Automatic quantification of left ventricular ejection fraction from gated blood pool SPECT

Kriekinge, Serge D. Van; Berman, Daniel S.; Germano, Guido

doi:10.1016/s1071-3581(99)90022-3

Cited by 82 publications

(34 citation statements)

References 30 publications

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“…Novel SPECT techniques for early detection of cardiotoxicity are shown in Table 6. 46 These novel techniques include static volume indices and functional LV indices by gated SPECT ERNA and MPI, 27,28 sympathetic neuronal imaging with a wide variety of SPECT and PET tracers, [47][48][49][50][51][52][53][54][55] In-111 antimyosin which is a specific marker of myocyte injury and necrosis, 54,56,57 Tc-99m annexin V which visualized apoptosis and programmed cell death, [58][59][60] fatty acid scintigraphy which visualizes fatty acid retention in the lipid pool of the cytosol which can be impaired by cardiotoxic agents, 61 and direct imaging of In-111 trastuzumab to study trastuzumab targeting of the myocardium have been considered. 62 Each of these techniques would require a prospective clinical trial to assess its incremental value in avoiding clinical CHF.…”

Section: Novel Scintigraphic Methodsmentioning

confidence: 99%

“…However, recent availability of ECG-gated SPECT ERNA offers advantages over the conventional planar ERNA in monitoring chemotherapy-induced cardiotoxicity and risk of CHF. 27 The accuracy of gated blood pool SPECT (GBPS) software for the calculation of LVEF has been validated. 27 The software provides sophisticated wall motion and phase analyses in addition to right ventricular ejection fraction (RVEF), LVEF, and left and right ventricular end-systolic and end-diastolic absolute volumes.…”

Section: Non-anthracycline Chemotherapy Cardiotoxicitymentioning

confidence: 99%

“…27 The accuracy of gated blood pool SPECT (GBPS) software for the calculation of LVEF has been validated. 27 The software provides sophisticated wall motion and phase analyses in addition to right ventricular ejection fraction (RVEF), LVEF, and left and right ventricular end-systolic and end-diastolic absolute volumes. End-systolic volume index (ESVI) is a powerful marker of risk in patients with known or suspected coronary heart disease, 28,29 and may also be a useful parameter to quantify risk of CHF in patients receiving cancer chemotherapy.…”

Section: Non-anthracycline Chemotherapy Cardiotoxicitymentioning

confidence: 99%

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Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

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The field of cardio-oncology is challenged to address an ever greater spectrum of cardiotoxicity associated with combination chemotherapy, greater dose intensity, extremes of age, and enhanced patient survival which exposes more protracted risk of developing congestive heart failure (CHF). Recent reports of chemotherapy-induced hypertension as a common adverse effect of angiogenesis inhibitors and immunosuppressants clarify the need for routine blood pressure (BP) monitoring and guideline-based management of hypertension as an integral strategy to preserve LV function. Serial monitoring of radionuclide left ventricular ejection fraction (LVEF) in adults and echocardiography in children continues to provide outcome based, cost-effective prevention of CHF in high risk patients receiving chemotherapy. To optimize treatment and monitoring strategies to eliminate late-onset LV dysfunction and CHF, traditional and novel candidate methods for assessment of chemotherapy-induced LV dysfunction are reviewed. These include serial assessment of LV volume indices by gated SPECT ERNA and gated SPECT MPI, 3D echocardiography and contrast 2D echocardiography; longitudinal strain imaging, diastolic functional parameters, 123 I-MIBG, 111 In-Antimyosin antibody imaging, and 99m Tc-Annexin V apoptosis imaging, biomarkers including troponins and BNP; genetic markers, and both functional and tissue characterization techniques with T1 weighted and T2 weighted images with cardiac magnetic resonance imaging (CMR). In our quest to optimize strategies for long-term cancer survival and prevention of CHF for patients receiving chemotherapy, rigorous modality and guideline-specific clinical outcome trials are required. A new multi-modality monitoring approach is proposed, which integrates evidencebased strengths of CMR, echocardiography, ERNA, biomarkers, and BP management for surveillance and validation of cardiotoxicity and prevention of clinical heart failure in patients receiving a broad spectrum of cancer therapies.

