Department of Nuclear Medicine, Alfred Hospital, Monash University, Commercial Road, Melbourne, VIC 3004, Australia.
J Nucl Cardiol. 2012 Aug;19(4):713-8. doi: 10.1007/s12350-012-9561-6. Epub 2012 May 1.
To evaluate the reproducibility of serial re-acquisitions of gated Tl-201 and Tc-99m sestamibi left ventricular ejection fraction (LVEF) measurements obtained on a new generation solid-state cardiac camera system during myocardial perfusion imaging and the importance of manual operator optimization of left ventricular wall tracking.
Resting blinded automated (auto) and manual operator optimized (opt) LVEF measurements were measured using ECT toolbox (ECT) and Cedars-Sinai QGS software in two separate cohorts of 55 Tc-99m sestamibi (MIBI) and 50 thallium (Tl-201) myocardial perfusion studies (MPS) acquired in both supine and prone positions on a cadmium zinc telluride (CZT) solid-state camera system. Resting supine and prone automated LVEF measurements were similarly obtained in a further separate cohort of 52 gated cardiac blood pool scans (GCBPS) for validation of methodology and comparison. Appropriate use of Bland-Altman, chi-squared and Levene's equality of variance tests was used to analyse the resultant data comparisons.
For all radiotracer and software combinations, manual checking and optimization of valve planes (+/- centre radius with ECT software) resulted in significant improvement in MPS LVEF reproducibility that approached that of planar GCBPS. No difference was demonstrated between optimized MIBI/Tl-201 QGS and planar GCBPS LVEF reproducibility (P = .17 and P = .48, respectively). ECT required significantly more manual optimization compared to QGS software in both supine and prone positions independent of radiotracer used (P < .02).
Reproducibility of gated sestamibi and Tl-201 LVEF measurements obtained during myocardial perfusion imaging with ECT toolbox or QGS software packages using a new generation solid-state cardiac camera with improved image quality approaches that of planar GCBPS however requires visual quality control and operator optimization of left ventricular wall tracking for best results. Using this superior cardiac technology, Tl-201 reproducibility also appears at least equivalent to sestamibi for measuring LVEF.
评估在新一代固态相机系统上进行心肌灌注成像时，门控 Tl-201 和 Tc-99m sestamibi 左心室射血分数（LVEF）测量的系列重获的可重复性，以及手动优化左心室壁跟踪的重要性。
使用 ECT 工具包（ECT）和 Cedars-Sinai QGS 软件，在仰卧和俯卧两种体位下对 55 例 Tc-99m sestamibi（MIBI）和 50 例铊（Tl-201）心肌灌注研究（MPS）进行盲法自动（auto）和手动优化（opt）LVEF 测量。在另一组 52 例门控心脏血池扫描（GCBPS）中，同样获得了仰卧和俯卧自动 LVEF 测量，以验证方法并进行比较。使用 Bland-Altman、卡方和 Levene 方差齐性检验来分析所得数据比较。
对于所有示踪剂和软件组合，手动检查和优化瓣平面（ECT 软件的中心半径 +/-）可显著提高 MPS LVEF 的可重复性，接近平面 GCBPS。优化后的 MIBI/Tl-201 QGS 与平面 GCBPS 的 LVEF 重复性之间无差异（P=0.17 和 P=0.48）。ECT 在仰卧和俯卧位，无论使用何种示踪剂，都需要比 QGS 软件进行更多的手动优化（P<0.02）。
使用新一代固态相机系统，使用 ECT 工具包或 QGS 软件包进行心肌灌注成像时，门控 sestamibi 和 Tl-201 LVEF 测量的可重复性接近平面 GCBPS，但需要进行视觉质量控制和手动优化左心室壁跟踪，以获得最佳结果。使用这种先进的心脏技术，Tl-201 测量 LVEF 的重复性至少与 sestamibi 相当。
