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Huang Y, Zhang H, Hu X, Qin S, Hu F, Li Y, Cai H, Shi K, Yu F. The D-SPECT SH reconstruction protocol: improved quantification of small left ventricle volumes. EJNMMI Phys 2024; 11:5. [PMID: 38190088 PMCID: PMC10774323 DOI: 10.1186/s40658-023-00606-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Due to spatial resolution limitations, conventional NaI-SPECT typically overestimates the left ventricular (LV) ejection fraction (EF) in patients with small LV volumes. The purpose of this study was to explore the clinical application value of the small heart (SH) reconstruction protocol embedded in the postprocessing procedure of D-SPECT. METHODS We retrospectively analyzed patients who undergo both D-SPECT and echocardiography (Echo) within one week. Patients with small LV volume were defined as those with a rest end-systolic volume (rESV) ≤ 25 mL and underwent reconstruction using the standard (SD) reconstruction protocol. The SH protocol was deemed successful in correcting the LVEF value if it decreased by 5% or more compared to the SD protocol. The ROC curve was used to calculate the optimal cutoff value of the SH protocol. LVEF, ESV and EDV were computed with SD and SH, respectively. Echo was performed as a reference, and Echo-LVEF, ESV, and EDV were calculated using the Teichholz formula. One-way ANOVA was used to compare these parameters among the three groups. RESULTS The final study included 209 patients (73.21% female, age 67.34 ± 7.85 years). Compared with the SD protocol, the SH protocol significantly decreased LVEF (67.43 ± 7.38% vs. 71.30 ± 7.61%, p < 0.001). The optimal cutoff value for using the SH protocol was rESV > 17 mL (AUC = 0.651, sensitivity = 78.43%, specificity = 45.57%, p = 0.001). In the subgroup of rESV > 17 mL, there was no significant difference in LVEF (61.84 ± 4.67% vs. 62.83 ± 2.85%, p = 0.481) between the SH protocol and Echo, and no significant difference was observed in rESV (26.92 ± 3.25 mL vs. 27.94 ± 7.96 mL, p = 0.60) between the SH protocol and Echo. CONCLUSION This pilot study demonstrated that the SH reconstruction protocol was able to effectively correct the overestimation of LVEF in patients with small LV volumes. Particularly, in the rESV > 17 mL subgroup, the time and computing power waste could be reduced while still ensuring the accuracy of the LVEF value and image quality.
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Affiliation(s)
- Yan Huang
- Medical College, Anhui University of Science and Technology, Huainan, China
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Han Zhang
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Xueping Hu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Shanshan Qin
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Fan Hu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Yuchen Li
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China
| | - Haidong Cai
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kuangyu Shi
- Department of Informatics, Technical University of Munich, Munich, Germany
- Department of Nuclear Medicine, University of Bern, Bern, Switzerland
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
- Institute of Nuclear Medicine, Tongji University School of Medicine, Yanchang RD.301, Shanghai, 200072, China.
