Download PDF
Nuklearmedizin 2007; 46(01): 22-28
DOI: 10.1055/s-0037-1616622
Original Article
Schattauer GmbH

Quantification of left ventricular volumes and ejection fraction from 16- and rebinned 8-frame gated 99mTc-tetrofosmin SPECT

Comparison of 4D-MSPECT and QGSBestimmung der linksventrikulären Volumina und Ejektionsfraktion aus 16- und rebinnten 8-Frame-gated-99mTc-Tetrofosmin-SPECT-StudienVergleich von 4D-MSPECT und QGS
W. M. Schaefer
1   Department of Nuclear Medicine, University of Technology, Aachen, Germany
,
H.-J. Kaiser
1   Department of Nuclear Medicine, University of Technology, Aachen, Germany
,
H. Kuehl
2   Medical Clinic I (Cardiology), University Hospital, University of Technology, Aachen, Germany
,
K.-C. Koch
2   Medical Clinic I (Cardiology), University Hospital, University of Technology, Aachen, Germany
,
B. Nowak
1   Department of Nuclear Medicine, University of Technology, Aachen, Germany
,
U. Buell
1   Department of Nuclear Medicine, University of Technology, Aachen, Germany
› Author Affiliations
Further Information

Publication History

Received: 31 May 2006

accepted in revised form: 10 October 2006

Publication Date:
08 January 2018 (online)

Also available at
    Permissions and Reprints

Summary

Aim: Using 8-frames/cardiac cycle with gated SPECT underestimates end-diastolic volumes (EDV) and ejection fractions (LVEF), and overestimates end-systolic volumes (ESV). However, using 16-frames/cardiac cycle significantly decreases the signal-to-noise-ratio. We analyzed 16-frames and rebinned 8-frame gated SPECT data using common 4D-MSPECT and QGS algorithms. Patients, methods: 120 patients were examined using gated SPECT on a Siemens Multispect 3 (triple-head gamma camera) 60 minutes after intravenous administration at rest of about 450 MBq (two-day protocol) or about 750 MBq (one-day protocol) 99mTc-tetrofosmin. Reoriented short axis slices (16-frames) were summed framewise (1+2,3+4, etc.) yielding 8-frame data sets. EDV, ESV and LVEF were calculated for both data sets using 4D-MSPECT and QGS. Results: QGS succeeded with 119, 4D-MSPECT with 117 patients. For the remaining 116 patients, higher EDV (+0.8ml/+3.8ml) and LVEF (+1.5%/+2.6%; absolute) and lower ESV (–1.7ml/–0.9ml) (4D-MSPECT/QGS) were found for 16-frame runs. Bland-Altman limits were smaller for QGS than 4D-MSPECT [EDV 32/12ml, ESV 21/10ml, LVEF 17/7% (4D-MSPECT/QGS)]. Conclusion: Both algorithms showed the expected effects. Contour finding using QGS failed with only one data set, whereas contour finding using 4D-MSPECT failed with three data sets. Since the effects observed between the 8– and the 16-frame studies are relatively small and quite predictable, 8-frame studies can be employed in clinical routine with hardly any loss at all, plus contour finding appears less susceptible to error.

Zusammenfassung

Ziel: Erfolgt bei der herzphasengetriggerten (gated) myokardialen Perfusions-SPECT die Akquisition mit nur 8-Frames/Herzzyklus, dann resultiert daraus eine Unterschätzung der linksventrikulären end-diastolischen Volumina (EDV) und der Ejektionsfraktion (LVEF) und eine Überschätzung der end-systolischen Volumina( ESV).Nutztmanjedoch16-Frames/Herzzyklus,umdiese Effekte zu minimieren, ergibt sich eine signifikante Reduktion des Signal-zu-Rausch-Verhältnisses. Um die Auswirkungen der schlechteren zeitlichen Auflösung bei besserem Signal-zu- Rausch-Verhältnis auf die Ergebnisse zu untersuchen, analysierten wir 16-Frames/Herzzyklus Gated-SPECT-Daten und daraus rebinnte 8-Frames/Herzzyklus Gated-SPECT-Daten mit den weit verbreiteten Konturfindungsalgorithmen 4D-MSPECT und QGS. Patienten, Methoden: 120 Patienten wurden an einer Siemens Multispect 3 (Drei-Kopf-Kamera) ca. 60 min nach i.v.-Injektion (Ruhe-Studie) von 450 MBq (2-Tages-Protokoll) oder von 750 MBq (1-Tages-Protokoll) 99mTc-Tetrofosmin mit gated SPECT (16-frames/ Herzzyklus) untersucht. Die reorientierten Kurzachsendatensätze (16 frames) wurden frameweise (1+2,3+4, etc.) zu 8-Frames-Kurzachsendatensätzen summiert. EDV, ESV und LVEF wurden für je beide Datensätze mit den Konturfindungsalgorithmen 4D-MSPECT und QGS berechnet. Ergebnisse: Die Konturfindung mit QGS war bei 119, die mit 4D-MSPECT bei117Patientenerfolgreich.Beidengemeinsamen116Patienten ergaben die 16-Frames-Studien höhere EDV- (+0.8ml/+3.8ml) und LVEF- (+1.5%/+2.6%; absolut) und niedrigere ESV-Werte (–1.7ml/–0.9ml; 4D-MSPECT/ QGS).DieBland-Altman-GrenzenwarenfürQGSschmaleralsfür 4D-MSPECT (EDV 32/12ml, ESV 21/10ml, LVEF 17/7%; 4D-MSPECT/QGS). Schlussfolgerungen: Beide Konturfindungsalgorithmen zeigten die erwarteten Effekte. Mit QGS gelang die Konturfindung nur in einem Datensatz nicht adäquat, wohingegensiemit4D-MSPECTindreiDatensätzenversagte.Da die beobachteten Effekte zwischen 8- und 16-Frames-Studien relativ klein und sehr gut vorhersehbar sind, können in der klinischen Routine 8-Frames-Studien nahezu verlustfrei eingesetzt werden, wobei dann die Konturfindung weniger störanfällig erscheint.

