1. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
Respiratory Motion Reduction with a Dual Gating Approach in Myocardial Perfusion SPECT: Effect on Left Ventricular Functional Parameters
Matti J. Kortelainen, Tuomas M. Koivumäki, Marko J. Vauhkonen, Marja K. Hedman, Satu T. J. Kärkkäinen, Juanita Nino Quintero, Mikko A. Hakulinen
University of Eastern Finland, Kuopio, Finland;
Kuopio University Hospital, Kuopio, Finland;
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2. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
BACKGROUND
1- Respiratory motion (RM) is inevitable in myocardial perfusion SPECT and may compromise the diagnostic accuracy of the examination1
2- RM can be reduced with respiratory gating; however, the reconstructed images may contain limited-angle errors if conventional gamma cameras are used2
3- It is unclear how RM reduction affects left ventricular (LV) functional parameters
4- In this paper, a novel dual gating algorithm is presented to reduce RM and its impact on LV function quantification is evaluated
1 Polycarpou I, Chrysanthou-Baustert I, Demetriadou O, Parpottas Y, Panagidis C, Marsden PK, et al. Impact of respiratory motion correction on SPECT myocardial perfusion imaging using a mechanically moving phantom assembly with variable cardiac defects. J Nucl Cardiol. 2015:1-10. doi: /s
2 Qi W, Yang Y, Wernick MN, Pretorius PH, King MA. Limited-angle effect compensation for respiratory binned cardiac SPECT. Med Phys. 2016;43:
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3. METHODS Study type: Retrospective/Repeated measures
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
METHODS
Study type: Retrospective/Repeated measures
Study subjects: 18 patients with known or suspected CAD and referred to one-day stress/rest MP-SPECT examinations
ECG and thoracic electrical impedance signals of the patients were recorded during rest MP-SPECT image acquisition
Signals and list-mode emission data were processed to generate cardiac-gated and dual-gated images with cardiac cycle divided to 1, 8 and 16 frames
Study variables: LV perfusion, shape index, volumes, wall motion, wall thickening and phase analysis parameters evaluated with QPS/QGS software (Cedars-Sinai Medical Center)
Statistical significance evaluated with Wilcoxon signed rank test
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4. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
Results from the automatic analysis (QPS) of 1-frame cardiac-gated and dual-gated images, N = 16
Cardiac-gated
Dual-gated P q
V1 (ml)
77.1 ± 26.8
79.8 ± 27.6
.006*
-.486
SI1
0.57 ± 0.05
0.56 ± 0.05
.036*
-.371
MPANT (%)
64.4 ± 6.5
65.4 ± 5.2
.268
-.196
MPLAT (%)
69.4 ± 5.6
68.1 ± 5.3
.079
-.311
MPINF (%)
58.6 ± 9.1
59.1 ± 9.3
.800
-.045
MPSEP (%)
66.3 ± 6.2
65.7 ± 5.9
.528
-.112
MPAPX (%)
73.5 ± 7.2
73.3 ± 8.4
.468
-.128
V1 left ventricular volume, SI1 shape index, MP myocardial perfusion, ANT anterior, LAT lateral, INF inferior, SEP septal, APX apical, P p-value, q effect size.
The results are expressed as mean ± standard deviation.
Asterisk (*) denotes a statistically significant difference at level p < .05 between cardiac-gated and dual-gated images.
