Comparison of interstudy reproducibility of equilibrium electrocardiography-gated SPECT radionuclide angiography versus planar radionuclide angiography for the quantification of global left ventricular function.

Background: Electrocardiography-gated single photon emission computed tomography (SPECT) radionuclide angiography (RNA) provides accurate measurement of both left ventricular (LV) ejection fraction (EF) and end-diastolic and end-systolic volumes. In this study we studied the interstudy precision and reliability of SPECT RNA as compared with planar RNA for the measurement of global systolic LV function.

Methods And Results: The population included 10 patients with chronic coronary artery disease having 2 sets of acquisitions, each consisting of planar and SPECT RNA. SPECT RNA was processed with SPECT-QBS and SPECT-35%. (For SPECT-35%, a manual segmentation method based on the 35% threshold of the maximum LV cavity activity is used to provide estimates of the number of voxels and the activity included in the LV cavity. The calculated LV number of voxels is then used to calculate LV volume measurement. The LV EF is calculated as the ratio of LV end-diastolic and end-systolic activity.) For LV EF, end-diastolic volume, and end-systolic volume, the interstudy precision, as reflected by the correlation coefficient, coefficient of variability, coefficient of repeatability, and within-subject coefficient of variation, and the interstudy reliability, as reflected by the intraclass correlation coefficient, were best with SPECT-35%, followed by planar RNA and then SPECT-QBS, respectively. The sample size needed to objectify a change in a parameter of LV function is lowest with SPECT-35%, followed by planar RNA and then SPECT-QBS, respectively.

Conclusions: The SPECT-35% processing method provides excellent interstudy precision and reliability for LV function measurement. In this aspect it seems to be better than planar RNA and SPECT-QBS. These results need to be confirmed in a larger patient population.