was reported to provide accurate left ventricular ejection fraction (LVEF) using an automated algorithm. We hypothesized that other various functional data may be obtained using reinjection-g-SPECT and MIBI-g-SPECT. METHODS Reinjection-g-SPECT, MIBI-g-SPECT, and three-dimensional magnetic resonance imaging (3DMRI) were conducted in 20 patients with coronary artery disease. Regional wall motion (RWM) and wall thickening (RWT) were analyzed using semiquantitative visual scoring by each g-SPECT and 3DMRI. The left ventricular end-systolic and end-diastolic volumes (EDV, ESV) and LVEF estimated by reinjection-and MIBI-g-SPECT were compared with the results of 3DMRI. RESULTS A high degree of agreement in RWM and RWT assessment was observed between each g-SPECT and 3DMRI (kappa Ͼ.70, p Ͻ .001). The LVEF values by reinjection-and MIBI-g-SPECT correlated and agreed well with those by 3DMRI (reinjection: r ϭ .92, SEE ϭ 5.9%, SD of differences ϭ 5.7%; sestamibi: r ϭ .94, SEE ϭ 4.4%, SD of differences ϭ 5.1%). The same also pertained to EDV (reinjection: r ϭ .85, SEE ϭ 18.7 ml, SD of differences ϭ 18.4 ml; sestamibi: r ϭ .92, SEE ϭ 13.1 ml, SD of differences ϭ 13.0 ml) and ESV (reinjection: r ϭ .94, SEE ϭ 10.3 ml, SD of differences ϭ 10.3 ml; sestamibi: r ϭ .97, SEE ϭ 6.7 ml [p Ͻ .05 vs. reinjection by F test], SD of differences ϭ 6.6 ml [p Ͻ .05 vs. reinjection by F test]). CONCLUSIONS Reinjection-and MIBI-g-SPECT provide clinically satisfactory various functional data. These functional data in combination with the perfusion information will improve diagnostic and prognostic accuracy without an increase in cost or the radiation dose to the patients.