Comparison of blood pool gated spect with three different gated myocardial perfusion spect programs for left ventricular functional parameters in patients with low likelihood for cad

Amaç: Bu çalışmanın amacı koroner arter hastalığı (KAH) riski düşük olan hastalarda sol ventrikülün fonksiyonel parametrelerini belirlemede farklı gated miyolcardiyal perftizyon SPECT (gMPS) programlarını gated kan havuzu SPECT (BPGS) ile karşılaştırmaktı. Ayrıca kalp boyutunun fonksiyonel parametreler üzerine etkisini araştırmaktı. Gereç ve Yöntem : KAH riski diisük olan ve gMPS incelemesi normal olarak değerlendirilen 40 hastaya gMPS incelemesini takip eden 3 gün içinde istirahat kan havuzu görüntülemesi yapıldı. 3 farklı gMPS programına (Emory Cardiac Toolbox (ECT), Quantitative Gated SPECT (QGS) and 4DMSPECT) ait sonuçlar BPGS referans alınarak değerlendirildi ve tüm programlar birbiri ile karşılaştırıldı. Ayrıca hastalar sistol-sonu hacimlerine (SSH) göre gruplandı; SSH< 30 ml olan hastalar (grup 1) SSH> 30 mi olan hastalar (grup 2) ile fonksiyonel parametreler açısından karşılaştırıldı. Karşılaştırmada tekrarlayan ANOVA ölçümü, doğrusal regresyon analizi ve Bland-Altman metodu ile yapıldı. Bulgular: Tüm gMPS programları BPGS ile iyi korele olup 4D-MSPECT programcı en iyi korelasyonu gösterdi. ECT dışında diğer gMPS programları ile BPGS arasındaki ortalama EF farkı istatistiksel olarak anlamlı bulunmadı. ECT programı ile ise belirgin yüksek ejeksiyon fraksiyonu (EF) değerleri hesaplandı. BPGS ve gMPS programlan arasında ortalama diyastol sonu hacmi (DSH) değerleri açısından istatistiksel farklılık saptanmamıs olup, ECT ve 4D-MSPECT ile hesaplanan ortalama SSH değerleri BPGS'den anlamlı derecede düşüktü. Tüm programlar ile küçük hacimli kalplerde EF değerleri istatiksel olarak anlamlı ölçüde yüksek olarak hesaplandı ve BPGS yöntemine en yakın sonuçlar grup 1 de 4D-MSPECT ile grup 2 de ise QGS ile bulundu. Sonuç: Sol ventrikül fonksiyonlarını belirlemede gMPS programları ve BPGS iyi korele ve uyumludur. Tüm hasta grubunda ve küçük kalpli hasta grubunda referans yönteme en yakın sonuçlar 4D-MSPECT ile hesaplandı. Küçük kalplerde EF değerlerinin olduğundan yüksek hesaplanması gMPS programlarının yanında ERNA ve BPGS için de önemli bir problemdir. Bu çalışmada küçük kalplerde cn düşük EF değerleri QGS ile hesaplandı.

Koroner arter hastalığı riski düşük olan hastalarda sol ventrikül fonksiyonlarının değerlendirilmesinde gated kan havuzu spect programının karşılaştırılması

Purpose: To compare several gated myocardial perfusion SPECT (gMPS) programs with blood pool gated SPECT (BPGS) for the evaluation of left ventricular (LV) functional parameters and further investigate the effect of heart size in a population with low coronary artery disease (CAD) risk. Materials and Methods: Forty patients whose gMPS were seen to be normal were included. Rest blood pool studies were performed in patients 3 days after the evaluation of gMPS, and the data were processed with 3 different programs: Emory Cardiac Toolbox (ECT), Quantitative Gated SPECT (QGS), and 4D-MSPECT. The results of each program were evaluated using BPGS as the reference method and all programs were compared with each other. Patients were also grouped according to their end systolic volumes (ESV) with BPGS; the ESV < 30 ml (small heart) group was compared to group 2 (ESV >30 ml) for functional parameters. Repeated measures ANO- VA, linear regression, and Bland-Altman analysis were used to compare the methods. Results: All gMPS programs were well correlated with BPGS, while 4D-MSPECT had fee best correlation. Mean differences in EF between gMPS programs and BPGS were not significant, except for ECTb, with which EF values were significantly higher from BPGS. No statistically significant differences were observed between BPGS and gMPS programs for mean end diastolic volume (EDV) values. However, ESV values from ECT and 4D M SPECT' programs were significantly lower than those from BPGS. EF values were significantly higher in patients with small hearts for all methods. The closest EF values to the reference method values were calculated with 4D MSPECT in group 1 and with QGS in group 2. Conclusion: gMPS programs yield accurate and reliable results in the assessment of myocardial function in addition to myocardial perfusion. In all patient groups and the small heart group, the closest LVEF values to those of the reference method were calculated with 4D-MSPECT. Overestimation of LVEF in small hearts isjhe major problem of gMPS methods and also ERNA and BPGS. In this study the lowest overestimations of LVEF values were obtained with QGS in small hearts.

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