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Optimal reproducibility of gated sestamibi and thallium myocardial perfusion study left ventricular ejection fractions obtained on a solid-state CZT cardiac camera requires operator input

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Journal of Nuclear Cardiology Aims and scope

Abstract

Aim

To evaluate the reproducibility of serial re-acquisitions of gated Tl-201 and Tc-99m sestamibi left ventricular ejection fraction (LVEF) measurements obtained on a new generation solid-state cardiac camera system during myocardial perfusion imaging and the importance of manual operator optimization of left ventricular wall tracking.

Methods

Resting blinded automated (auto) and manual operator optimized (opt) LVEF measurements were measured using ECT toolbox (ECT) and Cedars-Sinai QGS software in two separate cohorts of 55 Tc-99m sestamibi (MIBI) and 50 thallium (Tl-201) myocardial perfusion studies (MPS) acquired in both supine and prone positions on a cadmium zinc telluride (CZT) solid-state camera system. Resting supine and prone automated LVEF measurements were similarly obtained in a further separate cohort of 52 gated cardiac blood pool scans (GCBPS) for validation of methodology and comparison. Appropriate use of Bland-Altman, chi-squared and Levene’s equality of variance tests was used to analyse the resultant data comparisons.

Results

For all radiotracer and software combinations, manual checking and optimization of valve planes (+/− centre radius with ECT software) resulted in significant improvement in MPS LVEF reproducibility that approached that of planar GCBPS. No difference was demonstrated between optimized MIBI/Tl-201 QGS and planar GCBPS LVEF reproducibility (P = .17 and P = .48, respectively). ECT required significantly more manual optimization compared to QGS software in both supine and prone positions independent of radiotracer used (P < .02).

Conclusions

Reproducibility of gated sestamibi and Tl-201 LVEF measurements obtained during myocardial perfusion imaging with ECT toolbox or QGS software packages using a new generation solid-state cardiac camera with improved image quality approaches that of planar GCBPS however requires visual quality control and operator optimization of left ventricular wall tracking for best results. Using this superior cardiac technology, Tl-201 reproducibility also appears at least equivalent to sestamibi for measuring LVEF.

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Disclosure

All authors have nothing to declare.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia

    Martin H. Cherk MBBS, Jason Ky MBBS, Kenneth S. K. Yap MBBS, Patrina Campbell MBBS, Catherine McGrath BApSci & Victor Kalff MBBS

  2. Department of Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia

    Martin H. Cherk MBBS & Victor Kalff MBBS

  3. Department of Epidemiology & Preventative Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC, 3004, Australia

    Michael Bailey PhD

Authors
  1. Martin H. Cherk MBBS
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  2. Jason Ky MBBS
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  3. Kenneth S. K. Yap MBBS
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  4. Patrina Campbell MBBS
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  5. Catherine McGrath BApSci
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  6. Michael Bailey PhD
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  7. Victor Kalff MBBS
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Corresponding author

Correspondence to Martin H. Cherk MBBS.

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Cherk, M.H., Ky, J., Yap, K.S.K. et al. Optimal reproducibility of gated sestamibi and thallium myocardial perfusion study left ventricular ejection fractions obtained on a solid-state CZT cardiac camera requires operator input. J. Nucl. Cardiol. 19, 713–718 (2012). https://doi.org/10.1007/s12350-012-9561-6

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  • DOI: https://doi.org/10.1007/s12350-012-9561-6

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