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Factors Affecting Accuracy of Ventricular Volume and Ejection Fraction Measured by Gated Tl-201 Myocardial Perfusion Single Photon Emission Computed Tomography

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Abstract

The electrocardiogram-gated single photon emission computed tomography (SPECT) measurement of left ventricular end-diastolic volume, end-systolic volume and ejection fraction may contain substantial errors. We evaluated whether patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. A total of 518 patients without perfusion defects on Tl-201 SPECT or coronary artery disease were studied. Left ventricular volume and ejection fraction were measured from echocardiography and adenosine stress/redistribution gated Tl-201 SPECT using commercially available software packages (QGS and 4D-MSPECT). We identified factors affecting the accuracy of gated SPECT via multiple linear regression analysis of the differences between echocardiography and gated SPECT. Gated SPECT analyzed with QGS underestimated end-diastolic and end-systolic volume, and overestimated ejection fraction, but 4D-MSPECT overestimated all those values (P<0.001). Independent variables associated with increasing the difference in end-diastolic volume between echocardiography and gated SPECT were decreasing left ventricular end-diastolic wall thickness, decreasing body surface area, female sex and increasing end-diastolic volume (P<0.001). Those for end-systolic volume were decreasing left ventricular end-systolic wall thickness, female sex, and decreasing end-systolic volume (P<0.001). Increasing end-systolic wall thickness, male sex and decreasing age were independent determinants associated with an increased difference in ejection fraction (P<0.001). Adenosine stress SPECT showed significantly higher end-diastolic and end-systolic volume values and a lower ejection fraction than did redistribution SPECT (P<0.001). Patient-related factors affect the accuracy of left ventricular volume and ejection fraction measured by gated Tl-201 SPECT. Modification of gated SPECT measurements by taking account of these factors would lead to reduce systemic errors.

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Abbreviations

SPECT:

Single photon emission computed tomography

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Acknowledgement

We are grateful to Hyun Mi Kim for her excellent assistance in data collection.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Ulsan College of Medicine, Seoul, Korea

    Moonsun Pai, You-Jung Yang, Il Ki Hong & Dae Hyuk Moon

  2. Division of Nuclear Medicine, Department of Radiology, Ewha Womans University Mokdong Hospital, Seoul, Korea

    Moonsun Pai

  3. Department of Nuclear Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul, 138-736, Korea

    You-Jung Yang, Ki Chun Im, Il Ki Hong & Dae Hyuk Moon

  4. Division of Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea

    Sung Cheol Yun

  5. Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Duk-Hyun Kang & Jae-Kwan Song

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  1. Moonsun Pai
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Correspondence to Dae Hyuk Moon.

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The authors do not have any financial associations that might pose a conflict of interest in connection with the submitted article. None of the authors has a financial interest in any cardiac software package, and this study was not supported by any vendor or cardiac software producer.

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Pai, M., Yang, YJ., Im, K.C. et al. Factors Affecting Accuracy of Ventricular Volume and Ejection Fraction Measured by Gated Tl-201 Myocardial Perfusion Single Photon Emission Computed Tomography. Int J Cardiovasc Imaging 22, 671–681 (2006). https://doi.org/10.1007/s10554-006-9098-3

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  • DOI: https://doi.org/10.1007/s10554-006-9098-3

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