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Normal limits of gated blood pool SPECT count-based regional cardiac function parameters

  • Kenneth J. Nichols
  • Andrew Van Tosh
  • Pieter De Bondt
  • Steven R. Bergmann
  • Christopher J. Palestro
  • Nathaniel Reichek
Original Paper

Abstract

Purpose Computations of left and right ventricular (LV and RV) gated blood pool SPECT (GBPS) ejection fraction (EF) have been well validated against other imaging modalities. As GBPS images depict the entire extent of both blood pools, it is possible to compute not only global but also regional biventricular function parameters, which have the prospect of being clinically useful for planning cardiac resynchronization therapy. This investigation sought to establish LV and RV count-based GBPS regional functional normal limits and to quantify their reproducibility. Methods and materials Count-versus-time curves were fit to third-order Fourier series for each of 17 LV and RV sub-volumes to compute global and regional EF, timing, phase and dyssynchrony parameters. Algorithms were applied to data for 40 normal controls (NLs) and 15 patients with CHF. To assess reproducibility, data were reprocessed a second time, blinded to initial calculations. Results There were no statistically significant differences between any initial and reprocessed LV or RV parameters for NLs or patients with CHF. Percent of subjects categorized as abnormal were the same for initial and reprocessed parameters (McNemar’s differences = 0–7%, > 0.05 for each parameter). Most parameters were significantly different for patients with CHF versus NLs. Normal limits for the new technique agreed well with the literature for other imaging methods, and RV normal limits closely paralleled LV limits. Conclusion GBPS global and regional LV and RV normal limits are reproducible, and application of these normal limits to patients with CHF results in reproducible detection of functional abnormalities.

Keywords

Heart function tests Radionuclide ventriculography Left ventricular hypertrophy Right ventricular hypertrophy 

Notes

Acknowledgments

We would like to thank Jing Han for her expert assistance with the statistical analysis reported for this report. This work received material support of the Saint Francis Cardiac Research Foundation. Kenneth Nichols shares in royalties for BP-SPECT algorithms.

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Copyright information

© Springer Science+Business Media, B.V. 2008

Authors and Affiliations

  • Kenneth J. Nichols
    • 1
    • 2
    • 3
  • Andrew Van Tosh
    • 3
  • Pieter De Bondt
    • 4
  • Steven R. Bergmann
    • 5
  • Christopher J. Palestro
    • 1
    • 2
  • Nathaniel Reichek
    • 3
  1. 1.Division of Nuclear MedicineNorth Shore Long Island Jewish Health SystemNew Hyde ParkUSA
  2. 2.Division of Molecular ImagingNorth Shore Long Island Jewish Health SystemNew Hyde ParkUSA
  3. 3.Cardiac Imaging Research ProgramRoslynUSA
  4. 4.The Division of Nuclear MedicineOLV HospitalAalstBelgium
  5. 5.The Division of CardiologyBeth-Israel HospitalNew YorkUSA

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