Abstract
A comparison of geometric and count-volume scintigraphic methods for measuring left ventricular ejection fraction (EF) is presented. The particular count-volume method used is a modification of an established first-pass technique. It is shown that a modification of the technique is necessary to prevent a positive bias in the EF estimate due to Poisson noise. Using the same simulated data, EF estimates by the modified technique were always closer to the actual EF volume than were the estimates by the original method. Maximum Likelihood estimates were also more accurate than were the other two estimates. In 56 patients with either acute myocardial infarcts or unstable angina pectoris, the scintigraphic single-plane gated geometric method tended to overestimate EF in each of the patient groups when compared with the geometry-independent count-volume estimates. The results also point out that the error in the geometric estimates tended to be greater for larger ejection fractions and appears to be due to the systematic underestimation of end-systolic volumes.
Similar content being viewed by others
References
Chapman, C. B., Baker, O., Reynolds, J., and Bonte, F. J., Use of biplane cinefluorography for measurement of ventricular volume,Circulation 1958,18, 1105.
Chapman, C. B., Baker, V., Mitchell, J. H., and Collier, R. G., Experiences with a cinefluoro-graphic method for measuring ventricular volume.American Journal of Cardiology 1966,18, 25–30.
Davila, J. C., and Sanmarco, M. E., An analysis of the fit of mathematical models applicable to the measurement of left ventricular volume.American Journal of Cardiology 1966,18, 31–42.
Dodge, H. R., Sandler, H., Ballew, D. W., and Lord, J. D., Jr., The use of biplane angiocardiography for measurement of left ventricular volume in man,American Heart Journal 1960,60, 762.
Keshavan, H. R., Nardizzi, L. R., Srinath, M. D., and Doss, J., Noninvasive radioisotope cardiographic images with digital prefiltering and boundary detection for measuring left ventricular parameters,Mathematical Biosciences, 1977,37, 223–243.
Melsa, J. L., and Sage, A. P.,An introduction to probability and stochastic processes, Englewood Cliffs, N.J.: Prentice-Hall, 1973.
Mitchell, J. H., Wildenthal, K., and Mullins, C. B., Geometrical studies of the left ventricle utilizing biplane cinefluorography,Federation Proceedings 1969,28, 1334–1343.
Mullins, C. B., Mason, D. T., Ashburn, W. L., et al., Determination of ventricular volume by radioisotope angiography,American Journal of Cardiology 1969,24, 72–78.
Rackley, C. E., Quantitative evaluation of left ventricular function by radiographic techniques,Circulation 1976,54, 862–879.
Rigo, P., Murray, M., Strauss, H. W., Taylor, D., Kelley, D., Weisfeldt, M., and Pitt, B., Left ventricular function in acute myocardial infarction evaluated by gated scintiphotography,Circulation 1974,50, 678.
Sandler, H., Dimensional analysis of the heart—A review,American Journal of Medical Sciences 1970,260, 56–70.
Sandler, H., and Dodge, H. F., The use of single plane angiocardiograms for the calculation of left ventricular volume in man,American Heart Journal 1968,75, 325.
Schelbert, H. R., Verba, J. W., Johnson, A. D., Brock, G. W., Alazraki, N. P., Rose, F. J., and Ashburn, W. L., Nontraumatic determination of left ventricular ejection fraction by radionuclide angiography,Circulation 1975,51, 902–909.
Snedecor, G. W., and Cochran, W. G.,Statistical methods, Ames, Iowa: Iowa State Univ. Press, 1967.
Stokely, E. M., Parkey, R. W., Bonte, F. J., Graham, K. D., Stone, J., and Willerson, J. T., Gated blood pool imaging following99mTc stannous prophosphate imaging,Radiology 1976,120, 433.
Twieg, D. B., Stokely, E. M., Parkey, R. W., Doss, J. K., Pulido, J., Poliner, L., Bonte, F. J., and Willerson, J. T., Noninvasive myocardial imaging to define myocardial performance in patients with acute ischemic heart disease (Abstract),Clinical Research 1977,25.
Author information
Authors and Affiliations
Additional information
This work was supported in part by NSF Grant ENG 73–03789 A02, by NIH Ischemic SCOR Grant HL-17669, and by NIH Grant HL-17777.
Rights and permissions
About this article
Cite this article
Twieg, D., Nardizzi, L.R., Parkey, R. et al. Comparison of scintigraphic count-volume and geometric methods for measuring left ventricular ejection fraction. Ann Biomed Eng 6, 310–325 (1978). https://doi.org/10.1007/BF02409347
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02409347