title: Gated blood pool SPECT: The estimation of right ventricular volume and function is algorithm dependent in a clinical setting.
abstract: BACKGROUND
  Gated blood pool SPECT (GBPS) requires further validation for the assessment of the right ventricle (RV). This study evaluated three algorithms: BP-SPECT, QBS, and TOMPOOL (results are referred using this order). We compared (1) their "quantitative-accuracy": estimation of RV ejection fraction (EF), end-diastolic volume (EDV), and cardiac output (CO); (2) their "qualitative-accuracy": threshold values allowing diagnosing an impairment of the RV function; (3) their reproducibility: inter-observer relative variability (IOV).
  
  
  RESULTS
  Forty-eight consecutive patients underwent GBPS. Recommended reference standards were used: cardiac magnetic resonance imaging (CMR) (EDV, EF, n = 48), catheter measurements from thermodilution (TD) (CO, n = 25). (1) "Quantitative-accuracy": r = 0.42, 0.30, 0.42 for RVEF (CMR); r = 0.69, 0.77, 0.53 for RVEDV (CMR); 0.32, 0.36, 0.52 for RCO (TD). (2) "Qualitative-accuracy": optimal thresholds were 54.7%, 38.5%, 45.2% (AUC: 0.83, 0.80, 0.79) for RVEF; 229, 180, 94 mL (AUC: 0.83, 0.81, 0.81) for RVEDV; 4.1, 4.4, 2.6 L·minute(-1) (AUC: 0.73, 0.77, 0.80) for RCO. (3) Reproducibility: IOV was 5% ± 6%, 8% ± 12%, 17% ± 18% for RVEF; 6% ± 8%, 4% ± 4%, 21% ± 18% for RVEDV; 8% ± 8%, 11% ± 15%, 24% ± 20% for RCO.
  
  
  CONCLUSIONS
  Diagnostic accuracies are similar. A CMR-based calibration is required for a quantitative-analysis (cautious interpretation) or an accurate qualitative analysis (thresholds must be adjusted). Automatic procedures (BP-SPECT, QBS) offer the best compromise accuracy/reproducibility.
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: Monia
authors.initials: M
authors.lastname: Ouali
authors.forename: Pierre
authors.initials: P
authors.lastname: Pascal
authors.forename: Thomas
authors.initials: T
authors.lastname: Giraudmaillet
authors.forename: Roland
authors.initials: R
authors.lastname: Chisin
authors.forename: Olivier
authors.initials: O
authors.lastname: Lairez
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Marachet
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.forename: Delphine
authors.initials: D
authors.lastname: Bastié
authors.forename: Fayçal Ben
authors.initials: FB
authors.lastname: Bouallègue
authors.forename: Isabelle
authors.initials: I
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001331:Automation; D003971:Diastole; D005260:Female; D015637:Gated Blood-Pool Imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013815:Thermodilution; D015899:Tomography, Emission-Computed, Single-Photon; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging