1. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
Evaluation of Left Ventricular Mass on Cadmium-Zinc-Telluride Imaging: Validation against Cardiac Magnetic Resonance
Alessia Gimelli, MD* 1, Riccardo Liga, MD* 2, Serena Magro, MD 1, 3, Salvatore Novo, MD3, Roberto Pedrinelli, MD 2, Anna Sonia Petronio, MD 2, Paolo Marzullo, MD 1, 4, and Alessia Pepe, MD, Ph.D 1
1Fondazione Toscana G. Monasterio, Pisa, Italy; 2 Dipartimento di Patologia Chirurgica, Molecolare e dell'Area Critica, Università di Pisa, Italy ; Department of Cardiology, University of Palermo, Italy ; 4CNR, Institute of Clinical Physiology, Pisa, Italy
* Drs Gimelli and Liga contributed equally to the study and share the first co-authorship
Copyright American Society of Nuclear Cardiology

2. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
BACKGROUND
1- Left ventricular (LV) hypertrophy (LVH) associates with an increased risk of cardiac events
2- While cardiac magnetic resonance (CMR) still represents the gold-standard for the non-invasive measurement of LV mass and for the diagnosis of LVH, single-photon emission computed tomography (SPECT) has generally shown relevant limitations in the quantification of LV mass, predominantly due to its lower spatial resolution
3- The recently introduced cardiac cameras equipped with Cadmium-Zinc- Telluride (CZT) detectors are characterized by significantly higher photon sensitivity and spatial resolution than traditional SPECT devices
4- Whether the favorable technical characteristics of CZT cameras may also lead to a precise assessment of LV mass has not been yet evaluated.
Copyright American Society of Nuclear Cardiology

3. METHODS Study type: Retrospective, observational.
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
METHODS
Study type: Retrospective, observational.
Study subjects: 25 consecutive subjects that underwent myocardial perfusion imaging with resting gated 99mTc-tetrofosmin tomographic acquisition on a dedicated CZT camera and CMR.
Study endpoints: To assess the accuracy of different commercially available software packages for myocardial perfusion imaging (MPI) [Corridor 4D-MSPECT (4DM) and Emory Cardiac Toolbox (ECTb)] in the quantification of LV mass on CZT images as compared to CMR
Study variables: LV mass, LVH, summed rest score
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4. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
Linear regression analysis and Bland-Altman plots for comparison of LV mass values obtained on CMR and on CZT images with either 4DM (Panel A) or ECTb (Panel B) software in the entire study population
Copyright American Society of Nuclear Cardiology

5. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
RESULTS
Linear regression analysis and Bland-Altman plots for comparison of LV mass values obtained on CMR and on CZT images with either 4DM (Panel A) or ECTb (Panel B) software in patients with previous MI
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6. Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology
CONCLUSIONS
1- Values of LV mass that are automatically computed on CZT imaging are comparable to the ones obtained on CMR, being able to individuate the presence of pathologic LV hypertrophy in the great majority of patients
2- Both software have an elevated accuracy in quantifying LV mass with respect to CMR. However, while 4DM provides accurate estimates of LV mass over the entire range of values, ECTb measures tend to overestimate the effective LV mass at lower values and underestimate at higher values
3- However, despite the differences, both software could define the presence of significant LVH in the great majority of patients with very good reproducibility, confirming their possible clinical value.
Copyright American Society of Nuclear Cardiology