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5. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
Results from the automatic analysis (QGS) of 8-frame and 16-frame cardiac-gated and dual-gated images, N = 16
8-frame images
16-frame images
Cardiac-gated
Dual-gated P q
EDV (ml)
81.0 ± 26.8
82.9 ± 28.8
.123
-.273
82.4 ± 26.9
84.6 ± 28.4
.156
-.251
ESV (ml)
33.3 ± 21.1
34.5 ± 21.4
.034*
-.374
30.1 ± 20.5
31.2 ± 21.4
.154
-.252
SV (ml)
47.7 ± 9.87
48.4 ± 11.4
.752
-.056
52.3 ± 10.6
53.4 ± 12.7
.680
-.073
EF (%)
62.2 ± 12.8
61.2 ± 11.2
.219
-.217
66.7 ± 12.4
66.2 ± 12.3
.380
-.155
SIED
0.64 ± 0.05
0.62 ± 0.05
.006*
-.487
0.65 ± 0.05
0.63 ± 0.05
-.482
SIES
0.47 ± 0.064
0.46 ± 0.06
.350
-.165
0.45 ± 0.07
0.45 ± 0.06
.900
-.022
WMANT (mm)
8.3 ± 1.7
8.4 ± 1.5
.534
-.110
9.4 ± 1.9
9.5 ± 2.0
.460
-.131
WMLAT (mm)
9.1 ± 1.9
8.9 ± 1.5
.660
-.078
10.3 ± 1.9
10.2 ± 1.7
.977
-.005
WMINF (mm)
6.4 ± 1.9
6.2 ± 1.7
.338
-.169
7.1 ± 2.0
7.0 ± 1.8
.477
-.126
WMSEP (mm)
4.8 ± 2.0
4.5 ± 1.7
.125
-.271
5.4 ± 2.2
5.2 ± 2.2
.178
-.238
WMAPX (mm)
7.3 ± 2.2
6.8 ± 1.9
.112
-.281
7.9 ± 2.3
8.0 ± 2.3
.918
-.018
WMGLB (mm)
7.2 ± 1.6
6.9 ± 1.3
.162
-.247
8.0 ± 1.7
.438
-.137
WTANT (%)
35.8 ± 10.5
34.5 ± 8.4
.301
-.183
39.4 ± 10
38.7 ± 11.5
.332
-.171
WTLAT (%)
36.6 ± 13.0
35.6 ± 9.5
.628
-.086
42.3 ± 12.9
41.7 ± 12.5
.816
-.041
WTINF (%)
30.4 ± 12.1
29.3 ± 10.1
.207
-.223
33.4 ± 14.0
34.1 ± 11.6
.586
-.096
WTSEP (%)
37.1 ± 12.3
33.6 ± 10.0
.008*
-.469
40.8 ± 12.0
38.6 ± 11.9
.023*
-.403
WTAPX (%)
55.1 ± 15.9
51.8 ± 13.9
.083
-.307
60.6 ± 19.2
60.1 ± 16.2
.887
-.025
WTGLB (%)
39.0 ± 11.8
36.9 ± 9.4
-.375
43.3 ± 12.0
42.6 ± 11.3
.320
-.176
BW (°)
44.8 ± 20
48.8 ± 27.2
.826
-.039
41.3 ± 18.7
38.8 ± 16.1
StDev (°)
13 ± 6.2
14.5 ± 8.7
.642
-.082
11.3 ± 5.7
11.5 ± 5.3
.959
-.009
ENT (%)
59.3 ± 5.85
60.3 ± 6.4
58.3 ± 6.4
58.3 ± 6.2
EDV end-diastolic volume, ESV end-systolic volume, SV stroke volume, EF ejection fraction, SIED shape index at end-diastole, SIES shape index at end-systole, WM wall motion, WT wall thickening, ANT anterior, LAT lateral, INF inferior, SEP septal, APX apical, GLB global, BW bandwidth of phase angle histogram, StDev standard deviation of phase angle histogram, ENT entropy of phase angle histogram, P p-value, q effect size.
The results are expressed as mean ± standard deviation.
Asterisk (*) denotes a statistically significant difference at level p < .05 between cardiac-gated and dual-gated images.
Insert a key table or a key figure If figure, insert legend Delete slide if second results slide not necessary
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6. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
CONCLUSIONS
1- A novel dual gating algorithm was introduced to reduce RM in MP-SPECT
2- RM reduction increases LV volumes and reduces LV shape index and wall thickening
3- RM does not significantly affect phase analysis parameters
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