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Ben Bouallègue F, Maïmoun L, Kucharczak F, Le Fur P, Vauchot F, Hay B, Rondet E, Mariano-Goulart D. Left ventricle function assessment using gated first-pass 18F-FDG PET: Validation against equilibrium radionuclide angiography. J Nucl Cardiol 2021; 28:594-603. [PMID: 31044403 DOI: 10.1007/s12350-019-01731-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE We appraised the feasibility of left ventricle (LV) function assessment using gated first-pass 18F-FDG PET, and assessed the concordance of the produced measurements with equilibrium radionuclide angiography (ERNA). MATERIALS AND METHODS Twenty-four oncologic patients benefited from 99mTc-labeled red-blood-cell ERNA, in planar mode (all patients) and using SPECT (22 patients). All patients underwent gated first-pass 18F-FDG cardiac PET. Gated dynamic PET images were reconstructed over 1 minute during tracer first-pass inside the LV and post-processed using in-house software (TomPool). After re-orientation into cardiac canonical axes and adjustment of the valves plane using a phase image, pseudo-planar PET images obtained by re-projection were automatically segmented using thresholded region growing and gradient-based delineation to produce an LV ejection fraction (EF) estimate. PET images were also post-processed in fully-tomographic mode to produce LV end diastole volume (EDV), end systole volume (ESV), and EF estimates. Concordance was assessed using Lin's concordance (ccc) and Bland-Altman analysis. Reproducibility was assessed using the coefficient of variation (CoV) and intra-class correlation (ICC). RESULTS Pseudo-planar PET EF estimates were concordant with planar ERNA (ccc = 0.81, P < .001) with a bias of 0% (95% CI [- 2%; 3%], limits of agreement [- 11%; 12%]). Reproducibility was excellent and similar for both methods (CoV = 2 ± 1% and 3 ± 2%, P = NS; ICC = 0.97 and 0.92, for PET and ERNA, respectively). Measurements obtained in fully-tomographic mode were concordant with SPECT ERNA: ccc = 0.83 and bias = - 3 mL for LV EDV, ccc = 0.92 and bias = 0 mL for LV ESV, ccc = 0.89 and bias = - 1% for LV EF (all P values < .001 for ccc, all biases not significant). CONCLUSIONS Gated first-pass 18F-FDG PET might stand as a relevant alternative to ERNA for LV function assessment, enabling a joint evaluation of both therapeutic response and cardiac toxicity in oncologic patients receiving cardiotoxic chemotherapy.
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Affiliation(s)
- Fayçal Ben Bouallègue
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France.
- PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France.
| | - Laurent Maïmoun
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France
- PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
| | | | - Pierre Le Fur
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France
| | - Fabien Vauchot
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France
| | - Boramy Hay
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France
| | - Eric Rondet
- UMR QualiSud, Montpellier University, Montpellier, France
| | - Denis Mariano-Goulart
- Nuclear Medicine Department, Lapeyronie University Hospital, Avenue du Doyen Giraud 371, 34295, Montpellier Cedex 5, France
- PhyMedExp, INSERM, CNRS, Montpellier University, Montpellier, France
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Ben Bouallègue F, Mariano-Goulart D, Agostini D, Manrique A. Feasibility of biventricular volume and function assessment using first-pass gated 15O-water PET. EJNMMI Res 2018; 8:92. [PMID: 30225682 PMCID: PMC6141411 DOI: 10.1186/s13550-018-0445-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/07/2018] [Indexed: 01/17/2023] Open
Abstract
Background We investigated the feasibility of left ventricular (LV) and right ventricular (RV) volume and function estimation using a first-pass gated 15O-water PET. This prospective study included 19 patients addressed for myocardial perfusion reserve assessment using 15O-water PET. PET data were acquired at rest and after regadenoson stress, and gated first-pass images were reconstructed over the time range corresponding to tracer first-pass through the cardiac cavities and post-processed using TomPool software; LV and RV were segmented using a semi-automated 4D immersion algorithm. LV volumes were computed using a count-based model and a fixed threshold at 30% of the maximal activity. RV volumes were computed using a geometrical model and an adjustable threshold that was set so as to fit LV and RV stroke volumes. Ejection curves were fitted using a deformable reference curve model. LV results were compared to those obtained using 99mTc-sestamibi gated myocardial SPECT in terms of end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF). Results There was an excellent concordance between rest and stress PET in terms of EDV and ESV (Lin’s coefficient ~ 0.85–0.90), SV (~ 0.80), and EF (~ 0.75) for both ventricles. Correlation with myocardial SPECT was high for LV EDV (Pearson’s R = 0.89, p < 0.001) and ESV (R = 0.87, p < 0.001) and satisfying for LV SV (R = 0.67, p < 0.001) and EF (R = 0.67, p < 0.001). Minimal LV ESV overestimation (+ 4 mL, p = 0.03) and EF underestimation (− 4%, p = 0.01) were observed using PET. Conclusions Biventricular volume and function assessment are achievable using the first-pass PET, and LV parameters correlate well with those derived from gated myocardial SPECT.
