Left ventricular ejection fraction determined with the simulation of a very low-dose CZT-SPECT protocol and an additional count-calibration on planar radionuclide angiographic data

J Nucl Cardiol. 2019 Oct;26(5):1539-1549. doi: 10.1007/s12350-019-01619-w. Epub 2019 Feb 27.

Abstract

Purpose: To determine whether the left ventricular ejection fractions (EFs), measured on a high-sensitivity CZT single photon emission computed tomography (SPECT)-camera with a 70% reduction in recording times and a prevention of EF overestimation through an additional count-calibration, are concordant with reference EF from planar radionuclide angiography (2D-RNA).

Methods: An additional 10-minute CZT-SPECT recording was performed in patients referred to 2D-RNA for cardiomyopathy (n = 23) or chemotherapy monitoring (n = 50) with an in vivo red blood cell labeling with 850 MBq [Formula: see text]. The EF, obtained from CZT-SPECT with 100% (SPECT100) or 30% (SPECT30) projection times and with a SPECT-count calibration on the 2D-RNA counts of corresponding cavity volumes, were compared to EF from 2D-RNA.

Results: Strong and equivalent relationships were documented between the EF from 2D-RNA and the calibrated EF from SPECT100 (y = 0.89x + 6.62; R2 = 0.87) and SPECT30 (y = 0.87x + 8.40; R2 = 0.85), and the mean EF from SPECT100 (54% ± 15%) and SPECT30 (53% ± 16%) were close to that from 2D-RNA (55% ± 15%). However, upward shifts in these mean values were documented in the absence of count calibration for both SPECT100 (60% ± 18%) and SPECT30 (60% ± 18%).

Conclusion: Left ventricular EF may be determined on a high-sensitivity CZT-camera, a 70% reduction in injected activities, and an additional count-calibration for further enhancing the concordance with 2D-RNA values.

Keywords: Blood-pool SPECT; CZT-camera; Calibration curve; Left ventricular ejection fraction; Radionuclide angiography.

MeSH terms

  • Adult
  • Aged
  • Angiography*
  • Antineoplastic Agents / therapeutic use
  • Cadmium
  • Calibration
  • Cardiomyopathies / diagnostic imaging*
  • Computer Simulation
  • Erythrocytes / drug effects
  • Female
  • Gamma Cameras
  • Heart Ventricles / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / diagnostic imaging*
  • Neoplasms / drug therapy
  • Prospective Studies
  • Radionuclide Angiography
  • Stroke Volume
  • Tellurium
  • Tomography, Emission-Computed, Single-Photon*
  • Ventricular Function, Left
  • Zinc

Substances

  • Antineoplastic Agents
  • CdZnTe
  • Cadmium
  • Zinc
  • Tellurium