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Wei H, Wu J, Han K, Hu G, Wang H, Guo X, Liu H, Wu Z, Li S. CMR validation of left ventricular volumes and ejection fraction measured by the IQ-SPECT system in patients with small heart size. EJNMMI Res 2023; 13:33. [PMID: 37093329 PMCID: PMC10126186 DOI: 10.1186/s13550-023-00987-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/19/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND The IQ-SPECT system is equipped with multifocal collimators and uses ordered-subset conjugate gradient minimization (OSCGM) as its reconstruction algorithm, achieving a shorter acquisition time than conventional SPECT. Left ventricular ejection fraction (LVEF) is overestimated by conventional SPECT in patients with small heart size. In this study, we compared IQ-SPECT with conventional SPECT and cardiovascular magnetic resonance (CMR) for the estimation of LVEF in patients with small hearts (males: EDV ≤ 60 ml, ESV ≤ 25 ml; females: EDV ≤ 45 ml, ESV ≤ 20 ml). METHODS The study consisted of 49 consecutive patients (20 normal and 29 with small heart size) undergoing gated myocardial perfusion imaging (GMPI) with a 99mTc-labelled agent during stress or rest to assess the risk of coronary artery disease (CAD). The data were reconstructed using filtered back-projection (FBP) for conventional SPECT and OSCGM for IQ-SPECT. ESV, EDV, and LVEF were calculated using quantitative gated SPECT (QGS). To determine the optimal ordered-subset reconstruction parameters, we compared the LVEF from SPECT to the corresponding measurement from CMR. RESULTS EDV, ESV, and LVEF values obtained from IQ-SPECT and conventional SPECT showed that the results of these two forms of SPECT were significantly correlated, although the EDV and ESV obtained by IQ-SPECT were higher than those obtained by conventional SPECT. IQ-SPECT yielded lower LVEF measurements than conventional SPECT (normal heart size: 50.6 ± 4.3% vs. 73.4 ± 8.4%, P = 0.002; small heart size: 62.1 ± 7.8% vs. 75.0 ± 11.4%, P < 0.001). There were no significant differences in LVEF measurements made by IQ-SPECT and CMR (normal heart size: 50.6 ± 4.3% vs. 53.2 ± 5.8%, P > 0.05; small heart size: 62.1 ± 7.8% vs. 64.6 ± 8.8%, P > 0.05). Five subsets (S) and 12 iterations (I) did not differ significantly in LVEF between CMR and IQ-SPECT for patients with small hearts (64.6 ± 8.8% vs. 62.1 ± 7.8%, P = 0.120), while 3 S and 10 I were the best parameters for patients with normal heart size (50.6 ± 4.3% vs. 53.1 ± 5.8%, P = 0.117). CONCLUSION With CMR as the standard, IQ-SPECT yields more reliable LVEF values than conventional SPECT for populations with small heart size. The best reconstruction parameters from IQ-SPECT were 5 S and 12 I for patients with small hearts.
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Affiliation(s)
- Hua Wei
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Center for Post-Doctoral Studies, Second Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Jiaojiao Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Ke Han
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Guang Hu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Hongliang Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Xiaoshan Guo
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Haiyan Liu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Kiss J, Balkay L, Kukuts K, Miko M, Forgacs A, Trencsenyi G, Krizsan AK. 3D printed anthropomorphic left ventricular myocardial phantom for nuclear medicine imaging applications. EJNMMI Phys 2022; 9:34. [PMID: 35503184 PMCID: PMC9065219 DOI: 10.1186/s40658-022-00461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Anthropomorphic torso phantoms, including a cardiac insert, are frequently used to investigate the imaging performance of SPECT and PET systems. These phantom solutions are generally featuring a simple anatomical representation of the heart. 3D printing technology paves the way to create cardiac phantoms with more complex volume definition. This study aimed to describe how a fillable left ventricular myocardium (LVm) phantom can be manufactured using geometry extracted from a patient image. Methods The LVm of a healthy subject was segmented from 18F-FDG attenuation corrected PET image set. Two types of phantoms were created and 3D printed using polyethylene terephthalate glycol (PETG) material: one representing the original healthy LVm, and the other mimicking myocardium with a perfusion defect. The accuracy of the LVm phantom production was investigated by high-resolution CT scanning of 3 identical replicas. 99mTc SPECT acquisitions using local cardiac protocol were performed, without additional scattering media (“in air” measurements) for both phantom types. Furthermore, the healthy LVm phantom was inserted in the commercially available DataSpectrum Anthropomorphic Torso Phantom (“in torso” measurement) and measured with hot background and hot liver insert. Results Phantoms were easy to fill without any air-bubbles or leakage, were found to be reproducible and fully compatible with the torso phantom. Seventeen segments polar map analysis of the "in air” measurements revealed that a significant deficit in the distribution appeared where it was expected. 59% of polar map segments had less than 5% deviation for the "in torso” and "in air” measurement comparison. Excluding the deficit area, neither comparison had more than a 12.4% deviation. All the three polar maps showed similar apex and apical region values for all configurations. Conclusions Fillable anthropomorphic 3D printed phantom of LVm can be produced with high precision and reproducibility. The 3D printed LVm phantoms were found to be suitable for SPECT image quality tests during different imaging scenarios. The flexibility of the 3D printing process presented in this study provides scalable and anthropomorphic image quality phantoms in nuclear cardiology imaging.
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Affiliation(s)
- Janos Kiss
- Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary.
| | - Laszlo Balkay
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
| | - Kornel Kukuts
- ScanoMed Nuclear Medicine Centers, Nagyerdei krt. 98., Debrecen, 4032, Hungary
| | - Marton Miko
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
| | - Attila Forgacs
- ScanoMed Nuclear Medicine Centers, Nagyerdei krt. 98., Debrecen, 4032, Hungary.,Mediso Ltd., Laborc Utca 3., Budapest, 1037, Hungary
| | - Gyorgy Trencsenyi
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary
| | - Aron K Krizsan
- ScanoMed Nuclear Medicine Centers, Nagyerdei krt. 98., Debrecen, 4032, Hungary
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Kato T, Ichikawa H, Miwa K, Okuda K, Shibutani T, Nagaki A, Tsushima H. [A Nationwide Survey on Additional Scan in Nuclear Medicine Imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:285-294. [PMID: 32201419 DOI: 10.6009/jjrt.2020_jsrt_76.3.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The aim of the present study was to clarify the routine protocols and the frequency of added or omitted imaging on nuclear medicine imaging in Japan. A nationwide survey on routine protocols and current state of added or omitted imaging in major nuclear medicine imaging were performed for Japanese nuclear medicine technologist. The survey showed that the routine protocols were almost 100% fixed, some of the routine protocols were found to be useful and percentage of imaging techniques such as single photon emission computed tomography/computed tomography that increased patient burden and reduced through put were low. Furthermore, the survey showed that additional or omission imaging were frequently performed on bone scintigraphy and positron emission tomography and added or omitted judgements were often depend upon the rule of thumb by nuclear medicine technologist. In this study, we have concluded that the quality of examination and the diagnosis might depend on the knowledge of nuclear medicine technologist, performed added or omitted imaging.
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Affiliation(s)
- Toyohiro Kato
- Department of Radiology, Toyohashi Municipal Hospital
| | | | - Kenta Miwa
- Department of Radiological Sciences, School of Health Science, International University of Health and Welfare
| | - Koichi Okuda
- Department of Physics, Kanazawa Medical University
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Faculty of Health Sciences, Kanazawa University
| | - Akio Nagaki
- Department of Radiological Technology, Kurashiki Central Hospital
| | - Hiroyuki Tsushima
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences
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Shibutani T, Okuda K, Ichikawa H, Kato T, Miwa K, Tsushima H, Onoguchi M, Nagaki A. Imaging technology for myocardial perfusion single-photon emission computed tomography 2018 in Japan. Jpn J Radiol 2020; 38:274-282. [PMID: 31919636 DOI: 10.1007/s11604-019-00915-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022]
Abstract
AIM Recently, nuclear cardiology has dramatically advanced by a new technology development such as the device, short-term acquisition system, image reconstruction algorithm and image analysis. Although these innovations have been gradually employed in routine examinations, we did not investigate the current use of image acquisition, image reconstruction, and image analysis with myocardial perfusion single-photon emission computed tomography (MPS). We investigated the current status of MPS imaging technology in Japan. METHODS We carried out a survey using a Web-based questionnaire system, the opening of which was announced via e-mail, and it was available on a website for 3 months. We collected data on the current use of MPS with 201Tl and/or 99mTc agents with respect to routine protocols, image acquisition, image reconstruction, and image analysis. RESULTS We received responses to the Web-based questionnaire from 178 and 174 people for 99mTc and 201Tl MPS, respectively. The routine protocols of MPS of stress-rest and rest-stress MPS on 1-day protocols with 99mTc were 41.2% and 14.5%, respectively, and the rest-only scan response rate was 23.7%, whereas that of 201Tl MPS was 65.9% with stress-rest MPS, 19.0% with rest-only MPS, and 10.9% with stress-rest MPS adding a rest scan 24 h after injection. The filtered back projection (FBP) method is most commonly used image reconstruction method, yielding 70.5% for 99mTc MPS and 76.8% for 201Tl MPS, including combined FBP and ordered subset expectation maximization method. The results for no-correction (NC) images were 49.2% with 99mTc MPS and 55.2% with 201Tl MPS including the response of NC and combined attenuation correction (AC) and scatter correction (SC) (i.e., ACSC) images. The AC or ACSC images of 99mTc and 201Tl were provided by 30-40% of the institutions surveyed. CONCLUSIONS We investigated the current status of MPS imaging technology in Japan, and found that although the use of various technical developments has been reported, some of these technologies have not been utilized effectively. Hence, we expect that nuclear medicine technology will be used more effectively to improve diagnosis.
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Affiliation(s)
- Takayuki Shibutani
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan.
| | - Koichi Okuda
- Department of Physics, Kanazawa Medical University, Kahoku, Japan
| | - Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Toyohiro Kato
- Department of Radiology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, International University of Health and Welfare, Ohtawara, Japan
| | - Hiroyuki Tsushima
- Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Akio Nagaki
- Department of Radiological Technology, Kurashiki Central Hospital, Kurashiki, Japan
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Shibutani T, Nakajima K, Wakabayashi H, Mori H, Matsuo S, Yoneyama H, Konishi T, Okuda K, Onoguchi M, Kinuya S. Accuracy of an artificial neural network for detecting a regional abnormality in myocardial perfusion SPECT. Ann Nucl Med 2018; 33:86-92. [DOI: 10.1007/s12149-018-1306-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022]
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Chono T, Onoguchi M, Hashimoto A. [Assessment of Left Ventricular Diastolic Function Using ECG-gated Myocardial Perfusion SPECT in Small Heart: Comparison with Ultrasound Echocardiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:572-579. [PMID: 29925752 DOI: 10.6009/jjrt.2018_jsrt_74.6.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Assessment of left ventricular (LV) diastolic function is important because it is possible to detect early sign of myocardial ischemia by this assessment. The purpose of this study was to compare between electrocardiogram (ECG) -gated myocardial perfusion single photon emission computed tomography (G-SPECT) and ultrasound echocardiography in assessment of LV diastolic function in the small heart (SH). METHODS The study population consisted of 144 patients who underwent both G-SPECT and ultrasound echocardiography. Peak filling rate (PFR), one-third mean filling rate (1/3 MFR) and the ratio of time to PFR to the RR interval (TPFR/RR) were calculated by quantitative gated SPECT (QGS) and heart risk view-F (HRV-F). Peak early mitral annular velocity (e') was used as the reference standard of LV diastolic function. RESULTS There were 33 patients with end-systolic volume (ESV) of ≤10 ml (SH10), 51 patients with ESV of 11-20 ml (SH 20) and 60 patients with ESV of >20 ml (normal-sized heart: NH). In SH10, PFR calculated by QGS was not correlated with e'. However, that by HRV-F was significantly correlated with e' (r=0.47, p=0.006). On the other hand, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were not correlated with e' in SH10 and SH20. PFR, 1/3 MFR and TPFR/RR calculated by QGS and HRV-F were correlated with e' in NH.
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Affiliation(s)
- Taiki Chono
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University
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Alexiou S, Georgoulias P, Angelidis G, Valotassiou V, Tsougos I, Psimadas D, Lakiotis V, Kaspiri A, Alexopoulos D, Apostolopoulos D, Vassilakos P. Myocardial perfusion and left ventricular quantitative parameters obtained using gated myocardial SPECT: Comparison of three software packages. J Nucl Cardiol 2018; 25:911-924. [PMID: 27873167 DOI: 10.1007/s12350-016-0730-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of the present study was to compare Emory Cardiac Toolbox, Myovation, and Quantitative Gated SPECT software regarding the automatic measurements of perfusion and functional left ventricular (LV) quantitative parameters, summed stress score (SSS), perfusion defect score, LV ejection fraction (LVEF), end-diastolic volume, and end-systolic volume (ESV). METHODS AND RESULTS 99mTc-tetrofosmin gated SPECT studies were performed in 634 consecutive patients based on the one-day stress/rest protocol. Participants were divided into subgroups according to heart size (ESV cut-off value: 25 mL), perfusion (SSS >/≤3), and other patient/protocol-related factors. LVEF was categorized as normal (≥50%), mildly moderately impaired (35-49%), and severely abnormal (<35%). The concordance between the packages was good to excellent, in overall population, ESV ≤25 mL, ESV >25 mL, and SSS >3 subgroups (intraclass correlation coefficients, ICCs 0.73-0.93). In SSS ≤3 subgroup, the correlation was excellent for LV functional parameters, but suboptimal for perfusion variables (ICCs 0.30-0.83). LVEF categorization revealed similar variability (discordance 18.1 and 11.1% for stress/rest LVEF values, respectively). Pair comparisons demonstrated considerable differences concerning all parameters for all patient subgroups. The statistical significance of our findings by ESV and SSS classifications was evaluated. CONCLUSIONS Despite the significant concordance between software packages, considerable differences in mean values of myocardial perfusion and LV functional parameters were demonstrated.
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Affiliation(s)
- Sotiria Alexiou
- Department of Nuclear Medicine, University Hospital of Patras, Patras, Greece.
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece.
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - George Angelidis
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - Varvara Valotassiou
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - Ioannis Tsougos
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - Dimitrios Psimadas
- Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | | | - Agaristi Kaspiri
- Department of Nuclear Medicine, University Hospital of Patras, Patras, Greece
| | | | | | - Pavlos Vassilakos
- Department of Nuclear Medicine, University Hospital of Patras, Patras, Greece
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Nakajima K, Kudo T, Nakata T, Kiso K, Kasai T, Taniguchi Y, Matsuo S, Momose M, Nakagawa M, Sarai M, Hida S, Tanaka H, Yokoyama K, Okuda K, Edenbrandt L. Diagnostic accuracy of an artificial neural network compared with statistical quantitation of myocardial perfusion images: a Japanese multicenter study. Eur J Nucl Med Mol Imaging 2017; 44:2280-2289. [PMID: 28948350 PMCID: PMC5680364 DOI: 10.1007/s00259-017-3834-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 09/06/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Artificial neural networks (ANN) might help to diagnose coronary artery disease. This study aimed to determine whether the diagnostic accuracy of an ANN-based diagnostic system and conventional quantitation are comparable. METHODS The ANN was trained to classify potentially abnormal areas as true or false based on the nuclear cardiology expert interpretation of 1001 gated stress/rest 99mTc-MIBI images at 12 hospitals. The diagnostic accuracy of the ANN was compared with 364 expert interpretations that served as the gold standard of abnormality for the validation study. Conventional summed stress/rest/difference scores (SSS/SRS/SDS) were calculated and compared with receiver operating characteristics (ROC) analysis. RESULTS The ANN generated a better area under the ROC curves (AUC) than SSS (0.92 vs. 0.82, p < 0.0001), indicating better identification of stress defects. The ANN also generated a better AUC than SDS (0.90 vs. 0.75, p < 0.0001) for stress-induced ischemia. The AUC for patients with old myocardial infarction based on rest defects was 0.97 (0.91 for SRS, p = 0.0061), and that for patients with and without a history of revascularization based on stress defects was 0.94 and 0.90 (p = 0.0055 and p < 0.0001 vs. SSS, respectively). The SSS/SRS/SDS steeply increased when ANN values (probability of abnormality) were >0.80. CONCLUSION The ANN was diagnostically accurate in various clinical settings, including that of patients with previous myocardial infarction and coronary revascularization. The ANN could help to diagnose coronary artery disease.
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Affiliation(s)
| | | | | | - Keisuke Kiso
- National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tokuo Kasai
- Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | | | | | | | | | | | | | - Hirokazu Tanaka
- Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | | | - Koichi Okuda
- Kanazawa Medical University, Uchinada, Kahoku, Japan
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Germano G, Kavanagh PB. Ready, shoot, aim? Summary justice for small hearts in nuclear cardiology. J Nucl Cardiol 2017; 24:1389-1392. [PMID: 27207632 DOI: 10.1007/s12350-016-0545-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Guido Germano
- Department of Medicine, Cedars-Sinai Medical Center, Artificial Intelligence in Medicine Program, Los Angeles, USA.