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Section: Novel Scintigraphic Methodsmentioning

confidence: 99%

Section: Non-anthracycline Chemotherapy Cardiotoxicitymentioning

confidence: 99%

Section: Non-anthracycline Chemotherapy Cardiotoxicitymentioning

confidence: 99%

See 1 more Smart Citation

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

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“…In the last decade, software packages dedicated to the segmentation of gated blood-pool SPECT (GBPS) acquisitions have been developed and validated, making possible the widespread clinical use of this technique (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). However, in routine clinical settings, the time-activity curve that characterizes the wall motion at the scale of a single voxel on the surface of a ventricle involves the variation of limited activity and is thus affected by relatively large error from the random Poisson noise.…”

mentioning

confidence: 99%

Diagnosis of Diffuse and Localized Arrhythmogenic Right Ventricular Dysplasia by Gated Blood-Pool SPECT

Mariano‐Goulart¹,

Dechaux²,

Rouzet³

et al. 2007

Journal of Nuclear Medicine

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This study aimed to assess the ability of global and local systolic parameters measured with gated blood-pool SPECT (GBPS) to diagnose and characterize the severity of diffuse or localized arrhythmogenic right ventricular dysplasia (ARVD). Methods: Fiftynine subjects with symptomatic ventricular arrhythmias were prospectively included in the study. With the International Society and Federation of Cardiology criteria for ARVD as a gold standard, these subjects were classified as subjects without ARVD (21 control subjects) and patients with localized ARVD (16 patients) or diffuse ARVD (22 patients). Right ventricular volumes, right ventricular ejection fractions (EF), the SD of local EF (s-EF), and the SD of the local times of end systole (s-TES) were computed from GBPS data and compared among the groups in the study population. Results: s-EF did not differ between control subjects and patients with diffuse or localized ARVD. Right ventricular EF and volumes differed between patients with diffuse ARVD and control subjects, with similar areas under the receiver-operating-characteristic curves, but right ventricular EF and volumes failed to differentiate patients with localized ARVD. In contrast, s-TES differed between patients with diffuse or localized ARVD and control subjects. Regression analysis showed that the systolic parameter most strongly associated with the diagnosis of ARVD was s-TES. The probabilities of a randomly chosen patient in the diffuse ARVD group and of a randomly chosen patient in the localized ARVD group having s-TES values greater than that of a randomly chosen control subject were 98.5% and 96.7%, respectively. For the diagnosis of localized ARVD, a threshold of 80 ms for s-TES corresponded to sensitivity, specificity, and positive and negative predictive values of 100%, 81%, 80%, and 100%, respectively. Conclusion: With GBPS, both diffuse ARVD and localized ARVD can be accurately diagnosed by computing s-TES for all of the pixels on the surface of the right ventricle.

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“…For processing, midventricular locations were determined by the maximum activity in the likely ventricles, and a continuous dynamic biventricular surface was generated by the combination of spatial and temporal information. Volumes were computed from the number of voxels greater than 50% of maximum volumetric counts, and EF was computed from count changes in areas with counts greater than 35% of maximum volumetric counts (20).…”

Section: Gbps Data Acquisition and Processingmentioning

confidence: 99%

Evaluation of Left and Right Ventricular Ejection Fraction and Volumes from Gated Blood-Pool SPECT in Patients with Dilated Cardiomyopathy: Comparison with Cardiac MRI

et al. 2012

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This prospective study evaluated the accuracy of electrocardiogram-gated blood-pool SPECT (GBPS) for the assessment of left ventricular (LV) and right ventricular (RV) ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) in patients with dilated cardiomyopathy (DCM), using cardiac magnetic resonance (CMR) imaging as the reference standard. Methods: Thirty-two patients (24 men and 8 women; mean age, 51 y) with a diagnosis of idiopathic DCM underwent GBPS and CMR. LV and RV parameters including EDV, ESV, and EF from GBPS were calculated using fully automated gradient software and compared with those obtained by CMR. Results: Biventricular volumes were underestimated by GBPS, compared with CMR (P , 0.001). We found no statistical difference between these 2 methods in the assessment of LV EF (P 5 0.23), whereas RV EF was overestimated by GBPS (P , 0.001 vs. CMR). Regression analysis yielded significant correlations between GBPS and CMR in the assessments of biventricular parameters (r 5 0.83 for LV EDV, 0.88 for LV ESV, 0.89 for LV EF, 0.86 for RV EDV, 0.86 for RV ESV, and 0.62 for RV EF; all P , 0.001). Comparison of the deviations of RV indices between GBPS and CMR with the ratio of RV EDV to LV EDV showed that there was a statistically significant trend for RV volumes to be underestimated and for RV EF to be overestimated as the biventricular volumetric ratio decreased (r 5 0.61 for RV EDV, 0.68 for RV ESV, and 20.55 for RV EF; all P , 0.001). Conclusion: For patients with DCM, GBPS correlated well with CMR for the assessment of biventricular parameters, but RV indices should be cautiously interpreted.

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Automatic quantification of left ventricular ejection fraction from gated blood pool SPECT

Abstract: Our automatic algorithm agrees with conventional radionuclide measurements of LVEF and provides the basis for 3-dimensional analysis of wall motion.

Cited by 82 publications

References 30 publications

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Diagnosis of Diffuse and Localized Arrhythmogenic Right Ventricular Dysplasia by Gated Blood-Pool SPECT

Evaluation of Left and Right Ventricular Ejection Fraction and Volumes from Gated Blood-Pool SPECT in Patients with Dilated Cardiomyopathy: Comparison with Cardiac MRI

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