title: UK audit of left ventricular ejection fraction estimation from equilibrium ECG gated blood pool images.
abstract: OBJECTIVE
  To examine the variability of results obtained from computer analysis of left ventricular gated blood pool (LVGBP) images by nuclear medicine centres in the UK.
  
  
  METHODS
  Twelve data sets of LVGBP images were distributed via commercial software suppliers to nuclear medicine centres in the UK. Two of the data sets were duplicates and three were acquired from the same patient with different total counts in the images. The quality of the images was also variable and two images had poorly defined left ventricular walls. A questionnaire was used to identify the parameters used during the analysis and to give an indication of the number of LVGBP scans per year routinely carried out by each centre as well as report the results obtained from the analysis.
  
  
  RESULTS
  Results were received from 63 nuclear medicine centres using 77 computer systems. The vast majority of participants (57) carried out fewer than 10 scans per month. Only two centres performed more than 30 scans per month. Sixteen centres did not quote a minimum normal value for left ventricular ejection fraction (LVEF) and 36 did not record a maximum value. The remainder recorded between 0.40 and 0.60 for the minimum of normal range and 0.60-0.90 for the maximum of normal range. Analysis of returns showed that LVEF estimates for the data sets were highly variable between centres and computer systems. The overall standard deviation of results compared to the mean for each study was 0.076. Approximately half this variation was due to systematic variation between centres. The overall precision taking into consideration this systematic variation, was 0.055. Lower variability was found between studies with higher overall counts and this was highly significant.
authors.affiliation: IPEM Nuclear Medicine Software Working Party, York, UK. john.skrypniuk@nnuh.nhs.uk
authors.forename: John V
authors.initials: JV
authors.lastname: Skrypniuk
authors.forename: Dale
authors.initials: D
authors.lastname: Bailey
authors.forename: Philip S
authors.initials: PS
authors.lastname: Cosgriff
authors.forename: John S
authors.initials: JS
authors.lastname: Fleming
authors.forename: Alex S
authors.initials: AS
authors.lastname: Houston
authors.forename: Peter H
authors.initials: PH
authors.lastname: Jarritt
authors.forename: David R
authors.initials: DR
authors.lastname: Whalley
mesh_terms: D015637:Gated Blood-Pool Imaging / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards / Q000706:statistics & numerical data*; D008485:Medical Audit / Q000379:methods*; D015588:Observer Variation; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D006113:United Kingdom / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*