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Comparison of three commercially available softwares for measuring left ventricular perfusion and function by gated SPECT myocardial perfusion imaging

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The three softwares, Quantitative Perfusion SPECT (QPS), Emory Cardiac Toolbox, and 4 Dimension-Myocardial SPECT (4DM) are widely used with myocardial perfusion imaging (MPI) to determine perfusion defect size (PDS) and left ventricular (LV) function. There are limited data on the degree of agreement between these methods in quantifying the LV perfusion pattern and function.

Methods and Results

In 120 consecutive patients who had abnormal regadenoson SPECT MPI with a visually derived summed stress score ≥4, the correlation between the softwares for measurements of PDS, reversible, and fixed defects was poor to fair (Spearman’s ρ = 0.18-0.72). Overall, estimation of defect size was smaller by QPS and larger by 4DM. There was discordance among the softwares in 62% of the cases in defining PDS as small/moderate/large. The correlation between the softwares was better for measuring LVEF, volumes and mass (ρ = 0.84-0.97), and discrepant results for defining normal/mild-moderate/severe LV systolic dysfunction were prevalent in 28% of the patients.

Conclusion

There are significant differences between the softwares in measuring PDS as well as LV function, and more importantly in defining small, moderate, or large ischemic burden. These results suggest the necessity of using the same software when assessing interval changes by serial imaging.

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Conflict of interest

The authors have indicated that they have no financial conflict of interest.

Disclosure

Dr Iskandrian is a scientific advisor for Rapidscan, Pharma and has received research grants from Astellas Pharma USA. Dr Hage is a scientific advisor for Astellas Pharma USA and has received investigator-initiated grant support from Astellas Pharma USA. The other authors report no financial disclosures.

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Authors and Affiliations

  1. Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, 35294, USA

    Sameer Ather MD, PhD, Jaekyeong Heo MD, Ami E. Iskandrian MD & Fadi G. Hage MD

  2. Division of Cardiovascular Disease, University of Minnesota Medical Center, Minneapolis, MN, USA

    Fahad Iqbal MD

  3. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    John Gulotta MD

  4. University of Beirut, Beirut, Lebanon

    Wael Aljaroudi MD

  5. Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA

    Fadi G. Hage MD

Authors
  1. Sameer Ather MD, PhD
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  2. Fahad Iqbal MD
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  3. John Gulotta MD
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  4. Wael Aljaroudi MD
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  5. Jaekyeong Heo MD
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  6. Ami E. Iskandrian MD
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  7. Fadi G. Hage MD
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Corresponding author

Correspondence to Fadi G. Hage MD.

Additional information

See related editorials, doi: 10.1007/s12350-014-9874-8 and doi: 10.1007/s12350-014-9875-7.

Sameer Ather and Fahad Iqbal have contributed equally to this manuscript.

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Supplementary material 1 (DOC 74 kb)

Figure S1

3D scatter plots with data for (A) perfusion defect size (PDS), (B) summed stress score (SSS), (C) reversible perfusion defect (RPD), and (D) fixed Perfusion Defect (FPD), from all the three programs. X-axis represents data from ECTb, Y-axis represents data from QPS, and Z-axis represents data from 4D-MSPECT. Scatter plots included a line of unity and a zone of 10% variance (TIFF 832 kb)

Figure S2

3D scatter plots with data for (A) left ventricular ejection fraction (LVEF), (B) end-diastolic volume (EDV), (C) end-systolic volume (ESV), and (D) left ventricular (LV) mass, from all the three programs. X-axis represents data from ECTb, Y-axis represents data from QPS, and Z-axis represents data from 4D-MSPECT. Scatter plots included a line of unity and a zone of 10% variance (TIFF 1195 kb)

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Ather, S., Iqbal, F., Gulotta, J. et al. Comparison of three commercially available softwares for measuring left ventricular perfusion and function by gated SPECT myocardial perfusion imaging. J. Nucl. Cardiol. 21, 673–681 (2014). https://doi.org/10.1007/s12350-014-9885-5

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  • DOI: https://doi.org/10.1007/s12350-014-9885-5

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