- David Geffen School of Medicine, UCLA, Los Angeles, USA.
| | - Paul B Kavanagh
- Department of Medicine, Cedars-Sinai Medical Center, Artificial Intelligence in Medicine Program, Los Angeles, USA
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Yoneyama H, Shibutani T, Konishi T, Mizutani A, Hashimoto R, Onoguchi M, Okuda K, Matsuo S, Nakajima K, Kinuya S. Validation of Left Ventricular Ejection Fraction with the IQ•SPECT System in Small-Heart Patients. J Nucl Med Technol 2017; 45:201-207. [DOI: 10.2967/jnmt.116.188680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/09/2017] [Indexed: 11/16/2022] Open
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Okuda K, Nakajima K, Matsuo S, Kashiwaya S, Yoneyama H, Shibutani T, Onoguchi M, Hashimoto M, Kinuya S. Comparison of diagnostic performance of four software packages for phase dyssynchrony analysis in gated myocardial perfusion SPECT. EJNMMI Res 2017; 7:27. [PMID: 28337725 PMCID: PMC5364119 DOI: 10.1186/s13550-017-0274-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/08/2017] [Indexed: 12/30/2022] Open
Abstract
Background Phase analysis of gated myocardial perfusion single-photon emission computed tomography (SPECT) for assessment of left ventricular (LV) dyssynchrony was investigated using the following dedicated software packages: Corridor4DM (4DM), cardioREPO (cREPO), Emory Cardiac Toolbox (ECTb), and quantitative gated SPECT (QGS). The purpose of this study was to evaluate the normal values of 95% histogram bandwidth, phase standard deviation (SD), and entropy and to compare the diagnostic performance of the four software packages. A total of 122 patients with normal myocardial perfusion and cardiac function (58.9 ± 12.3 years, 60 women, ejection fraction (EF) 74.3 ± 5.7%, and end-diastolic volume (EDV) 83.5 ± 3.6 mL) and 34 patients with suspected LV dyssynchrony (64.1 ± 12.2 years, 9 women, EF 52.0 ± 18.0%, and EDV 145.0 ± 6.8 mL) who underwent Tc-99m methoxy-isobutyl-isonitrile/tetrofosmin gated SPECT were retrospectively evaluated. Dyssynchrony indices of the 95% histogram bandwidth, phase SD, and entropy were computed with the four software programs. Diagnostic performance of LV phase dyssynchrony assessments was determined by receiver operator characteristic (ROC) analysis. The area under the ROC curve (AUC) was used to compare the software programs. The optimal cutoff point was determined by ROC curve based on the Youden index. Results The average of normal bandwidth significantly differed among the four software programs except in the comparison of 4DM and ECTb. Moreover, the normal phase SD significantly differed among the four software programs except in the comparison of cREPO and ECTb. The software programs showed high correlation levels for bandwidth, phase SD, and entropy (r ≥ 0.73, p < 0.001). ROC AUCs of bandwidth, phase SD, and entropy were ≥0.850, ≥0.858, and ≥0.900, respectively. Moreover, the ROC AUCs of bandwidth, phase SD, and entropy did not significantly differ among the four software programs. Optimal cutoff points for phase parameters were 24°–42° for bandwidth, 8.6°–15.3° for phase SD, and 31–48% for entropy. Conclusions Although the optimal cutoff value for determining LV phase dyssynchrony by ROC analysis varied depending on the use of the different software programs, all software programs can be used reliably for phase dyssynchrony analysis.
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Affiliation(s)
- Koichi Okuda
- Department of Physics, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
| | - Kenichi Nakajima
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Shinro Matsuo
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Soichiro Kashiwaya
- Department of Radiological Technology, Kanazawa Municipal Hospital, Kanazawa, Japan
| | - Hiroto Yoneyama
- Department of Radiological Technology, Kanazawa University Hospital, Kanazawa, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Kanazawa University, Kanazawa, Japan
| | - Mitsumasa Hashimoto
- Department of Physics, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| | - Seigo Kinuya
- Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Okuda K, Nakajima K. Normal Values and Gender Differences of Left Ventricular Functional Parameters with CardioREPO Software. ACTA ACUST UNITED AC 2017. [DOI: 10.17996/anc.17-00004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Koichi Okuda
- Department of Physics, Kanazawa Medical University
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