Yi-Hwa Liu1,2,3,4, Ramesh Fazzone-Chettiar5, Veronica Sandoval5, Vera Tsatkin5, Edward J Miller6,5,7, Albert J Sinusas6,5,7. 1. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA. yi-hwa.liu@yale.edu. 2. Department of Nuclear Cardiology, Heart and Vascular Center, Yale New Haven Hospital, New Haven, CT, USA. yi-hwa.liu@yale.edu. 3. Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan. yi-hwa.liu@yale.edu. 4. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan. yi-hwa.liu@yale.edu. 5. Department of Nuclear Cardiology, Heart and Vascular Center, Yale New Haven Hospital, New Haven, CT, USA. 6. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, 06520, USA. 7. Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA.
Abstract
BACKGROUND: Planar equilibrium radionuclide angiocardiography (ERNA) has been used as the gold standard for assessment of left ventricular (LV) function for over three decades. However, this imaging modality has recently gained less favor due to growing concerns about radiation exposure. We developed a novel approach that involves integrating short axis slices of gated bloodpool SPECT for quantification of LV function with improved signal-to-noise ratio and reduced radioactive dose while maintaining image quality and quantitative precision. METHODS: Twenty patients referred for ERNA underwent standard in vitro 99mTc-labeling of red blood cells (RBC), and were initially imaged following a low-dose (~ 8 mCi) injection using a dedicated cardiac SPECT camera, and then had planar imaging following a high-dose (~ 25 mCi) injection. Four different quantification methods were utilized to assess the LV function and were compared for quantitative precision and inter-observer reproducibility of the quantitative assessments. RESULTS: The Yale method resulted in the most consistent assessment of LV function compared with the gold standard high-dose ERNA method, along with excellent inter-observer reproducibility. CONCLUSIONS: The new low-dose 99mTc-RBC imaging method provides precise quantification of LV function with a greater than 67% reduction in dose and may potentially improve assessment of regional function.
BACKGROUND: Planar equilibrium radionuclide angiocardiography (ERNA) has been used as the gold standard for assessment of left ventricular (LV) function for over three decades. However, this imaging modality has recently gained less favor due to growing concerns about radiation exposure. We developed a novel approach that involves integrating short axis slices of gated bloodpool SPECT for quantification of LV function with improved signal-to-noise ratio and reduced radioactive dose while maintaining image quality and quantitative precision. METHODS: Twenty patients referred for ERNA underwent standard in vitro 99mTc-labeling of red blood cells (RBC), and were initially imaged following a low-dose (~ 8 mCi) injection using a dedicated cardiac SPECT camera, and then had planar imaging following a high-dose (~ 25 mCi) injection. Four different quantification methods were utilized to assess the LV function and were compared for quantitative precision and inter-observer reproducibility of the quantitative assessments. RESULTS: The Yale method resulted in the most consistent assessment of LV function compared with the gold standard high-dose ERNA method, along with excellent inter-observer reproducibility. CONCLUSIONS: The new low-dose 99mTc-RBC imaging method provides precise quantification of LV function with a greater than 67% reduction in dose and may potentially improve assessment of regional function.
Entities:
Keywords:
ERNA; Gated bloodpool SPECT; ejection fraction; left ventricular volumes
Authors: Pieter De Bondt; Kenneth Nichols; Stijn Vandenberghe; Patrick Segers; Olivier De Winter; Christophe Van de Wiele; Pascal Verdonck; Arsalan Shazad; Abu H Shoyeb; Johan De Sutter Journal: J Nucl Med Date: 2003-06 Impact factor: 10.057