Automatic quantification of left ventricular ejection fraction from gated blood pool SPECT

Division of Medical Physics and Imaging, Department of Medicine, UCLA School of Engineering and Applied Science, Los Angeles, Calif., USA; Burns and Allen Research Institute, Cedars-Sinai Medical Center, The Department of Computer Science, UCLA School of Engineering and Applied Science, Los Angeles, Calif., USA; Division of Nuclear Medicine, Department of Imaging, UCLA School of Engineering and Applied Science, Los Angeles, Calif., USA; Department of Radiological Sciences, and the Department of Medicine Los Angeles, Calif., USA; The Division of Nuclear Medicine and Biophysics Los Angeles, Calif., USA
Journal of Nuclear Cardiology (Impact Factor: 2.85). 01/1999; DOI: 10.1016/S1071-3581(99)90022-3

ABSTRACT Background. Cardiac gated blood pool single photon emission computed tomography (GBPS) better separates cardiac chambers compared with planar radionuclide ventriculography (PRNV). We have developed a completely automatic algorithm to measure quantitatively the left ventricular ejection fraction (LVEF) from gated technetium 99m-red blood cells (RBC) GBPS short-axis 3-dimensional image volumes.Methods and Results. The algorithm determines an ellipsoidal coordinate system for the left ventricle and then computes a static estimate of the endocardial surface by use of counts and count gradients. A dynamic surface representing the endocardium is computed for each interval of the cardiac cycle by use of additional information from the temporal Fourier transform of the image data sets. The algorithm then calculates the left ventricular volume for each interval and computes LVEF from the end-diastolic and end-systolic volumes. The algorithm was developed in a pilot group (N = 45) and validated in a second group (N = 89) of patients who underwent PRNV and 8-interval GBPS. Technically inadequate studies (N = 38) were rejected before grouping and processing. Automatic identification and contouring of the left ventricle was successful in patients (70%) globally and in patients (85%) in the validation group. Correlation between LVEFs measured from GBPS and PRNV was high (y = 2.00 + 1.01x, r = 0.89), with GBPS LVEF significantly higher than PRNV LVEF (average difference = 2.8%, P < .004).Conclusions. Our automatic algorithm agrees with conventional radionuclide measurements of LVEF and provides the basis for 3-dimensional analysis of wall motion.

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    ABSTRACT: Background The evaluation of the Right ventricle (RV) is a challenge; as a result six transthoracic echocardiography (TTE) parameters have been suggested. While gated blood-pool single photon electron computed tomography (GBPS) is a promising technique, there is currently no completely automated and validated processing software available clinically. Consequently, cardiac magnetic resonance (CMR) imaging remains the gold standard for RV assessment. We aimed to compare RV evaluation by GBPS and TTE to CMR. Methods 58 patients underwent CMR, GBPS and TTE for RV assessment, including volumes, RVEF and TTE’s indices of RV function (fractional area change (FAC), RV myocardial performance index by pulsed wave Doppler (MPI-PWD) and tissue Doppler (MPI-TDI) and tricuspid annular plane systolic excursion (TAPSE) by M-Mode and tissue Doppler (TAPSE-TDI)). GBPS was performed using both a commercial (QBS) and the Montreal Heart Institute (MHI) proprietary softwares. Results Nuclear medicine derived volumes quantification showed very good correlations with CMR, for RV end-diastolic (r = 0.84 and 0.77, all p < 0.001) and end-systolic (r = 0.82 and 0.67, all p < 0.001) volumes by MHI and QBS softwares respectively. RVEF showed a significant correlation with CMR in patients with RVEF ≤ 45% (r = 0.54, p = 0.029 and r = 0.55, p = 0.028, by MHI and QBS respectively). Amongst TTE parameters, only FAC and MPI-TDI were significantly correlated with CMR-RVEF, mainly for RVEF ≤ 45% (r = 0.63, p = 0.011 and r = 0.58, p = 0.046). Conclusions GBPS, both with MHI and QBS softwares, exhibited significant correlations with CMR for evaluation of the RV (volumes and decreased RVEF estimation). Amongst TTE’s parameters, only FAC and MPI-TDI showed significant correlation with CMR with RVEF ≤ 45%.
    International journal of cardiology 01/2013; · 6.18 Impact Factor
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    ABSTRACT: PURPOSE: The purpose of this study is to evaluate left ventricular functional parameters in healthy mice and in different murine models of cardiomyopathy with the novel blood pool (BP) positron emission tomography (PET) tracer [(68)Ga]-albumin. PROCEDURES: ECG-gated microPET examinations were obtained in healthy mice, and mice with dilative (DCM) and ischemic cardiomyopathy (ICM) using the novel BP tracer [(68)Ga]-albumin (Alb(BP)), as well as [(18)F]-FDG microPET. Cine-magnetic resonance imaging (MRI) examination performed on a clinical 1.5-T MRI provided the reference standard measurements. RESULTS: When considering the combined group of healthy controls, DCM and ICM Alb(BP)-PET significantly overestimated the magnitudes of EDV (Alb(BP), 181 ± 86 μl; cine-MRI, 125 ± 80 μl; P < 0.001) and ESV (Alb(BP), 136 ± 92 μl; cine-MRI, 96 ± 77 μl; P < 0.001), whereas the EF (Alb(BP), 31 ± 16 %; cine-MRI, 33 ± 21 %; P = 0.910) matched closely to cine-MRI results, as did findings with [(18)F]-FDG. High correlations were found between the measured cardiac parameters (EDV: R = 0.978, ESV: R = 0.989, and LVEF: R = 0.992). CONCLUSIONS: Measuring left ventricular function in mice with [(68)Ga]-albumin BP PET is feasible and showed a high correlation compared to cine-MRI, which was used as a reference standard.
    Molecular Imaging & Biology 02/2013; · 3.10 Impact Factor
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    ABSTRACT: The technique of SPECT-RNV (radionuclide ventriculography) offers a greater amount of clinically usable data than its planar counterpart (P-RNV). In transitioning from planar to SPECT-only acquisition methodologies, reprojection of the SPECT data can provide a planar dataset which can be used as an interim technique. The aim of this study was to test if reprojected planar images could be used as a surrogate for true planar images in SPECT-only setting.
    Journal of Nuclear Cardiology 08/2014; · 2.85 Impact Factor