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Variability of serial same-day left ventricular ejection fraction using quantitative gated SPECT
Enrique Vallejo1, Hugo Chaya, Gerardo Plancarte
1Department of Nuclear Cardiology at Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. epvv2@hotmail.com
Summary
Quantitative gated SPECT (QGS) for left ventricular ejection fraction (LVEF) estimation shows significant serial variability. This variability is influenced by image counts and patient group, impacting serial LVEF evaluation.
Area of Science:
- Nuclear cardiology
- Cardiovascular imaging
- Medical physics
Background:
- Quantitative gated SPECT (QGS) is widely used for assessing left ventricular ejection fraction (LVEF).
- Previous research focused on QGS accuracy but less on its serial variability.
- Understanding serial variability is crucial for accurate longitudinal LVEF assessment.
Purpose of the Study:
- To evaluate the serial variability of QGS in estimating LVEF.
- To compare this variability between healthy subjects and patients with coronary artery disease (CAD).
- To identify factors influencing serial LVEF variability in gated SPECT imaging.
Main Methods:
- Two sequential resting technetium 99m sestamibi-gated SPECT acquisitions were performed.
- The study included 21 healthy volunteers and 22 patients with documented CAD.
- Left ventricular ejection fraction (LVEF) was calculated from serial SPECT images.
Main Results:
- High overall correlation (r=0.94) was observed between sequential QGS images.
- Mean serial LVEF variability was 5.15% ± 3.51%.
- Variability was lower in high-count images compared to low-count images and higher in abnormal low-dose images.
Conclusions:
- QGS is effective for LVEF approximation and risk stratification in CAD patients.
- Significant variability exists in serial LVEF estimations using QGS.
- This variability must be considered during serial LVEF monitoring.