title: 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.
abstract: The main aim of this study was to validate the accuracy of 4D-MSPECT in the assessment of left ventricular (LV) end-diastolic/end-systolic volumes (EDV, ESV) and ejection fraction (LVEF) from gated technetium-99m methoxyisobutylisonitrile single-photon emission tomography ((99m)Tc-MIBI SPET), using cardiac magnetic resonance imaging (cMRI) as the reference method. By further comparing 4D-MSPECT and QGS with cMRI, the software-specific characteristics were analysed to elucidate clinical applicability. Fifty-four patients with suspected or proven coronary artery disease (CAD) were examined with gated (99m)Tc-MIBI SPET (8 gates/cardiac cycle) about 60 min after tracer injection at rest. LV EDV, ESV and LVEF were calculated from gated (99m)Tc-MIBI SPET using 4D-MSPECT and QGS. On the same day, cMRI (20 gates/cardiac cycle) was performed, with LV EDV, ESV and LVEF calculated using Simpson's rule. Both algorithms worked with all data sets. Correlation between the results of gated (99m)Tc-MIBI SPET and cMRI was high for EDV [ R=0.89 (4D-MSPECT), R=0.92 (QGS)], ESV [ R=0.96 (4D-MSPECT), R=0.96 (QGS)] and LVEF [ R=0.89 (4D-MSPECT), R=0.90 (QGS)]. In contrast to ESV, EDV was significantly underestimated by 4D-MSPECT and QGS compared to cMRI [130+/-45 ml (4D-MSPECT), 122+/-41 ml (QGS), 139+/-36 ml (cMRI)]. For LVEF, 4D-MSPECT and cMRI revealed no significant differences, whereas QGS yielded significantly lower values than cMRI [57.5%+/-13.7% (4D-MSPECT), 52.2%+/-12.4% (QGS), 60.0%+/-15.8% (cMRI)]. In conclusion, agreement between gated (99m)Tc-MIBI SPET and cMRI is good across a wide range of clinically relevant LV volume and LVEF values assessed by 4D-MSPECT and QGS. However, algorithm-varying underestimation of LVEF should be accounted for in the clinical context and limits interchangeable use of software.
authors.affiliation: Department of Nuclear Medicine, University Hospital, Aachen University of Technology, Pauwelsstrasse 30, 52074, Aachen, Germany.
authors.forename: Claudia S A
authors.initials: CS
authors.lastname: Lipke
authors.forename: Harald P
authors.initials: HP
authors.lastname: Kühl
authors.forename: Bernd
authors.initials: B
authors.lastname: Nowak
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Kaiser
authors.forename: Patrick
authors.initials: P
authors.lastname: Reinartz
authors.forename: Karl-Christian
authors.initials: KC
authors.lastname: Koch
authors.forename: Udalrich
authors.initials: U
authors.lastname: Buell
authors.forename: Wolfgang M
authors.initials: WM
authors.lastname: Schaefer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002306:Cardiac Volume; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi