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Caderas de Kerleau C, Crouzet JF, Ahronovitz E, Rossi M, Mariano-Goulart D. Automatic generation of noise-free time-activity curve with gated blood-pool emission tomography using deformation of a reference curve. IEEE TRANSACTIONS ON MEDICAL IMAGING 2004; 23:485-491. [PMID: 15084073 DOI: 10.1109/tmi.2004.825638] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This paper describes a new method for assessing clinical parameters from a noisy regional time-activity curve (TAC) in tomographic gated blood-pool ventriculography. This method is based on a priori knowledge on the shape of a TAC, and shape approximation. The rejection method was used to generate different random Poisson deviates, covering standard count levels, of six representative TACs in order to test and compare the proposed method with harmonic and multiharmonic reconstruction methods. These methods were compared by evaluating four clinical parameters: time of end systole, amplitude, peak ejection and filling rates. Overall, the accuracy of assessment of these parameters was found to be better with the method described in this paper than with standard multiharmonic fits.
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Affiliation(s)
- Charles Caderas de Kerleau
- Montpellier Medical University, Biophysics and Nuclear Medicine Department, Service de médecine nucléaire, CHU Lapeyronie, Montpellier 34295, 5 France
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Schmidt MA, Starling MR. Physiologic assessment of left ventricular systolic and diastolic performance. Curr Probl Cardiol 2000; 25:827-908. [PMID: 11153466 DOI: 10.1067/mcd.2000.110699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M A Schmidt
- Division of Cardiology, University of Michigan Medical Center, Cardiology Section, Ann Arbor Veterans Administration Medical Center, Ann Arbor, Michigan
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Toba M, Kumita S, Cho K, Mizumura S, Kijima T, Nakajo H, Kumazaki T. Comparison of Emory and Cedars-Sinai methods for assessment of left ventricular function from gated myocardial perfusion SPECT in patients with a small heart. Ann Nucl Med 2000; 14:421-6. [PMID: 11210094 DOI: 10.1007/bf02988287] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To evaluate the effect of left ventricular (LV) size on the calculation of LV function from gated myocardial SPECT with Emory and Cedars-Sinai programs, we performed 99mTc-tetrofosmin gated SPECT on 49 patients with ischemic heart disease. End-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) were semi-automatically calculated by each program. All patients underwent left ventriculography (LVG) within 3 months before and after the SPECT study. We grouped the patients into 22 with a calculated ESV obtained from LVG of over 50 ml (group A) and 27 with an ESV value of 50 ml or below (group B). We then compared the ESV values from gated SPECT with those from LVG in each group. In group A, the ESV from both Emory and Cedars-Sinai programs similarly correlated well with those from LVG (r = 0.92 and r = 0.93, respectively), but in group B, the ESV calculated from the Cedars-Sinai program correlated less with those from LVG (r = 0.53) than those from the Emory program did (r = 0.70). The calculated LV volumes had more errors in the Cedars-Sinai program than in the Emory program, when a patient had a small heart.
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Affiliation(s)
- M Toba
- Department of Radiology, Nippon Medical School, Tokyo, Japan.
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Van Kriekinge SD, Berman DS, Germano G. Automatic quantification of left ventricular ejection fraction from gated blood pool SPECT. J Nucl Cardiol 1999; 6:498-506. [PMID: 10548145 DOI: 10.1016/s1071-3581(99)90022-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiac gated blood pool single photon emission computed tomography (GBPS) better separates cardiac chambers compared with planar radionuclide ventriculography (PRNV). We have developed a completely automatic algorithm to measure quantitatively the left ventricular ejection fraction (LVEF) from gated technetium 99m-red blood cells (RBC) GBPS short-axis 3-dimensional image volumes. METHODS AND RESULTS The algorithm determines an ellipsoidal coordinate system for the left ventricle and then computes a static estimate of the endocardial surface by use of counts and count gradients. A dynamic surface representing the endocardium is computed for each interval of the cardiac cycle by use of additional information from the temporal Fourier transform of the image data sets. The algorithm then calculates the left ventricular volume for each interval and computes LVEF from the end-diastolic and end-systolic volumes. The algorithm was developed in a pilot group (N = 45) and validated in a second group (N = 89) of patients who underwent PRNV and 8-interval GBPS. Technically inadequate studies (N = 38) were rejected before grouping and processing. Automatic identification and contouring of the left ventricle was successful in 121/172 patients (70%) globally and in 76/89 patients (85 %) in the validation group. Correlation between LVEFs measured from GBPS and PRNV was high (y = 2.00 + 1.01x, r = 0.89), with GBPS LVEF significantly higher than PRNV LVEF (average difference = 2.8%, P < .004). CONCLUSIONS Our automatic algorithm agrees with conventional radionuclide measurements of LVEF and provides the basis for 3-dimensional analysis of wall motion.
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Affiliation(s)
- S D Van Kriekinge
- Department of Medicine, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif 90048, USA
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Brigger P, Bacharach SL, Srinivasan G, Nour KA, Carson JA, Dilsizian V, Aldroubi A, Unser M. Segmentation of gated Tl-SPECT images and computation of ejection fraction: a different approach. J Nucl Cardiol 1999; 6:286-97. [PMID: 10385184 DOI: 10.1016/s1071-3581(99)90041-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We describe a set of image processing algorithms and mathematical models that can be advantageously used in schemes for the segmentation of thallium-201-single photon emission computed tomography (SPECT) images and for computation of left ventricular ejection fraction (EF). METHODS The system consists of two independent blocs for image segmentation and computation of function. The former is based on a multiresolution elliptical coordinate transformation and dynamic contour tracking. Computation of EF is formulated on the basis of both the endocardial and epicardial contours, and we compare this formulation with that using only the endocardial border for images with low signal-to-noise ratios. The accuracy of border detection was validated against manual border tracing on FDG-PET images, simulated Tl-201-SPECT images where the true underlying borders were known, and actual Tl-201-SPECT images. Finally, we compared EFs computed for FDG-PET, technetium-99m-SPECT and Tl-201-SPECT with those obtained from planar gated blood pool imaging. RESULTS The automatically obtained results always were within the manual uncertainty range. Agreement between myocardial volumes from positron emission tomography and automatically obtained values from the simulated Tl-201-SPECT images was excellent (r = 0.95, n = 32). Agreement between EFs from planar gated blood pool imaging and the other image modalities was good (FDG-PET: y = 5.89 + 1.21x, r = 0.92, see = 6.24, n = 19, Tc-99m-SPECT: y = -3.86 + 1.06x, r = 0.88, see = 7.78, n = 9, Tl-201-SPECT: y = 17.8 + 0.81x, r = 0.77, see = 7.44, n = 26). For noisy input data the combined use of information from epicardial and endocardial contours gives more accurate EF values than the traditional formula on the basis of the endocardial contour only. CONCLUSIONS Alternate approaches for segmentation and computation of function have been presented and validated. They might also be advantageously incorporated into other existing techniques.
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Affiliation(s)
- P Brigger
- National Institutes of Health, Bethesda, Md 20892-1180, USA
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Germano G, Kavanagh PB, Kavanagh JT, Wishner SH, Berman DS, Kavanagh GJ. Repeatability of automatic left ventricular cavity volume measurements from myocardial perfusion SPECT. J Nucl Cardiol 1998; 5:477-83. [PMID: 9796894 DOI: 10.1016/s1071-3581(98)90178-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND This study sought to assess the repeatability of automatic quantitative measurements of left ventricular (LV) cavity volumes in a large patient population (N = 926), to correlate those measurements to similarly obtained LV ejection fraction (LVEF) measurements, and to investigate the relationship between ungated and gated volumes. METHODS All 926 patients underwent ungated single photon emission computed tomography (SPECT) immediately followed by 8-frame gated SPECT. LV cavity volumes were automatically measured from ungated (V), summed gated (SUMV), end-systolic (ESV) and end-diastolic (EDV) images, and LVEFs derived from the latter 2. RESULTS Repeatability (SUMV vs V) was very good overall (6.4%+/-6.6%), further improving for volumes >25 mL (5.7%+/-5.5%) and >40 mL (5.2%+/-5.0%). Exponential regression between ESV and LVEF (r = 0.925, SEE = 15.0 mL), EDV and LVEF (r = 0.802, SEE = 24.2 mL), and SUMV and LVEF (r = 0.867, SEE = 19.7 mL) was also very good. Summed gated volumes were closer to ESV than to EDV (43.3%+/-8.8% of EDV-ESV range). SUMV <50 mL and SUMV >110 mL were good substitutes for LVEF >50% and LVEF <40% (93.4% and 97.1%, respectively). CONCLUSION Automatic quantitative measurements of gated and ungated volumes with our algorithm are repeatable, correlate well with other global myocardial parameters, and may contribute important additional information to that conventionally provided by myocardial perfusion SPECT studies.
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Affiliation(s)
- G Germano
- Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, Calif, USA.
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Lee HS, Cross S, Norton M, Walton S. Comparison between planar and tomographic radionuclide ventriculography for detecting inferior wall motion abnormalities. Clin Radiol 1998; 53:264-7. [PMID: 9585041 DOI: 10.1016/s0009-9260(98)80124-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gated planar radionuclide ventriculography is routinely used for the detection of regional wall motion abnormalities of the left ventricle. However, for inferior wall motion abnormalities, sensitivity is known to be low in the left anterior oblique 'best septal' projection, although improved if a left posterior oblique (LPO) view is also acquired. Gated tomography of the cardiac blood pool is now available. This study compared the sensitivity of planar 'best septal' projection, LPO and tomographic radionuclide ventriculography in the detection of inferior wall motion abnormalities. Thirty-two patients consisting of 18 with previous inferior myocardial infarction and 14 normal controls were studied. All patients underwent equilibrium planar 'best septal', planar LPO and then tomographic radionuclide ventriculography. Inferior wall motion abnormality was detected in 'best septal' in eight (44%) patients, LPO in 12 (67%) and tomography in 17 (94%) patients, respectively. Tomographic radionuclide ventriculography was best at detecting inferior wall motion abnormality while planar LPO projection is better than 'best septal' projection.
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Affiliation(s)
- H S Lee
- Department of Cardiology, Aberdeen Royal Infirmary, UK
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Metcalfe MJ, Norton MY, Jennings K, Walton S. Improved detection of abnormal left ventricular wall motion using tomographic radionuclide ventriculography compared with planar radionuclide and single plane contrast ventriculography. Br J Radiol 1993; 66:986-93. [PMID: 8281391 DOI: 10.1259/0007-1285-66-791-986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Tomographic radionuclide ventriculography is a technique which could have major advantages over conventional planar imaging, such as better assessment of ventricular wall motion abnormalities. This possibility was therefore investigated in 100 consecutive patients undergoing routine cardiac catheterization. Following angiography, planar blood pool images were conventionally acquired and tomographic imaging performed using the Aberdeen Section Scanner. All derived wall motion data were subsequently analysed in an objective and blinded manner. The mean age was 56 (range 33-71) and 79% were male. 67 patients had experienced prior myocardial infarction, 27 were categorized as having significant and six insignificant coronary artery disease. The detection rates for patients with prior myocardial infarction were 95% for angiography, 57% for planar imaging and 90% for tomography. Even taking patients with only prior anterior myocardial infarction, the detection rates were 94%, 63% and 91% respectively. For those residual patients with significant coronary artery disease, the rates were 7%, 0% and 59% respectively. Overall for the detection of patients with significant coronary artery disease, the sensitivity was 70%, 40% and 81% respectively. Patients with insignificant coronary artery disease did not demonstrate any abnormalities using any method. These results demonstrate that tomography and angiography have similar detection rates in the presence of significant coronary artery disease and both are superior to planar imaging.
