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Published on: October 20, 2016
UK audit of left ventricular ejection fraction estimation from equilibrium ECG gated blood pool images
John V Skrypniuk1, Dale Bailey, Philip S Cosgriff
1IPEM Nuclear Medicine Software Working Party, York, UK. john.skrypniuk@nnuh.nhs.uk
Insights
Computer analysis of left ventricular gated blood pool (LVGBP) images shows significant variability between UK nuclear medicine centres. Improving image quality and standardizing analysis parameters are crucial for consistent left ventricular ejection fraction (LVEF) results.
Area of Science:
- Nuclear Medicine
- Cardiovascular Imaging
- Medical Imaging Analysis
Background:
- Computer analysis of left ventricular gated blood pool (LVGBP) images is a key diagnostic tool in nuclear medicine.
- Variability in results can impact patient diagnosis and treatment.
- Standardization of analysis protocols is essential for reliable cardiovascular imaging assessment.
Purpose of the Study:
- To investigate the variability in results from computer-aided analysis of LVGBP images across UK nuclear medicine facilities.
- To identify factors contributing to discrepancies in left ventricular ejection fraction (LVEF) measurements.
- To assess the impact of image quality and acquisition parameters on analysis consistency.
Main Methods:
- Distribution of 12 standardized LVGBP image datasets to 63 UK nuclear medicine centres.
- Inclusion of duplicate and varied count datasets to assess reproducibility.
- Collection of analysis parameters and reported results via questionnaire.
- Analysis of variability in left ventricular ejection fraction (LVEF) estimates.
Main Results:
- Significant variability in LVEF estimates was observed across different centres and computer systems.
- Approximately 50% of the variation in results was attributed to systematic differences between centres.
- Higher image counts correlated with lower variability in LVEF measurements, indicating improved precision.
- Inconsistent reporting of normal ranges for LVEF was noted among participating centres.
Conclusions:
- Substantial variability exists in the computer analysis of LVGBP images within UK nuclear medicine centres.
- Image quality, specifically total counts, significantly influences the precision of LVEF measurements.
- Standardization of analysis protocols and reporting of normal ranges is recommended to improve consistency and reliability in cardiovascular imaging.
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.
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