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Affiliation(s)
- Fayçal Ben Bouallègue
- Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France. .,PhyMedExp, INSERM - CNRS, Montpellier University, Montpellier, France. .,Nuclear Medicine Department, CHU de Caen, Caen, France.
| | - Denis Mariano-Goulart
- Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM - CNRS, Montpellier University, Montpellier, France
| | | | - Alain Manrique
- Nuclear Medicine Department, CHU de Caen, Caen, France.,UNICAEN, EA 4650 SEILIRM, GIP Cyceron, Normandie University, Caen, France
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Dercle L, Ouali M, Pascal P, Giraudmaillet T, Chisin R, Lairez O, Marachet MA, Rousseau H, Bastié D, Bouallègue FB, Berry I. Gated blood pool SPECT: The estimation of right ventricular volume and function is algorithm dependent in a clinical setting. J Nucl Cardiol 2015; 22:483-92. [PMID: 25698473 DOI: 10.1007/s12350-014-0062-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/13/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Gated blood pool SPECT (GBPS) requires further validation for the assessment of the right ventricle (RV). This study evaluated three algorithms: BP-SPECT, QBS, and TOMPOOL (results are referred using this order). We compared (1) their "quantitative-accuracy": estimation of RV ejection fraction (EF), end-diastolic volume (EDV), and cardiac output (CO); (2) their "qualitative-accuracy": threshold values allowing diagnosing an impairment of the RV function; (3) their reproducibility: inter-observer relative variability (IOV). METHODS AND RESULTS Forty-eight consecutive patients underwent GBPS. Recommended reference standards were used: cardiac magnetic resonance imaging (CMR) (EDV, EF, n = 48), catheter measurements from thermodilution (TD) (CO, n = 25). (1) "Quantitative-accuracy": r = 0.42, 0.30, 0.42 for RVEF (CMR); r = 0.69, 0.77, 0.53 for RVEDV (CMR); 0.32, 0.36, 0.52 for RCO (TD). (2) "Qualitative-accuracy": optimal thresholds were 54.7%, 38.5%, 45.2% (AUC: 0.83, 0.80, 0.79) for RVEF; 229, 180, 94 mL (AUC: 0.83, 0.81, 0.81) for RVEDV; 4.1, 4.4, 2.6 L·minute(-1) (AUC: 0.73, 0.77, 0.80) for RCO. (3) Reproducibility: IOV was 5% ± 6%, 8% ± 12%, 17% ± 18% for RVEF; 6% ± 8%, 4% ± 4%, 21% ± 18% for RVEDV; 8% ± 8%, 11% ± 15%, 24% ± 20% for RCO. CONCLUSION Diagnostic accuracies are similar. A CMR-based calibration is required for a quantitative-analysis (cautious interpretation) or an accurate qualitative analysis (thresholds must be adjusted). Automatic procedures (BP-SPECT, QBS) offer the best compromise accuracy/reproducibility.
