title: Evaluation of the Left Ventricular Ejection Fraction with Gated IQ-SPECT Myocardial Perfusion Imaging.
abstract: The aim of this study was to evaluate the assessment of the left ventricular ejection fraction (LVEF) in patients by gated IQ-SPECT.
  
  
  METHODS
  Twenty-eight patients were examined using gated (99m)Tc-sestamibi IQ-SPECT. Two different reconstruction datasets were created using the same projection data. The number of iterations, subsets, and gaussian filtering were based on 2 different recommendations from the manufacturer. For each dataset, end diastolic volume, end systolic volume, and LVEF were calculated using 4DMSPECT. A multigated planar equilibrium radionuclide ventriculography (MUGA) study with (99m)Tc-labeled red blood cells was used as a reference for the LVEF.
  
  
  RESULTS
  The values of the different datasets were tested using the Bland-Altman analysis method. The calculated mean and 95% limits of agreement for the LVEF when dataset 1 and 2 were compared were -1.1% and ±15% points; when dataset 1 was compared with MUGA, the mean was calculated to -3.1% points and ±17% points for the 95% limits of agreement. When dataset 2 and MUGA were compared, the mean was -4.2% and 95% limits of agreement of ±18% points.
  
  
  CONCLUSIONS
  Neither of the gated reconstructed datasets analyzed with 4DMSPECT was comparable to LVEF estimated by MUGA, with a tendency to overestimate LVEF. However, large random variations of the end diastolic volume, end systolic volume, and LVEF between the 2 gated reconstructed datasets were found. The reconstructed datasets were not interchangeable. Thus, these values should only be used with great caution when evaluating the functional state of the heart.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Naestved Hospital, Naestved, Denmark troe@regionsjaelland.dk.
authors.forename: Troels
authors.initials: T
authors.lastname: Joergensen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Naestved Hospital, Naestved, Denmark.
authors.forename: Susanne Haase
authors.initials: SH
authors.lastname: Hansson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: IQ-SPECT; ejection fraction; gated blood pool; myocardial perfusion imaging