title: Is TOMPOOL (gated blood-pool SPECT processing software) accurate to diagnose right and left ventricular dysfunction in a clinical setting?
abstract: BACKGROUND
  The assessment of right ventricular function is crucial for management of heart disease. TOMPOOL is a software that processes data acquired with Tomographic Equilibrium Radionuclide Ventriculography. In this report, TOMPOOL's diagnostic accuracy and inter-observer reproducibility were assessed in a cohort of patients with various etiologies of ventricular dysfunction.
  
  
  RESULTS
  End-diastolic volume (EDV), ejection fraction (EF), and cardiac output (CO) were calculated for the right ventricle (RV) and the left ventricle (LV) using TOMPOOL in 99 consecutive patients. Thirty-five patients underwent cardiac magnetic resonance imaging (CMR) considered as the reference-standard to measure EDV and EF; the Spearman's rho correlation coefficients were r = 0.73/0.80 and 0.67/0.73 for right/left EF and EDV, respectively. Twenty-one patients had thermodilution measurements of right CO (reference-standard), the correlation was r = 0.57. The best cut-off points (sensitivity/specificity) in order to diagnose a ventricular dysfunction or enlargement were 46% for RVEF (67%/89%), 62% for LVEF (100%/90%), 94 mL for RVEDV (77%/73%), and 84 mL for LVEDV (100%/91%). The areas under the ROC curve were, respectively, 0.79, 0.91, 0.83, and 0.99. Inter-observer reproducibility was r = 0.81/0.94, 0.77/0.90, and 0.78/0.75 for Right/Left EF, EDV, and CO, respectively.
  
  
  CONCLUSIONS
  TOMPOOL is accurate: measurements of EDV, EF, and CO are reproducible and correlate with CMR and thermodilution. However, thresholds must be adjusted.
authors.affiliation: Department of Nuclear Medicine, Toulouse University Hospital, 1, Avenue Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France, laurent.dercle@gmail.com.
authors.forename: Laurent
authors.initials: L
authors.lastname: Dercle
authors.forename: Thomas
authors.initials: T
authors.lastname: Giraudmaillet
authors.forename: Pierre
authors.initials: P
authors.lastname: Pascal
authors.forename: Olivier
authors.initials: O
authors.lastname: Lairez
authors.forename: Roland
authors.initials: R
authors.lastname: Chisin
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Marachet
authors.forename: Monia
authors.initials: M
authors.lastname: Ouali
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.forename: Delphine
authors.initials: D
authors.lastname: Bastié
authors.forename: Isabelle
authors.initials: I
authors.lastname: Berry
mesh_terms: D000465:Algorithms; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D012986:Software Validation; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*