Absolute left ventricular volume from gated blood pool imaging with use of esophageal transmission measurement

A new method for determining absolute left ventricular (LV) volume from equilibrium gated blood pool images was validated in 36 patients by comparing gated blood pool (GBP) imaging with contrast ventriculography (CV) using both Simpson's rule (SR) and area-length (AL) calculations. The technique is geometry-independent and is the first to correct for tissue attenuation with use of an in vivo point source. An orally administered capsule containing 1 to 2 mCi of technetium-99m (Tc-99m) sulfur colloid is used for this purpose. Left ventricular volumes are determined by dividing attenuation and background-corrected count rates obtained from semiautomated LV regions of interest by the count rate per milliliter from a blood sample. The correlation between GBP and CV (SR) was 0.96 (CV [SR] = 0.99 GBP + 1.32 ml; standard error of the estimate [SEE] = 21.2 ml) for diastole and 0.97 (CV [SR] = 0.93 GBP - 0.03 ml; SEE = 11.9 ml) for systole. The correlation between GBP and CV (AL) was 0.92 (CV [AL] = 0.90 GBP + 16.72 ml; SEE = 27.8 ml) for diastole and 0.95 (CV [AL] = 0.87 GBP + 4.56 ml; SEE = 14.4 ml) for systole. The method is noninvasive and can be performed easily as part of routine gated blood pool imaging and analysis.