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Left ventricular ejection fraction determined with the simulation of a very low-dose CZT-SPECT protocol and an additional count-calibration on planar radionuclide angiographic data

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Journal of Nuclear Cardiology Aims and scope

Abstract

Purpose

To determine whether the left ventricular ejection fractions (EFs), measured on a high-sensitivity CZT single photon emission computed tomography (SPECT)-camera with a 70% reduction in recording times and a prevention of EF overestimation through an additional count-calibration, are concordant with reference EF from planar radionuclide angiography (2D-RNA).

Methods

An additional 10-minute CZT-SPECT recording was performed in patients referred to 2D-RNA for cardiomyopathy (n = 23) or chemotherapy monitoring (n = 50) with an in vivo red blood cell labeling with 850 MBq \( {}^{{99{\text{m}}}}{\text{TcO}}_{4}^{ - } \). The EF, obtained from CZT-SPECT with 100% (SPECT100) or 30% (SPECT30) projection times and with a SPECT-count calibration on the 2D-RNA counts of corresponding cavity volumes, were compared to EF from 2D-RNA.

Results

Strong and equivalent relationships were documented between the EF from 2D-RNA and the calibrated EF from SPECT100 (y = 0.89x + 6.62; R2 = 0.87) and SPECT30 (y = 0.87x + 8.40; R2 = 0.85), and the mean EF from SPECT100 (54% ± 15%) and SPECT30 (53% ± 16%) were close to that from 2D-RNA (55% ± 15%). However, upward shifts in these mean values were documented in the absence of count calibration for both SPECT100 (60% ± 18%) and SPECT30 (60% ± 18%).

Conclusion

Left ventricular EF may be determined on a high-sensitivity CZT-camera, a 70% reduction in injected activities, and an additional count-calibration for further enhancing the concordance with 2D-RNA values.

Spanish Abstract

Propósito

Determinar si la fracción de eyección del ventrículo izquierdo, medida con la cámara CZT-SPECT con una reducción del 70% en tiempo de grabación y con la prevención de la sobreestimación mediante una calibración de cuentas adicional, que sea concordante con el valor referencia de fracción de eyección mediante radiografía planar de radionucleidos. (2D-RNA).

Métodos

Una grabación adicional de 10 minutos con CZT-SPECT se realizo en pacientes referidos a radiografía planar de radionucleidos (2D-RNA) por miocardiopatías. (n = 23) o para monitorizar las quimioterapias (n = 50) con marcaje de glóbulos rojos con 850 MBq 99m TcO4. La fracción de eyección obtenida por CZT-SPECT con 100% (SPECT100) o 30% (SPECT30) de tiempo de proyección, y con SPECT con calibración de cuentas con el 2D-RNA, los volúmenes de cavidades fueron comparados con fracción de eyección . Relaciones fuertes y equivalentes fueron documentados entre fracción de eyección del 2D-RNA, y la forma calibrada de la fracción de eyección SPECT100 (y = 0.89x + 6.62; R2 = 0.87) y SPECT30 y = 0.87x + 8.40; R2 = 0.85), y la media de fracción de eyección de SPECT100 (54 ± 15%) and SPECT30 (53 ± 16%) fueron cercanos a la de el 2D-RNA (55 ± 15%). Aunque, aumentos en estas medias se documentaron en la ausencia de la calibración de cuentas para SPECT100 (60 ± 18%) y SPECT30 (60 ± 18%).

Conclusión

La fracción de eyección del ventrículo izquierdo puede ser determinada con una cámara CZT de alta sensibilidad, una reducción del 70% en actividades inyectadas y la calibración de cuentas adicional para realzar la concordancia con los valores de 2D-RNA.

Chinese Abstract

目的

以平面放射性核素血管造影 (2D-RNA) 测定左心室射血分数 (EF) 作为参考标准,为确定利用高灵敏度 CZT SPECT 相机在减少 70% 的记录时间, 并结合计数校准防止高估情况下测量的 EF值, 是否与 2D-RNA 测得的 EF 值一致。

方法

对心肌病 (n = 23) 或化疗监测 (n = 50) 的患者采用体内标记法注射 850 MBq 99mTcO4 标记的红细胞进行 2D-RNA ,随后再采集 10 分钟 CZT-SPECT。 对 CZT-SPECT 100% 投影时间 (SPECT100) 或 30% 投影时间 (SPECT30) 获得的图像进行重建, 并进行计数校准 (对相应容积获得的 2D-RNA 计数通过 SPECT 校准)获得 EF 值, 与 2D-RNA 测定的 EF 的进行比较。

结果

2D-RNA 测定的 EF 值与 SPECT100 校准后测定的 EF 值 (y = 0.89x + 6.62; R2 = 0.87) 及 SPECT30 (y = 0.87x + 8.40; R2 = 0.85) 校准后 EF 值具有高度相关性, 并且 SPECT100 (54 ± 15%) 和 SPECT30 (53 ± 16%) 测定的 EF 平均值与 2D-RNA 测定的 EF 平均值 (55 ± 15%) 非常接近。 但是, 在没有计数校准的情况下, SPECT100 (60 ± 18%) 和 SPECT30 (60 ± 18%) 测定的 EF 平均值会被高估。