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Affiliation(s)
- Laurent Dercle
- Department of Nuclear Medicine, Toulouse University Hospital, 1, avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France,
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Dercle L, Giraudmaillet T, Pascal P, Lairez O, Chisin R, Marachet MA, Ouali M, Rousseau H, Bastié D, Berry I. Is TOMPOOL (gated blood-pool SPECT processing software) accurate to diagnose right and left ventricular dysfunction in a clinical setting? J Nucl Cardiol 2014; 21:1011-22. [PMID: 24875579 DOI: 10.1007/s12350-014-9915-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The assessment of right ventricular function is crucial for management of heart disease. TOMPOOL is a software that processes data acquired with Tomographic Equilibrium Radionuclide Ventriculography. In this report, TOMPOOL's diagnostic accuracy and inter-observer reproducibility were assessed in a cohort of patients with various etiologies of ventricular dysfunction. METHODS AND RESULTS End-diastolic volume (EDV), ejection fraction (EF), and cardiac output (CO) were calculated for the right ventricle (RV) and the left ventricle (LV) using TOMPOOL in 99 consecutive patients. Thirty-five patients underwent cardiac magnetic resonance imaging (CMR) considered as the reference-standard to measure EDV and EF; the Spearman's rho correlation coefficients were r = 0.73/0.80 and 0.67/0.73 for right/left EF and EDV, respectively. Twenty-one patients had thermodilution measurements of right CO (reference-standard), the correlation was r = 0.57. The best cut-off points (sensitivity/specificity) in order to diagnose a ventricular dysfunction or enlargement were 46% for RVEF (67%/89%), 62% for LVEF (100%/90%), 94 mL for RVEDV (77%/73%), and 84 mL for LVEDV (100%/91%). The areas under the ROC curve were, respectively, 0.79, 0.91, 0.83, and 0.99. Inter-observer reproducibility was r = 0.81/0.94, 0.77/0.90, and 0.78/0.75 for Right/Left EF, EDV, and CO, respectively. CONCLUSION TOMPOOL is accurate: measurements of EDV, EF, and CO are reproducible and correlate with CMR and thermodilution. However, thresholds must be adjusted.
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Affiliation(s)
- Laurent Dercle
- Department of Nuclear Medicine, Toulouse University Hospital, 1, Avenue Jean Poulhès TSA 50032, 31059, Toulouse Cedex 9, France,
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Sibille L, Bouallegue FB, Bourdon A, Mariano-Goulart D. Influence of CT-based attenuation correction in assessment of left and right ventricular functions with count-based gated blood-pool SPECT. J Nucl Cardiol 2011; 18:642-9. [PMID: 21647809 DOI: 10.1007/s12350-011-9407-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 05/23/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Influence of CT-based attenuation correction (CT-AC) in assessment of left and right ventricular functions with count-based gated blood-pool SPECT (GBPS) was evaluated in a mixed population. METHODS Thirty-two patients (81% male; mean age 56 ± 12) referred for various symptoms or heart diseases were prospectively included. Data from 32 GBPS acquisitions were reconstructed using an iterative algorithm with (IRAC) and without (IRNC) CT-AC and analyzed using previously described segmentation software based on the watershed algorithm. LV and RV EF and volumes were assessed with and without CT-AC and compared. RESULTS EF and volumes were correlated (P < .001 for all parameters with r = 0.97 for LV and RV EF; r = 0.96 for LV EDV; r = 0.98 for LV ESV; r = 0.96 for RV EDV and ESV). The mean values using IRAC and IRNC were different for all parameters with lower EF (respectively, 49% ± 19% vs 51 %± 18%; P = .002 for LV EF and 50% ± 14% vs 54%±15%; P < .001 for RV EF) and higher volumes (respectively, 142 ± 41 mL vs 133 ± 40 mL; P < .001 and 79 ± 45 mL vs 71 ± 42 mL; P < .001 for LV EDV and ESV; 91 ± 32 mL vs 86 ± 31 mL; P = .003 and 48 ± 28 mL vs 43 ± 26 mL; P < .001 for RV EDV and ESV). Limits of agreement were -11% to 6% and -11% to 4% for LV and RV EF. We found wider limits of agreement for LV volumes (-13 to 32 mL for EDV and -10 to 27 mL for ESV) than for RV volumes (-13 to 23 mL for EDV and -9 to 20 mL for ESV). Taking into account all volumes, we found a trend with a significant positive correlation between means and differences in volumes assessed with and without CT-AC. CONCLUSION Assessment of both left and right ventricular functions by count-based GBPS with CT-AC showed higher volumes and lower EF. Differences were slight, especially for the range of normal to subnormal ventricular volumes.
