PubMed · 11337533
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G Germano, D S Berman. 2001. Quantitative gated SPECT.. https://pubmed.ncbi.nlm.nih.gov/11337533/
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SPECT of cardiac perfusion and blood pools provides ungated 3-dimensional and gated 4-dimensional (4D) datasets of the ventricular myocardium. Modern reconstruction and review software is used to reorient the transverse thoracic slices into cardiac short-axis slices. Several validated algorithms are used to analyze these data. These programs segment out the left ventricle, determine the apical and basal limits, and then contour the endo- and epicardial surfaces. From these, 4D images of cardiac function that enable a dynamic review of wall motion are obtained. Global function in gated studies can be quantified by automatic computation of stroke volume and ejection fraction. Remapping of myocardial perfusion and wall motion into polar maps enables standardized quantification of the extent and severity of heart disease after comparison with databases of healthy hearts (normal databases). Several validated software packages make processing of these SPECT datasets comparatively easy and operator independent. The objectives of this review article are to describe the steps in the processing of a cardiac SPECT dataset for viewing and quantification, to explain the underlying algorithms used for automated processing, to compare the features of various software packages, to demonstrate how to read polar maps, and to identify and correct artifacts resulting from errors in automated processing.
PURPOSE: To examine the variability of results obtained from computer analysis of left ventricular gated blood pool (LVGBP) images by nuclear medicine centres in the UK. METHODS: Twelve data sets of LVGBP images were distributed via commercial software suppliers to nuclear medicine centres in the UK. Two of the data sets were duplicates and three were acquired from the same patient with different total counts in the images. The quality of the images was also variable and two images had poorly defined left ventricular walls. A questionnaire was used to identify the parameters used during the analysis and to give an indication of the number of LVGBP scans per year routinely carried out by each centre as well as report the results obtained from the analysis. RESULTS: Results were received from 63 nuclear medicine centres using 77 computer systems. The vast majority of participants (57) carried out fewer than 10 scans per month. Only two centres performed more than 30 scans per month. Sixteen centres did not quote a minimum normal value for left ventricular ejection fraction (LVEF) and 36 did not record a maximum value. The remainder recorded between 0.40 and 0.60 for the minimum of normal range and 0.60-0.90 for the maximum of normal range. Analysis of returns showed that LVEF estimates for the data sets were highly variable between centres and computer systems. The overall standard deviation of results compared to the mean for each study was 0.076. Approximately half this variation was due to systematic variation between centres. The overall precision taking into consideration this systematic variation, was 0.055. Lower variability was found between studies with higher overall counts and this was highly significant.