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Affiliation(s)
- M J Metcalfe
- Department of Cardiology, University of Biomedical Physics, Aberdeen Royal Infirmary, UK
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Martin RW, Graham MM, Kao R, Bashein G. Measurement of left ventricular ejection fraction and volumes with three-dimensional reconstructed transesophageal ultrasound scans: comparison to radionuclide and thermal dilution measurements. JOURNAL OF CARDIOTHORACIC ANESTHESIA 1989; 3:260-8. [PMID: 2562480 DOI: 10.1016/0888-6296(89)90105-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A transesophageal, ultrasonic cardiac imaging probe was built that incorporated a mechanism for changing the angle of the imaging plane of a conventional phased array in a precise and known manner. This probe was used to acquire an angular spatial sequence of two-dimensional images of the left ventricular cavity over a series of cardiac cycles by sweeping the imaging plane through it stepwise. The endocardial borders of these images were manually outlined off-line and the application of a three-dimensional reconstruction algorithm was then used to compute the left ventricular end-diastolic and end-systolic volumes and ejection fraction. A study was conducted with seven anesthesized dogs to compare ultrasonic determinations by this method with determinations and measurements made using radionuclide and thermal dilution methods. Comparison of 33 ejection fractions, measured by the ultrasonic volume method and by the gated blood pool radionuclide approach, yielded a correlation coefficient of 0.87 and a standard error of the estimate of 5.7% measured over a range of 10% to 58% (average, 40%). Comparison of the ultrasonically measured volumes with those calculated from stroke volume (derived from thermal dilution cardiac output measurement) and ejection fraction (measured by radionuclide technique) produced a correlation coefficient of 0.92 and a standard error of the estimate of 10.3 mL over a range of 18 to 130 mL (average, 56 mL). The accuracy of volume and ejection fraction measurements with this new ultrasonic method seems comparable to that of other currently used clinical approaches such as radionuclide and angiography.
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Affiliation(s)
- R W Martin
- Department of Anesthesiology, University of Washington, Seattle 98195
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Valentinuzzi M, Spinelli J. Intracardiac measurements with the impedance technique. ACTA ACUST UNITED AC 1989; 8:27-34. [DOI: 10.1109/51.32402] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Fischman AJ, Moore RH, Gill JB, Strauss HW. Gated blood pool tomography: a technology whose time has come. Semin Nucl Med 1989; 19:13-21. [PMID: 2652303 DOI: 10.1016/s0001-2998(89)80032-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Tomographic gated blood pool imaging is a natural extension of the technologies of planar gated blood pool scanning and rotating Anger camera single photon emission computed tomography (SPECT). The high photon flux, optimum 140 keV energy, and volume sampling of tomography permit reconstruction of the data in any perspective. The true three-dimensional nature of this process allows the evaluation of regional wall motion of all the cardiac chambers, unencumbered by overlapping structures. The heart can be viewed from any angle, including a long axis, short axis, apical four chamber, and a true inferior view. In addition to evaluation of regional wall motion, precise determination of chamber volumes and ejection fractions is possible. Early clinical experience has demonstrated the superiority of tomographic gated blood pool imaging over planar blood pool imaging for precisely defining subtle functional abnormalities. The enormous amount of data generated by this procedure taxes the capacity of most nuclear medicine computer systems. However, the availability of 32-bit processors and large amounts of image memory in new machines should ultimately reduce this processing time to less than ten minutes. The combination of complete visualization and quantitation suggests that a renaissance for blood pool imaging is on the horizon.
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Affiliation(s)
- A J Fischman
- Department of Radiology, Massachusetts General Hospital, Boston 02114
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Cerqueira MD, Harp GD, Ritchie JL. Evaluation of myocardial perfusion and function by single photon emission computed tomography. Semin Nucl Med 1987; 17:200-13. [PMID: 3303340 DOI: 10.1016/s0001-2998(87)80034-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Although planar radionuclide techniques provide accurate, noninvasive measurements of myocardial perfusion and function that are of proven clinical value in the evaluation of the cardiac patient, they are limited by poor object contrast and superimposition of surrounding structures. Due to incomplete angular sampling and significant longitudinal distortion, limited angle tomography did not solve these problems. Single photon emission computed tomography (SPECT) can acquire scintillation information over very small angles of rotation and, thus, improve both object contrast and delineation of overlying or adjacent structures without distortion. The early SPECT systems were cumbersome, dependent on individual user developed software, and had extremely long acquisition and processing time. Improved camera design, new software algorithms, and the use of array processors have simplified and standardized quality control, decreased processing time, and minimized the number of user interventions. New image display formats and quantitative methods of analysis have made interpretation less cumbersome, more reliable and highly reproducible. Cardiac SPECT has been used with thallium-201 and gated blood pool imaging in both research and clinical applications and shown an improvement over planar methods of acquisition.
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