First-pass ventricular ejection fraction using a single-crystal nuclear camera.
The purpose of the study was to evaluate the reliability of ejection fractions obtained from first-pass radionuclide ventriculography with a large field-of-view tomographic single-crystal gamma camera.


METHODS
A SPECT camera had its electronics redesigned to improve counting efficiency and was equipped with an experimental ultra-high sensitivity collimator. Left ventricular ejection fraction (LVEF) was measured in 28 patients by 30 degrees RAO first-pass imaging and by "best septal view" LAO planar equilibrium radionuclide ventriculography on a conventional small field of view Anger camera. For 28 other patients, first-pass ejection fractions were compared to multicrystal gamma camera values. Visual analysis was performed to judge clinical acceptability of first-pass images for identification of wall-motion abnormalities.


RESULTS
Linear regression analysis of first-pass against equilibrium ejection fraction demonstrated good correlation (r = 0.92; slope = 0.90; intercept = 3.8; s.e.e. = 6.4%). First-pass ejection fraction values also correlated linearly with multicrystal camera values for the left ventricle (r = 0.94; slope = 1.05; intercept = 1.3; s.e.e. = 5.3%). For a subgroup of 19 patients, single-crystal camera right ventricle ejection fraction demonstrated good correlation with multicrystal camera values (r = 0.82; slope = 1.15; intercept = 1.3; s.e.e. = 6.1%). Interobserver variability correlated as r = 0.99 for LVEF ejection fraction and r = 0.92 for RVEF. Chi-square analysis of single-crystal first-pass image visual scores versus those from the gated equilibrium acquisitions showed close agreement (p < 10(-8)).


CONCLUSIONS
The evaluated camera/collimator system measured left and right ventricular ejection fraction accurately. Lung frame correction and dual regions were superior to paraventricular background correction and a fixed end-diastolic region.
Nichols
K
K
Department of Radiology, St. Luke's-Roosevelt Hospital Center, New York, NY 10025.
DePuey
E G
EG
Gooneratne
N
N
Salensky
H
H
Friedman
M
M
Cochoff
S
S
D005240:Feasibility Studies; D005260:Female; D015902:Gamma Cameras; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology*; D015646:Ventriculography, First-Pass / Q000295:instrumentation* / Q000706:statistics & numerical data