结论

高灵敏度 CZT 相机可在减少 70% 的注射剂量情况下测定左心室 EF 值, 结合计数校准可进一步提高与 2D-RNA测得的 EF 值的一致性。

关键词: 放射性核素血管造影; 血池 SPECT; CZT 相机; 左心室射血分数; 校准曲线。

French Abstract

Objectif

Déterminer si les fractions d'éjection ventriculaire gauche (EF) mesurées sur une caméra CZT SPECT à haute sensibilité avec une réduction de 70% des temps d'enregistrement et une prévention de la surestimation de l'EF grâce à un étalonnage supplémentaire des coups concordent avec les EF de référence obtenues par angiographie scintigraphique planaire (2D-RNA).

Méthodes

Un enregistrement CZT-SPECT supplémentaire de 10 minutes a été réalisé chez les patients référés pour évaluation de cardiomyopathie (n=23) ou suivi de chimiothérapie (n = 50) par angiographie scintigraphique planaire (2D-RNA) au globules rouges marqués avec 850 MBq 99mTcO4-. Les EF, obtenues au moyen d’une caméra CZT-SPECT avec 100% (SPECT100) ou 30% (SPECT30) de temps d’acquisition et avec étalonnage des coups SPECT sur les images 2D-RNA des volumes de cavité correspondants ont été comparés aux EF à partir de 2D-RNA.

Résultats

une corrélation significative existe entre les EF obtenues par 2D-RNA et les EF étalonnées obtenues par SPECT100 (y = 0,89x + 6,62; R2 = 0,87) et SPECT30 (y = 0,87x + 8,40; R2 = 0,85). Les EF moyennes de SPECT100 (54 ± 15%) et SPECT30 (53 ± 16%) sont similaires à celles obtenues par 2D-RNA (55 ± 15%). En l'absence d'étalonnage de comptage des études SPECT100 (60 ± 18%) et SPECT30 (60 ± 18%), ces valeurs moyennes d’EF sont généralement plus élevées.

Conclusion

La fonction ventriculaire gauche peut être déterminée avec une caméra CZT à haute sensibilité, une réduction des activités injectées et un étalonnage supplémentaire des coups pour améliorer la concordance avec les valeurs obtenues par 2D-RNA.

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Abbreviations

2D-RNA:

Planar radionuclide angiography

EDC:

End-diastolic counts

EDV:

End-diastolic volume

EF:

Ejection fraction

ESC:

End-systolic counts

ESV:

End-systolic volume

LV:

Left ventricle

SPECT:

Single photon emission computed tomography

SPECT30:

SPECT images reconstructed with only 30% of recorded counts

SPECT100:

SPECT images reconstructed with 100% of recorded counts

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Acknowledgments

The authors thank Nathaniel Roth and Rafael Baavour from Spectrum Dynamics Medical for their technical support and Pierre Pothier for critical review of the manuscript.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France

    Hubert Tissot MD, Antoine Verger MD, PhD, Gilles Karcher MD, PhD & Pierre-Yves Marie MD, PhD

  2. Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, 54000, Nancy, France

    Véronique Roch MSc & Laetitia Imbert PhD

  3. CHU-Besançon, Université de Franche-Comté, Service de Médecine Nucléaire, 25000, Besançon, France

    Olivier Morel MD

  4. Department of Nuclear Medicine, CHRU-Nancy, 54000, Nancy, France

    Nicolas Veran PharmD, Mathieu Perrin MD & Marine Claudin MD

  5. INSERM, UMR 1254, Université de Lorraine, 54000, Nancy, France

    Antoine Verger MD, PhD & Laetitia Imbert PhD

  6. INSERM, UMR 1116, Université de Lorraine, 54000, Nancy, France

    Pierre-Yves Marie MD, PhD

  7. Médecine Nucléaire, Hôpital de Brabois, CHRU-Nancy, Allée du Morvan, 54500, Vandoeuvre-Les-Nancy, France

    Laetitia Imbert PhD

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  1. Hubert Tissot MD
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  2. Véronique Roch MSc
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  3. Olivier Morel MD
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Correspondence to Laetitia Imbert PhD.

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JNC thanks Erick Alexanderson MD, Carlos Guitar MD, and Diego Vences MD, UNAM, Mexico, for providing the Spanish abstract; Haipeng Tang MS, Zhixin Jiang MD, and Weihua Zhou PhD, for providing the Chinese abstract; and Jean-Luc Urbain, MD, PhD, CPE, Past President CANM, Chief Nuclear Medicine, Lebanon VAMC, PA, for providing the French abstract.

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Tissot, H., Roch, V., Morel, O. et al. Left ventricular ejection fraction determined with the simulation of a very low-dose CZT-SPECT protocol and an additional count-calibration on planar radionuclide angiographic data. J. Nucl. Cardiol. 26, 1539–1549 (2019). https://doi.org/10.1007/s12350-019-01619-w

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