Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies

Montelatici, Giulia; Sciagrà, Roberto; Passeri, Alessandro; Dona, Manjola; Pupi, Alberto

doi:10.1007/s00259-008-0866-2

Cited by 17 publications

(13 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A phantom study did not demonstrate a clear superiority of a 16-frame acquisition over an 8-frame acquisition, with a similar underestimation of the LV volumes and a slight overestimation of the LVEF with the 16-frame solution (21). Moreover, a recent study comparing the quantitative data obtained with the QGS program from the 2 framing solutions (8 frames and 16 frames) acquired simultaneously showed only minor differences of questionable clinical value (31).…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Ordered-Subset Expectation Maximization Iterative Protocol for Evaluation of Left Ventricular Volumes and Function by Quantitative Gated SPECT: A Dynamic Phantom Study

Ceriani

Ruberto²,

Delaloye³

et al. 2010

Journal of Nuclear Medicine Technology

View full text Add to dashboard Cite

The purposes of this study were to characterize the performance of a 3-dimensional (3D) ordered-subset expectation maximization (OSEM) algorithm in the quantification of left ventricular (LV) function with 99m Tc-labeled agent gated SPECT (G-SPECT), the QGS program, and a beating-heart phantom and to optimize the reconstruction parameters for clinical applications. Methods: A G-SPECT image of a dynamic heart phantom simulating the beating left ventricle was acquired. The exact volumes of the phantom were known and were as follows: end-diastolic volume (EDV) of 112 mL, end-systolic volume (ESV) of 37 mL, and stroke volume (SV) of 75 mL; these volumes produced an LV ejection fraction (LVEF) of 67%. Tomographic reconstructions were obtained after 10-20 iterations (I) with 4, 8, and 16 subsets (S) at full width at half maximum (FWHM) gaussian postprocessing filter cutoff values of 8-15 mm. The QGS program was used for quantitative measurements. Results: Measured values ranged from 72 to 92 mL for EDV, from 18 to 32 mL for ESV, and from 54 to 63 mL for SV, and the calculated LVEF ranged from 65% to 76%. Overall, the combination of 10 I, 8 S, and a cutoff filter value of 10 mm produced the most accurate results. The plot of the measures with respect to the expectation maximization-equivalent iterations (I · S product) revealed a bell-shaped curve for the LV volumes and a reverse distribution for the LVEF, with the best results in the intermediate range. In particular, FWHM cutoff values exceeding 10 mm affected the estimation of the LV volumes. Conclusion: The QGS program is able to correctly calculate the LVEF when used in association with an optimized 3D OSEM algorithm (8 S, 10 I, and FWHM of 10 mm) but underestimates the LV volumes. However, various combinations of technical parameters, including a limited range of I and S (80-160 expectation maximization-equivalent iterations) and low cutoff values (#10 mm) for the gaussian postprocessing filter, produced results with similar accuracies and without clinically relevant differences in the LV volumes and the estimated LVEF. It erative reconstruction algorithms were recently proposed as a new potential tool for increasing the quality of tomographic images in nuclear medicine. Protocols based on ordered-subset expectation maximization (OSEM) have become the dominant iterative reconstruction procedures in SPECT and PET. The performance of OSEM was compared with that of filtered backprojection (FBP) in several experimental and clinical studies (1-5); OSEM was shown to have better noise properties and higher image contrast and resolution. On the other hand, even though iterative protocols were suggested for cardiac SPECT in the recent European Association of Nuclear Medicine/European Society of Cardiology guidelines (6), controversial results were reported when myocardial perfusion and left ventricular (LV) function were assessed by different iterative methods (maximumlikelihood expectation maximization, iterative-weighted, and 2-dimensional OSEM) (7-16). Standardization ...

show abstract

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Ordered-Subset Expectation Maximization Iterative Protocol for Evaluation of Left Ventricular Volumes and Function by Quantitative Gated SPECT: A Dynamic Phantom Study

Ceriani

Ruberto²,

Delaloye³

et al. 2010

Journal of Nuclear Medicine Technology

View full text Add to dashboard Cite

show abstract

“…We did not perform any arrhythmia rejection and therefore we cannot exclude that transient rhythm disturbances during the acquisition could have influenced the EF calculation. However, previous data indicate that the influence of arrhythmia rejection on the functional parameters derived from gated SPECT is limited [21]. Because we adopted a relatively low threshold for classifying the EF response as abnormal, the gated SPECT reproducibility is a major issue.…”

Section: Study Limitationsmentioning

confidence: 99%

Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities

Dona

Massi

Settimo

et al. 2010

Eur J Nucl Med Mol Imaging

Self Cite

View full text Add to dashboard Cite

Purpose The prognostic meaning of a post-stress ejection fraction (EF) decrease detected by perfusion gated SPECT is still unclear. We therefore followed up patients with post-stress EF decrease in the absence of stress-induced perfusion abnormalities. Methods We prospectively enrolled 57 consecutive patients with post-stress EF drop ≥5 EF units and summed difference score (SDS)≤1. They were followed up for more than 1 year and their outcome was compared with a group of sex-and agematched controls with the same SDS but without EF decrease. Results During follow-up there were 13 events (1 cardiac death, 1 non-fatal myocardial infarction, 1 congestive heart failure and 10 late revascularizations). In the control group we registered six events. There was a significant difference (p<0.0001) between the event-free survival curves of the two groups. ConclusionThe event rate of patients with post-stress EF decrease≥5 EF units is relatively high and is significantly worse than that of a control group of patients with similarly normal SDS but without EF changes. Therefore, a post-stress EF decrease without stress-induced perfusion abnormalities should be cautiously interpreted.

show abstract

“…Using eight intervals instead of 16, does lead to lower ejection fractions, as measured by QGS, because this smoothens the time-volume curve, with an average reduction of 3.71 percentage points [6]. However, the use of fewer intervals has only minor and predictable influences on functional data [16] and therefore is not a source of bias.…”

Section: Resultsmentioning

confidence: 99%

Assessment of left ventricular function at rest using rubidium-82 myocardial perfusion PET: comparison of four software algorithms with simultaneous 64-slice coronary CT angiography

Menezes

Groves²,

Prvulovich³

et al. 2009

Nuclear Medicine Communications

View full text Add to dashboard Cite

show abstract

Is 16-frame really superior to 8-frame gated SPECT for the assessment of left ventricular volumes and ejection fraction? Comparison of two simultaneously acquired gated SPECT studies

Cited by 17 publications

References 15 publications

Three-Dimensional Ordered-Subset Expectation Maximization Iterative Protocol for Evaluation of Left Ventricular Volumes and Function by Quantitative Gated SPECT: A Dynamic Phantom Study

Three-Dimensional Ordered-Subset Expectation Maximization Iterative Protocol for Evaluation of Left Ventricular Volumes and Function by Quantitative Gated SPECT: A Dynamic Phantom Study

Prognostic implications of post-stress ejection fraction decrease detected by gated SPECT in the absence of stress-induced perfusion abnormalities

Assessment of left ventricular function at rest using rubidium-82 myocardial perfusion PET: comparison of four software algorithms with simultaneous 64-slice coronary CT angiography

Contact Info

Product

Resources

About