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Gated blood pool SPECT: The estimation of right ventricular volume and function is algorithm dependent in a clinical setting

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

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).

Methods and 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.

Conclusion

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.

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Acknowledgments

Authors thank the staff of the Departments of Nuclear Medicine and Radiology of Rangueil for their technical support.

Disclosures

There is no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Toulouse University Hospital, 1, avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France

    Laurent Dercle MD, Pierre Pascal MD, Olivier Lairez MD, PhD, Delphine Bastié MD & Isabelle Berry MD, PhD

  2. Department of Medical Imaging, Gustave Roussy, Villejuif, France

    Laurent Dercle MD

  3. Department of Biostatistics, Institut Claudius Regaud, 20-24 rue du pont Saint Pierre, 31052, Toulouse, France

    Monia Ouali PhD

  4. Department of Radiology, Toulouse University Hospital, Toulouse, France

    Thomas Giraudmaillet MD, Marie-Agnès Marachet MD & Hervé Rousseau MD, PhD

  5. Department of Medical Biophysics and Nuclear Medicine, Hebrew University Hadassah Medical Center, Jerusalem, Israel

    Roland Chisin MD

  6. Department of Cardiology, University Hospital of Rangueil, Toulouse, France

    Olivier Lairez MD, PhD & Delphine Bastié MD

  7. Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France

    Olivier Lairez MD, PhD

  8. Medical School of Rangueil, University Paul Sabatier, Toulouse, France

    Olivier Lairez MD, PhD, Hervé Rousseau MD, PhD & Isabelle Berry MD, PhD

  9. Department of Nuclear Medicine, Montpellier University Hospital, Montpellier, France

    Fayçal Ben Bouallègue MD

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  1. Laurent Dercle MD
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  2. Monia Ouali PhD
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Correspondence to Laurent Dercle MD.

Additional information

See related editorial, doi:10.1007/s12350-015-0091-x.

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Dercle, L., Ouali, M., Pascal, P. et al. Gated blood pool SPECT: The estimation of right ventricular volume and function is algorithm dependent in a clinical setting. J. Nucl. Cardiol. 22, 483–492 (2015). https://doi.org/10.1007/s12350-014-0062-7

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  • DOI: https://doi.org/10.1007/s12350-014-0062-7

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