Abstract
Background
Quantification of right ventricular (RV) function is clinically relevant for the risk stratification and follow-up of patients with a wide spectrum of disease. This can be achieved with electrocardiography-gated blood pool single photon emission computed tomography (GBPS). We aimed to evaluate the accuracy of the completely automatic QBS GBPS processing software as compared with equilibrium planar radionuclide angiography (RNA) and with a GBPS manual segmentation method (GBPS35%) for the measurement of global RV ejection fraction (EF), taking the first-pass RNA (FP-RNA) as the gold standard. In parallel, we compared the RVEF, RV end-diastolic volume (EDV), and RV end-systolic volume (ESV) provided by QBS and GBPS35%.
Methods and Results
The population included 85 patients with chronic post-embolic pulmonary hypertension. Twenty-one patients were excluded because of unsuccessful FP-RNA. Intraobserver and interobserver RVEF, RVEDV, and RVESV reproducibilities encountered with planar RNA, QBS, and GBPS35% were similar and compared favorably with those calculated with FP-RNA for RVEF. Mean RVEF was different between all methods. RVEF calculated with FP-RNA was better correlated to QBS (r = 0.68) and GBPS35% (r = 0.70) than to planar RNA (r = 0.59). RVEDV and RVESV with QBS were lower than with GBPS35%, by 29% ± 14% and 36% ± 13%, respectively. RVEDV and RVESV with QBS were highly correlated to corresponding GBPS35%values: r = 0.88 and r = 0.91, respectively.
Conclusion
As opposed to FP-RNA, GBPS is highly successful for the quantification of RV function. Both QBS and GBPS35% provide RVEF values similarly well correlated to FP-RNA and performed better than planar RNA. RVEF, RVEDV, and RVESV provided by QBS and GBPS35% are highly correlated. All of these RV functional measurements require further validation versus a better gold standard before their accuracy can be established.
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References
Barst RJ, Rubin LJ, Long WA, et al. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy in primary pulmonary hypertension. N Engl J Med 1996;334:296- 301.
Schamberger MS, Hurwitz RA. Course of right and left ventricular function in patients with pulmonary insufficiency after repair of tetralogy of Fallot. Pediatr Cardiol 2000;21:244–8.
Ghio S, Gavazzi A, Campana C, et al. Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 2002;37:183–8.
Polak JF, Holman L, Wynne J, Colucci WS. Right ventricular ejection fraction: an indicator of increased mortality in patients with congestive heart failure associated with coronary artery disease. J Am Coll Cardiol 1983;2:217–24.
De Groote P, Millaire A, Foucher-Houssein C, et al. Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol 1998;32:948–54.
Gavazzi A, Berzuini C, Campana C, et al. Value of right ventricular ejection fraction in predicting short time prognosis of patients with severe chronic heart failure. J Heart Lung Transplant 1997; 16:774–85.
Chow LC, Dittrich HC, Hoit BD. Doppler assessment in rightsided cardiac hemodynamics after PTE. Am J Cardiol 1988;61:1092–7.
Dittrich HC, Nicod PH, Chow LC. Early changes in right heart geometry after PTE. J Am Coll Cardiol 1988;11:937–43.
Menzel T, Kramm T, Bruckner A, et al. Quantitative assessment of right ventricular volumes in severe chronic thromboembolic pulmonary hypertension using transthoracic three-dimensional echocardiography changes due to pulmonary thromboendarterectomy. Eur J Echocardiogr 2002;3:67–72.
Lewczuk J, Piszko P, Jagas J, et al. Prognostic factors in medically treated patients with chronic pulmonary embolism. Chest 2001; 119:818–23.
Jamieson SW, Auger WR, Fedullo PF, et al. Experience and results with 150 pulmonary thromboendarterectomy operations over a 29-month period. J Thorac Cardiovasc Surg 1993;106:116–27.
Daou D, Pointurier I, Vilain D, et al. Comparison of different methods for the calculation of cardiac ventricular chamber volume: a phantom study [abstract]. J Nucl Med 2000;41:175P.
Daou D, Coaguila C, Helal BO, et al. Repeatability of left and right ventricular function measured with ECG-gated blood-pool SPECT versus planar radionuclide cardiac angiography [abstract]. J Nucl Med 2001;42:137P.
Daou D, Harel F, Helal BO, Fourme T, et al. Electrocardiographically gated blood-pool SPECT and left ventricular function: comparative value of 3 methods for ejection fraction and volume estimation. J Nucl Med 2001;42:1043–9.
Van Kriekinge SD, Berman D, Germano G. Automatic quantification of left ventricular ejection fraction from gated blood pool SPECT. J Nucl Cardiol 1999;6:498–506.
Van Kriekinge SD, Berman DS, Germano G. Automatic quantification of left and right ventricular ejection fraction from gated blood pool SPECT [abstract]. Circulation 1999;100:I-26.
Green MV, Bacharach SL. Functional imaging of the heart: methods, limitations, and examples from gated blood pool scintigraphy. Prog Cardiovasc Dis 1986;28:319–48.
Véra P, Gardin I, Bok B. Comparative study of three automatic programs of left ventricular ejection fraction evaluation. Nucl Med Commun 1995;16:667–74.
Nelson AD, Muswick GJ, Muzic RF, Descamps X. A robust edge detection method for gated radionuclide ventriculograms. J Nucl Med 1996;37:685–9.
Bartlett ML, Srinivasan G, Barker WC, et al. Left ventricular ejection fraction: comparison of results from planar and SPECT gated blood-pool studies. J Nucl Med 1996;37:1795–9.
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Daou, D., Kriekinge, S.D.V., Coaguila, C. et al. Automatic quantification of right ventricular function with gated blood pool SPECT. J Nucl Cardiol 11, 293–304 (2004). https://doi.org/10.1016/j.nuclcard.2004.01.008
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DOI: https://doi.org/10.1016/j.nuclcard.2004.01.008