Keywords

Gated SPECT - 16 frames - 8 frames - 4D-MSPECT - QGS

Schlüsselwörter

Gated SPECT - 16 Frames - 8 Frames - 4D-MSPECT - QGS
 

  • References

  • 1 Bavelaar-Croon CDL, Kayser HWM, van der Wall EE. et al. Left ventricular function: correlation of quantitative gated SPECT and MR imaging over a wide range of values. Radiology 2000; 217: 572-5.
    CrossrefPubMedGoogle Scholar
  • 2 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-10.
    PubMedGoogle Scholar
  • 3 DePuey EG, Nichols K, Dobrinsky C. Left ventricular ejection traction assessed from gated tech- netium-99m-sestamibi SPECT. JNucl Med 1993; 34: 1871-6.
    Google Scholar
  • 4 Ficaro EP, Quaife RA, Kritzman JN. et al. Accuracy and reproducibility of 3D-MSPECT for estimating left ventricular ejection fraction in patients with severe perfusion abnormalities [abstract]. Circulation. 1999 100. (suppl 1) I26.
    Google Scholar
  • 5 Germano G, Kiat H, Kavanagh PB. et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT. J Nucl Med 1995; 36: 2138-47.
    PubMedGoogle Scholar
  • 6 Gutberlet M, Mehl S, Frohlich M. et al. Determination of ventricular volumes in coronary artery disease: comparison of two gated SPECT analysis tools with MRI. Nuklearmedizin 2006; 45: 63-73.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Kumita S, Cho K, Nakajo H. et al. Assessment of left ventricular diastolic function with electroc- ardiography-gated myocardial perfusion SPECT: comparison with multigated equilibrium radionuclide angiography. J Nucl Cardiol 2001; 8: 568-74.
    CrossrefPubMedGoogle Scholar
  • 8 Lipke C, Kuehl HP, 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 2004; 31: 482-90.
    CrossrefPubMedGoogle Scholar
  • 9 Manrique A, Koning R, Cribier A. et al. Effect of temporal sampling on evaluation of left ventricular ejection fraction by means of thallium-201 gated SPET: comparison of 16- and 8-interval gating, with reference to equilibrium radionuclide angiography. Eur J Nucl Med 2000; 27: 694-9.
    CrossrefPubMedGoogle Scholar
  • 10 Schaefer WM, Nowak B, Kaiser HJ. et al. An approach for comparative quantification of myocardial blood flow (O-15-H2O-PET), perfusion (99mTc-Tetrofosmin-SPECT), and metabolism (18F-FDG-PET). Nuklearmedizin 2001; 40: 164-71.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Schaefer WM, Lipke CS, Standke D. et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med 2005; 46: 1256-63.
    PubMedGoogle Scholar
  • 12 Sharir T, Germano G, Kang X. et al. Prediction of myocardial infarction versus cardiac death by gated myocardial perfusion SPECT: risk stratification by the amount of stress-induced ischemia and the poststress ejection fraction. J Nucl Med 2001; 42: 831-7.
    PubMedGoogle Scholar
  • 13 Zajic T, Fischer R, Saurbier B. et al. Assessment of left ventricular function and volume by myoc- ardial perfusion scintigraphy--comparison of two algorithms. Nuklearmedizin 2001; 40: 135-42.
    Article in Thieme ConnectPubMedGoogle Scholar