Normal limits of gated blood pool SPECT count-based regional cardiac function parameters.
OBJECTIVE
Computations of left and right ventricular (LV and RV) gated blood pool SPECT (GBPS) ejection fraction (EF) have been well validated against other imaging modalities. As GBPS images depict the entire extent of both blood pools, it is possible to compute not only global but also regional biventricular function parameters, which have the prospect of being clinically useful for planning cardiac resynchronization therapy. This investigation sought to establish LV and RV count-based GBPS regional functional normal limits and to quantify their reproducibility.


METHODS
Count-versus-time curves were fit to third-order Fourier series for each of 17 LV and RV sub-volumes to compute global and regional EF, timing, phase and dyssynchrony parameters. Algorithms were applied to data for 40 normal controls (NLs) and 15 patients with CHF. To assess reproducibility, data were reprocessed a second time, blinded to initial calculations.


RESULTS
There were no statistically significant differences between any initial and reprocessed LV or RV parameters for NLs or patients with CHF. Percent of subjects categorized as abnormal were the same for initial and reprocessed parameters (McNemar's differences = 0-7%, P > 0.05 for each parameter). Most parameters were significantly different for patients with CHF versus NLs. Normal limits for the new technique agreed well with the literature for other imaging methods, and RV normal limits closely paralleled LV limits.


CONCLUSIONS
GBPS global and regional LV and RV normal limits are reproducible, and application of these normal limits to patients with CHF results in reproducible detection of functional abnormalities.
Nichols
Kenneth J
KJ
Division of Nuclear Medicine, North Shore Long Island Jewish Health System, 270-05 76th Avenue, New Hyde Park, NY 11040, USA. knichols@lij.edu
Van Tosh
Andrew
A
De Bondt
Pieter
P
Bergmann
Steven R
SR
Palestro
Christopher J
CJ
Reichek
Nathaniel
N
D000465:Algorithms; D000583:Amikacin; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006333:Heart Failure / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012737:Sex Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging; D016276:Ventricular Function
D000583:Amikacin