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Comparison of biventricular ejection fractions using cadmium-zinc-telluride SPECT and planar equilibrium radionuclide angiography

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

We compared biventricular ejection fractions (EFs) from gated blood-pool single-photon emission computed tomography (SPECT) using a cadmium-zinc-telluride camera (CZT-SPECT) with planar equilibrium radionuclide angiography (ERNA) using a NaI gamma camera (NaI-planar). We also evaluated whether imaging time can be reduced without compromising image quality using the CZT camera.

Methods

Forty-eight patients underwent NaI-planar and CZT-SPECT on the same day. CZT-SPECT datasets were re-projected at an LAO orientation similar to ERNA acquisition, forming CZT-repro planar datasets. The resulting biventricular volumetric measurements and EFs were compared.

Results

LVEF calculated from CZT-SPECT and CZT-repro correlated better with NaI-planar (r = 0.93 and 0.99, respectively) than RVEF (r = 0.76 and 0.82, respectively). Excellent intra-class correlation and low bias in intra-observer comparisons were observed for the biventricular EFs derived from three datasets. A wider limit of agreement in CZT-SPECT-derived LVEFs, lower correlation and significant bias for NaI-planar, and CZT-repro-derived RVEFs was found in the inter-observer analyses. Nonetheless, the imaging time can be reduced to 4 minutes without increasing variability in EFs using the CZT camera (P = NS).

Conclusions

LVEFs calculated from CZT-SPECT and CZT-repro correlated well with NaI-planar. CZT camera may reduce imaging time while preserving image quality in the assessment of biventricular EFs.

Resumen

Antecedentes

Se compararon las fracciones de eyección (FsE) bi ventriculares de la ventriculografía SPECT (single photon emission computed tomography, por sus siglas en ingles) utilizando una cámara de Cadmio-Zinc-Teluro (CZT-SPECT) y de la Ventriculografia Radioisotópica Planar en Equilibrio (VRIE) utilizando una gammacámara de NaI (NaI-Planar). También se evaluó si el tiempo de adquisición de las imágenes se puede reducir sin comprometer la calidad de imagen mediante la cámara CZT.

Métodos

Cuarenta y ocho pacientes fueron sometidos a un estudio de VRIE NaI-planar y un estudio de CZT-SPECT el mismo día. Los datos del CZT-SPECT fueron re-proyectados en OAI similar a la adquisición de la VRIE, formando conjuntos de datos planares CZT-repro. Las mediciones volumétricas bi-ventriculares resultantes y las fracciones de expulsión (FsE) fueron comparadas.

Resultados

La FEVI calculada a partir del CZT-SPECT y CZT-repro correlaciono mejor con la VRIE NaI-planar (r = 0,93 y 0,99, respectivamente) que la FEVD (r = 0,76 y 0,82, respectivamente). Se observo una excelente correlación intra-clase y un bajo sesgo en las comparaciones intra-observador para las FsE bi-ventriculares derivadas de los tres conjuntos de datos. Se encontró un rango mas amplio de concordancia para la FEVI por CZT-SPECT, así como una menor correlación y un sesgo significativo para la FEVD por VRIE NaI-planar y CZT-repro en el análisis inter-observador. No obstante, el tiempo de adquisición de las imágenes se puede reducir a 4 minutos sin aumentar la variabilidad en las FsE utilizando la cámara CZT (P = NS).

Conclusiones

La FEVI calculada a partir del CZT-SPECT y CZT-repro tienen una buena correlación con las de la VRIE NaI-planar. La cámara CZT puede reducir el tiempo de adquisición de imágenes, preservando la calidad de imagen en la evaluación de las FsE bi-ventriculares.

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Abbreviations

EF:

Ejection fraction

SPECT:

Single-photon emission computed tomography

ERNA:

Equilibrium radionuclide angiography

CZT:

Cadmium-zinc-telluride

GBPS:

Gated blood-pool SPECT

LAO:

Left anterior oblique

LV:

Left ventricular

RV:

Right ventricular

EDV:

End-diastolic volume

ESV:

End-systolic volume

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Acknowledgments

This study was supported in part by Ministry of Science and Technology of Taiwan (MOST 101-2314-B-418-012-MY3 and 103-NU-E-002-001-NU). No other potential conflict of interest relevant to this article was reported.

Disclosures

The authors have disclosed that they do not have any potential conflicts of interest.

Author information

Author notes

    Authors and Affiliations

    1. Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan

      Yi-Chieh Chen MSc, Rouh-Fang Yen MD, PhD, Mei-Fang Lo Bsc, Yih-Hwen Huang MSc, Yen-Wen Wu MD, PhD & Mei-Fang Cheng MD

    2. Department of Nuclear Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou City, Yunlin County, Taiwan

      Chi-Lun Ko MD & Pei-Ying Hsu MD

    3. Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan

      Yih-Hwen Huang MSc

    4. Department of Nuclear Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, Taiwan

      Yen-Wen Wu MD, PhD

    5. Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, Taiwan

      Yen-Wen Wu MD, PhD

    6. School of Medicine, National Yang-Ming University, Taipei, Taiwan

      Yen-Wen Wu MD, PhD

    7. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan

      Mei-Fang Cheng MD

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    1. Yi-Chieh Chen MSc
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    Corresponding authors

    Correspondence to Yen-Wen Wu MD, PhD or Mei-Fang Cheng MD.

    Additional information

    Yen-Wen Wu and Mei-Fang Cheng contributed equally to the study.

    JNC thanks Dr. E. Alexanderson, UNAM, Mexico for providing the Spanish abstract.

    See related editorial, doi:10.1007/s12350-016-0414-6.

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    Chen, YC., Ko, CL., Yen, RF. et al. Comparison of biventricular ejection fractions using cadmium-zinc-telluride SPECT and planar equilibrium radionuclide angiography. J. Nucl. Cardiol. 23, 348–361 (2016). https://doi.org/10.1007/s12350-015-0367-1

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    • DOI: https://doi.org/10.1007/s12350-015-0367-1

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