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Affiliation(s)
- Louis Sibille
- Department of Nuclear Medicine, CHRU Lapeyronie, 371 Av. du Doyen Gaston Giraud, 34295, Montpellier, France.
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Comparative values of gated blood-pool SPECT and CMR for ejection fraction and volume estimation. Nucl Med Commun 2011; 32:121-8. [PMID: 21057340 DOI: 10.1097/mnm.0b013e32834155f1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Gated blood-pool single-photon emission computed tomography (GBPS) was compared with cardiac magnetic resonance (CMR) for the measurement of left ventricular (LV) and right ventricular (RV) ejection fractions (EF) and volumes [end-diastolic volume (EDV) or end-systolic volume (ESV)] in a mixed population. METHODS Thirty patients (70% men; mean age: 61±14 years) referred for various symptoms or heart diseases, predominantly ischemic, were included. GBPS data were analyzed using segmentation software described earlier based on the watershed algorithm. CMR images were acquired for both ventricles at the same time using a steady-state-free precession sequence and short-axis views. No compensation for papillary muscles was used. LVEF and RVEF and volumes were assessed with GBPS and CMR and were compared. RESULTS LVEF and volumes were correlated (P<0.001). The difference in LVEF between GBPS and CMR was not significant (P=0.063). The limits of agreement were close for LVEF (-11 to 15%) and wider for LV volumes (-82 to 11 ml for EDV and -52 to 15 ml for ESV), with higher volume values obtained with CMR (mean differences of 36±24 ml for EDV and 19±17 ml for ESV). The RVEF and volumes assessed by GBPS and CMR were correlated (P<0.001). The difference in RVESV between GBPS or CMR was not significant (P=0.136). The limits of agreement were relatively close for all RV parameters (-15 to 8% for EF; -44 to 22 ml for EDV, and -25 to 21 ml for ESV). In 24 patients without valvulopathy or shunt, the difference between LV stroke volume and RV stroke volume was lower with GBPS than with CMR (9±14 ml and 18±13 ml, respectively, with P=0.027). CONCLUSION GBPS is a simple and widely available technique that can assess both LVEF and RVEF, and volumes with slight differences compared with CMR.
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Ruiz-de-Jesus O, Yanez-Suarez O, Jimenez-Angeles L, Vallejo-Venegas E. Software phantom for the synthesis of equilibrium radionuclide ventriculography images. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2006; 2006:1085-1088. [PMID: 17946442 DOI: 10.1109/iembs.2006.260276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This paper presents the novel design of a software phantom for the evaluation of equilibrium radionuclide ventriculography systems. Through singular value decomposition, the data matrix corresponding to an equilibrium image series is decomposed into both spatial and temporal fundamental components that can be parametrized. This parametric model allows for the application of user-controlled conditions related to a desired dynamic behavior. Being invertible, the decomposition is used to regenerate the radionuclide image series, which is then translated into a DICOM ventriculography file that can be read by commercial equipment.
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Affiliation(s)
- Oscar Ruiz-de-Jesus
- Department of Electrical Engineering, Universidad Autonoma Metropolitana-Iztapalapa, Mexico City, Mexico.
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