Normal limits for left ventricular ejection fraction and volumes determined by gated single photon emission computed...

Area of Science:

• Nuclear Cardiology
• Cardiovascular Imaging
• Medical Physics

Background:

• Accurate assessment of left ventricular (LV) function is vital in cardiovascular disease management.
• Myocardial perfusion-gated single-photon emission computed tomography (SPECT) provides functional and volumetric data.
• Different quantification software packages may yield varying normal limits.

Purpose of the Study:

• To compare gender-specific normal limits for LV ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV).
• To evaluate differences in these parameters derived from two gated SPECT quantification methods: CAFU and quantitative-gated SPECT (QGS).

Main Methods:

• Retrospective analysis of 185 patients with normal or probably normal stress/rest perfusion SPECT.
• Gated SPECT studies utilized a Tc-99m sestamibi protocol.
• Image quantification performed using CAFU and QGS software packages.

Main Results:

• CAFU software yielded higher lower normal limits for LV EF in both women (59% vs. 53%) and men (54% vs. 47%) compared to QGS.
• CAFU software showed higher upper normal limits for LV EDV in women (133 vs. 107 ml) and men (182 vs. 161 ml) than QGS.
• Differences in LV ESV normal limits between software were minimal.

Conclusions:

• Gender-specific normal limits for LV EF and volumes are necessary when using gated SPECT.
• Software-dependent criteria for abnormal LV EF and EDV should be applied for accurate interpretation in men and women.