title: Factors affecting accuracy of ventricular volume and ejection fraction measured by gated tl-201 myocardial perfusion single photon emission computed tomography.
abstract: The electrocardiogram-gated single photon emission computed tomography (SPECT) measurement of left ventricular end-diastolic volume, end-systolic volume and ejection fraction may contain substantial errors. We evaluated whether patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. A total of 518 patients without perfusion defects on Tl-201 SPECT or coronary artery disease were studied. Left ventricular volume and ejection fraction were measured from echocardiography and adenosine stress/redistribution gated Tl-201 SPECT using commercially available software packages (QGS and 4D-MSPECT). We identified factors affecting the accuracy of gated SPECT via multiple linear regression analysis of the differences between echocardiography and gated SPECT. Gated SPECT analyzed with QGS underestimated end-diastolic and end-systolic volume, and overestimated ejection fraction, but 4D-MSPECT overestimated all those values (P<0.001). Independent variables associated with increasing the difference in end-diastolic volume between echocardiography and gated SPECT were decreasing left ventricular end-diastolic wall thickness, decreasing body surface area, female sex and increasing end-diastolic volume (P<0.001). Those for end-systolic volume were decreasing left ventricular end-systolic wall thickness, female sex, and decreasing end-systolic volume (P<0.001). Increasing end-systolic wall thickness, male sex and decreasing age were independent determinants associated with an increased difference in ejection fraction (P<0.001). Adenosine stress SPECT showed significantly higher end-diastolic and end-systolic volume values and a lower ejection fraction than did redistribution SPECT (P<0.001). Patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. Modification of gated SPECT measurements by taking account of these factors would lead to reduce systemic errors.
authors.affiliation: Department of Nuclear Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Moonsun
authors.initials: M
authors.lastname: Pai
authors.forename: You-Jung
authors.initials: YJ
authors.lastname: Yang
authors.forename: Ki Chun
authors.initials: KC
authors.lastname: Im
authors.forename: Il Ki
authors.initials: IK
authors.lastname: Hong
authors.forename: Sung Cheol
authors.initials: SC
authors.lastname: Yun
authors.forename: Duk-Hyun
authors.initials: DH
authors.lastname: Kang
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
authors.forename: Dae Hyuk
authors.initials: DH
authors.lastname: Moon
mesh_terms: D000241:Adenosine; D017677:Age Distribution; D000367:Age Factors; D000375:Aging; D003326:Coronary Circulation / Q000187:drug effects; D004452:Echocardiography / Q000379:methods; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012107:Research Design; D012727:Sex Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D012984:Software; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D000241:Adenosine