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Published on: February 16, 2016
Quantitative polar representation of left ventricular myocardial perfusion, function and viability using SPECT and
Peter A Cain1, Martin Ugander, John Palmer
1Department of Clinical Physiology, Lund University Hospital, Lund, Sweden.
Insights
This study demonstrates the feasibility of using quantitative polar plots to integrate left ventricular (LV) myocardial perfusion, function, and viability assessments in coronary artery disease (CAD) patients. The quantitative approach showed excellent agreement with visual scoring, improving clinical evaluation.
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Radiology
Background:
- Coronary artery disease (CAD) management requires complex assessment of left ventricular (LV) myocardial perfusion, function, and viability.
- Current methods may lack integrative quantitative representation for these parameters.
- Evaluating the agreement between visual and quantitative scoring is crucial for clinical utility.
Purpose of the Study:
- To explore the feasibility of an integrative quantitative representation of LV perfusion, function, and viability using adjacent polar plots.
- To assess the clinical usefulness of quantitative methods by determining the agreement with visual scoring.
Main Methods:
- Ten patients with CAD underwent rest/stress (99m)Tc-tetrofosmin SPECT and cardiac magnetic resonance (CMR) imaging.
- In-house software generated polar plots from semi-automatic quantification of SPECT perfusion and CMR function/viability.
- Kendall's coefficient of concordance (W) assessed agreement between visual and quantitative scoring.
Main Results:
- Quantitative polar plots integrating LV perfusion, function, and viability were successfully created.
- Excellent agreement (Kendall's W=1.0 for perfusion, W=0.85 for function) was found between quantitative measurements and visual scoring.
- The quantitative approach demonstrated high concordance with established visual assessment methods.
Conclusions:
- Integrative quantitative polar representation of LV perfusion, function, and viability is feasible.
- This approach can aid in the complex assessment of cardiac parameters in CAD patients.
- Very good agreement between quantitative and visual scoring supports the clinical utility of this method.
Background:
The clinical management of patients with coronary artery disease (CAD) often involves a complex assessment of the extent and severity of changes in left ventricular (LV) myocardial perfusion, function and viability. We aimed to explore the feasibility of integrative quantitative representation of LV perfusion, function and viability in adjacent polar plots. In order to assess the clinical usefulness of the quantitative methods, we also explored the relationship and determined the agreement between visual scoring and quantitative measurement of regional perfusion and function.
Methods:
Ten patients with CAD underwent rest and stress (99m)Tc-tetrofosmin single photon emission computed tomography (SPECT) and cardiac magnetic resonance (CMR) imaging. Software was developed in-house for generating polar plots from semi-automatic quantification of rest and stress perfusion from SPECT, function from cine CMR and viability from delayed contrast enhancement (DE) CMR. The agreement between visual assessment and quantification of both perfusion and function was tested by Kendall's coefficient of concordance (W).
Results:
Polar plots were created using quantitative data from the semi-automatic analysis of perfusion, function and viability. Kendall's W for agreement between quantitative measurement and visual scoring was 1.0 (P<0.001) for perfusion and 0.85 (P<0.001) for function.
Conclusions:
Side-by-side quantitative polar representation of LV perfusion, function and viability is feasible and may aid in the complex assessment of these parameters. The agreement between quantitative measurement and visual scoring was very good for both perfusion and function.
