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Ventricular ejection fraction in patients with dilated cardiomyopathy calculated by gated blood pool SPET processing
Bhagwant Rai Mittal1, Sampath Santhosh, Raghava Kashyap
1Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India. brmittal@yahoo.com
Insights
Automated gated blood pool scintigraphy (GBPS) accurately assesses left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) in dilated cardiomyopathy (DCM) patients, correlating well with standard methods like MUGA and FPRNV.
Area of Science:
- Nuclear Medicine
- Cardiology
- Medical Imaging
Background:
- Dilated cardiomyopathy (DCM) significantly impacts cardiac function.
- Accurate assessment of left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) is crucial for managing DCM.
- Gated blood pool scintigraphy (GBPS) is a nuclear imaging technique with potential for assessing ventricular function.
Purpose of the Study:
- To evaluate the accuracy of automated GBPS in calculating LVEF and RVEF in DCM patients.
- To correlate GBPS findings with established methods like first-pass radionuclide ventriculography (FPRNV) and multigated acquisition (MUGA).
- To explore the utility of GBPS as a reliable tool for ventricular function assessment in DCM.
Main Methods:
- Forty-one DCM patients underwent GBPS, FPRNV, and MUGA at rest after in-vivo red blood cell labeling.
- LVEF and RVEF were calculated using automated GBPS processing software.
- Results were compared with FPRNV, MUGA, and echocardiography using correlation coefficients and Bland-Altman analysis.
Main Results:
- LVEF values from MUGA, GBPS, and echocardiography showed strong correlations (r=0.924 and r=0.844, respectively; P < 0.0001).
- RVEF values from FPRNV and GBPS demonstrated good correlation (r=0.88; P < 0.0001).
- GBPS showed a tendency for overestimation of LVEF and RVEF compared to MUGA.
Conclusions:
- Automated GBPS is a reliable method for routine LVEF and RVEF calculation in DCM patients.
- GBPS offers a practical alternative for RVEF assessment, especially when FPRNV presents challenges.
- Both MUGA and GBPS are suitable for LVEF assessment in this patient cohort.
Abstract:
This study was performed to find out the left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) in patients with dilated cardiomyopathy (DCM) by using commercially available automated gated blood pool scintigraphy (GBPS) processing software and to correlate it with first pass radionuclide ventriculography (FPRNV) and planar multigated acquisition (MUGA). However, till date, no literature exists studying the application of GBPS and planar radionuclide ventriculography techniques in the setting of patients with DCM as a single cohort. Forty-one patients having DCM were prospectively included in the study. First pass RNV and MUGA were performed at rest after in-vivo labeling of red blood cells in all patients. Immediately after obtaining the planar views, GBPS was performed and LVEF and RVEF were calculated. Our results showed that the %LVEF values (mean±SD) calculated by MUGA, GBPS and echo cardiography were 31±11, 34±12 and 32±11, respectively. The % RVEF values (mean±SD) calculated by FPRNV and GBPS were 46±14 and 43±17, respectively. The LVEF values calculated by MUGA, GBPS and echcardiography showed very good correlation r=0.924 and r=0.844, respectively and for both P <0.0001. Bland-Altman plot showed overestimation for LVEF (and a tendency for overestimation of RVEF) values calculated by GBPS compared to MUGA. Values of RVEF calculated by GBPS and FPRNV also showed good correlation (r=0.88; P< 0.0001). In conclusion, the automated GBPS for LVEF and RVEF calculation using GBPS SPET can be routinely applied in DCM patients. Given the practical difficulties with FPRNV like good bolus administration, quantitative blood pool SPET (QBPS) can be used to calculate RVEF. Similarly MUGA and GBPS can be used to calculate LVEF.