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Gated blood pool SPECT: The estimation of right ventricular volume and function is algorithm dependent in a clinical
Laurent Dercle1, Monia Ouali, Pierre Pascal
1Department of Nuclear Medicine, Toulouse University Hospital, 1, avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France, laurent.dercle@gmail.com.
Summary
Gated blood pool SPECT (GBPS) requires validation for right ventricle (RV) assessment. Automatic procedures like BP-SPECT and QBS offer the best accuracy and reproducibility for RV function evaluation.
Area of Science:
- Nuclear Cardiology
- Cardiovascular Imaging
- Medical Physics
Background:
- Gated blood pool SPECT (GBPS) is utilized for cardiac function assessment but requires further validation for right ventricle (RV) evaluation.
- Accurate assessment of RV function is crucial for diagnosing and managing various cardiovascular conditions.
Purpose of the Study:
- To compare the quantitative accuracy, qualitative accuracy, and reproducibility of three GBPS algorithms: BP-SPECT, QBS, and TOMPOOL.
- To evaluate the diagnostic performance of these algorithms in assessing RV ejection fraction (EF), end-diastolic volume (EDV), and cardiac output (CO).
Main Methods:
- Forty-eight patients underwent GBPS, with results compared against reference standards: cardiac magnetic resonance imaging (CMR) for RVEDV and RVEF, and thermodilution (TD) catheter measurements for RCO.
- Quantitative accuracy was assessed using correlation coefficients (r) between GBPS algorithms and reference standards.
- Qualitative accuracy was determined by optimal threshold values and area under the curve (AUC) for diagnosing impaired RV function, and reproducibility was assessed via inter-observer variability (IOV).
Main Results:
- Quantitative accuracy for RVEF showed moderate correlations (r=0.30-0.42) with CMR.
- Quantitative accuracy for RVEDV (r=0.53-0.77) and RCO (r=0.32-0.52) also varied across algorithms.
- Optimal thresholds for qualitative assessment varied, with AUCs ranging from 0.73 to 0.83. Reproducibility (IOV) was best for BP-SPECT and QBS, particularly for RVEF and RVEDV.
Conclusions:
- Diagnostic accuracies of the evaluated GBPS algorithms are comparable, but a CMR-based calibration is recommended for precise quantitative or qualitative analysis.
- Automatic procedures, BP-SPECT and QBS, demonstrate a favorable balance between accuracy and reproducibility for RV assessment.
- Adjusted thresholds are necessary for accurate qualitative interpretation of RV function using GBPS.
