Diagnosis of arrhythmogenic right ventricular cardiomyopathy by Fourier analysis of gated blood pool single-photon emission tomography

Casset-Senon, Danielle; Philippe, Laurent; Babuty, Dominique; Eder, Véronique; Fauchier, Laurent; Fauchier, J P; Pottier, Jean Marie; Cosnay, P

doi:10.1016/s0002-9149(98)00649-3

Cited by 29 publications

(18 citation statements)

References 12 publications

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“…Detection of abnormal regional EF on BP SPECT has been shown to agree well with regional WM assessed by biplane radiographic contrast angiograms (12). RV regional phase delays detected by BP SPECT have been shown to agree with readers' qualitative impressions of RV WM abnormalities seen on biplane radiographic angiograms in patients with arrhythmogenic RV cardiomyopathy (27). Data comparing the assessment of regional WM using quantitative BP gated SPECT with cardiac MRI are, however, lacking.…”

Section: Discussionmentioning

confidence: 83%

Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements

Nichols¹,

Tosh²,

Wang³

et al. 2008

J Nucl Med

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Blood-pool (BP)-gated SPECT should be able to detect regional left ventricular (LV) dysfunction, as the modality is fully 3-dimensional and capable of resolving all cardiac chambers. This study investigates the hypothesis that LV segments that have abnormal regional wall motion (WM) on a cardiac MRI scan also have abnormal BP regional ejection fraction (EF) as computed by fully automated quantitation (AQ) of BP data. Methods: A total of 34 patients evaluated for coronary artery disease who underwent visual assessment of WM by review of BP cines and cardiac MRI evaluations were included in this retrospective investigation. Cardiac MRI values for these patients were compared with an institutional database of cardiac MRI values for an age-matched cohort of 10 healthy volunteers. An AQ algorithm segmented the LV BPs on the BP tomograms and subdivided volumes into 17 subregions. Count-versus-time curves were fit to third-order Fourier series for each LV subvolume to compute regional EFs. For cardiac MRI data, endocardial and epicardial drawings were performed manually for 60°sam-ples of 11-13 short-axis tomograms spanning the entire heart, from which regional WM values were computed and rebinned into 17 conventional LV segments. Results: Global EF ranged from 12% to 75% on AQ and from 14% to 75% on cardiac MRI (Pearson correlation coefficient 5 0.95, P , 0.0001). Differences were not significant between BP AQ and cardiac MRI in identifying the 12 patients with a global EF less than 35% (McNemar difference, 3%; P 5 1.0) and the 19 patients with an EF less than 50% (difference, 3%; P 5 1.0). BP AQ was more accurate than was visual assessment for identifying LV segments with abnormal cardiac MRI WM (receiver-operating-characteristic areas, 88% vs. 80%, P , 0.0001) and was more accurate for the left circumflex than for the left anterior descending coronary artery territories (95% vs. 86%, P 5 0.01). Differences were not significant between BP AQ and cardiac MRI WM for discriminating normal from abnormal LV segments (McNemar difference, 3.2%; P 5 0.14). Conclusion: AQ BP-gated SPECT assessment of regional and global LV WM agrees with independent cardiac MRI calculations and is superior to visual analysis for detecting regional WM abnormalities.

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Section: Discussionmentioning

confidence: 83%

Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements

Nichols¹,

Tosh²,

Wang³

et al. 2008

J Nucl Med

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“…Through analysis of GBPS right ventricular slices as planar acquisitions, it has been demonstrated that the SD of the first harmonic-phase histogram may be used for screening patients with right ventricular arrhythmias (27)(28)(29), but the localized or diffuse character of the ARVD in the patients studied in these investigations was not considered.…”

Section: Discussionmentioning

confidence: 99%

“…However, some limitations that are inherent to the overlap of vascular and cardiac structures during planar acquisitions make it difficult to analyze the right ventricle (RV) (25). GBPS can overcome these limitations, but only a few studies have evaluated GBPS in ARVD (27)(28)(29), and none of them has taken advantage of recent advances in the processing of such studies.…”

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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“…Gated blood pool SPECT (GBPS) calculations are based on counts emanating from pools of labeled red cells, providing unambiguous separation of cardiac chambers [3], lending itself well to evaluation of aberrant RV as well as LV function [4][5][6]. It has long been recognized that RV dysfunction is an important indicator in patients with CHF [7].…”

Section: Introductionmentioning

confidence: 99%

Normal limits of gated blood pool SPECT count-based regional cardiac function parameters

Nichols

Tosh²,

Bondt

et al. 2008

Int J Cardiovasc Imaging

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Purpose Computations of left and right ventricular (LV and RV) gated blood pool SPECT (GBPS) ejection fraction (EF) have been well validated against other imaging modalities. As GBPS images depict the entire extent of both blood pools, it is possible to compute not only global but also regional biventricular function parameters, which have the prospect of being clinically useful for planning cardiac resynchronization therapy. This investigation sought to establish LV and RV count-based GBPS regional functional normal limits and to quantify their reproducibility. Methods and materials Count-versus-time curves were fit to third-order Fourier series for each of 17 LV and RV sub-volumes to compute global and regional EF, timing, phase and dyssynchrony parameters. Algorithms were applied to data for 40 normal controls (NLs) and 15 patients with CHF. To assess reproducibility, data were reprocessed a second time, blinded to initial calculations. Results There were no statistically significant differences between any initial and reprocessed LV or RV parameters for NLs or patients with CHF. Percent of subjects categorized as abnormal were the same for initial and reprocessed parameters (McNemar's differences = 0-7%, P [ 0.05 for each parameter). Most parameters were significantly different for patients with CHF versus NLs. Normal limits for the new technique agreed well with the literature for other imaging methods, and RV normal limits closely paralleled LV limits. Conclusion GBPS global and regional LV and RV normal limits are reproducible, and application of these normal limits to patients with CHF results in reproducible detection of functional abnormalities.

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Diagnosis of arrhythmogenic right ventricular cardiomyopathy by Fourier analysis of gated blood pool single-photon emission tomography

Cited by 29 publications

References 12 publications

Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements

Validation of Gated Blood-Pool SPECT Regional Left Ventricular Function Measurements

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

Normal limits of gated blood pool SPECT count-based regional cardiac function parameters

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