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Titolo:
Clinical impact of arrhythmias on gated SPECT cardiac myocardial perfusionand function assessment
Autore:
Nichols, K; Yao, SS; Kamran, M; Faber, TL; Cooke, CD; DePuey, EG;
Indirizzi:
Columbia Univ, Div Cardiol, New York, NY 10032 USA Columbia Univ New YorkNY USA 10032 , Div Cardiol, New York, NY 10032 USA St Lukes Roosevelt Hosp, Div Cardiol, New York, NY 10025 USA St Lukes Roosevelt Hosp New York NY USA 10025 iol, New York, NY 10025 USA St Lukes Roosevelt Hosp, Div Nucl Med, New York, NY 10025 USA St Lukes Roosevelt Hosp New York NY USA 10025 Med, New York, NY 10025 USA Emory Univ, Div Nucl Med, Atlanta, GA 30322 USA Emory Univ Atlanta GA USA30322 Univ, Div Nucl Med, Atlanta, GA 30322 USA
Titolo Testata:
JOURNAL OF NUCLEAR CARDIOLOGY
fascicolo: 1, volume: 8, anno: 2001,
pagine: 19 - 30
SICI:
1071-3581(200101/02)8:1<19:CIOAOG>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMISSION COMPUTED-TOMOGRAPHY; TECHNETIUM-99M-SESTAMIBI SPECT; VENTRICULAR-FUNCTION; EJECTION FRACTION; QUANTIFICATION; QUANTITATION; VALIDATION; STRESS; IMAGES;
Keywords:
gated single photon emission computed tomography; arrhythmias; wall motion; wall thickening;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Nichols, K Columbia Univ, Div Cardiol, PH9-993B,622 W 168th St, New York, NY 10032 USA Columbia Univ PH9-993B,622 W 168th St New York NY USA 10032 USA
Citazione:
K. Nichols et al., "Clinical impact of arrhythmias on gated SPECT cardiac myocardial perfusionand function assessment", J NUCL CARD, 8(1), 2001, pp. 19-30

Abstract

Background. We reported previously that mean quantified cardiac functionalparameters computed by one gated single photon emission computed tomography (SPECT) technique were not significantly altered by common gating errors. However, it is not known to what extent other gated SPECT approaches that are based on different ventricular modeling assumptions are influenced by arrhythmias, nor are the effects of gating errors on visual analyses and their subsequent clinical implications known. Methods. Projection data for 50 patients (aged 64 +/- 12 years; 68% men; 76% with myocardial perfusion defects) undergoing technetium-99m sestamibi gated SPECT who were in sinus rhythm during data acquisition were altered tosimulate common arrhythmias, To determine quantitative effects, we performed calculations for original control and altered images by Gaussian myocardial detection (Quantitative Gated SPECT [QGS] program) and by wall thickening derived from gated perfusion polar maps (Emory Cardiac Toolbox program). To evaluate visual assessment in control and simulated-arrhythmia tomograms, 2 experienced blinded observers independently interpreted perfusion frompolar maps and wall motion and thickening from tomographic cines, using a 4-point scale. Results. Although mean functional parameters were scarcely altered, pairedt tests showed ejection fraction fluctuations to be significantly different from control values, causing patients to change between abnormal and normal ejection fraction categories (2% of patients by QGS and 14% by Emery Cardiac Toolbox). Visual examination of QGS polar perfusion and function maps showed changes for 72% of cases, although in only 4% were these considered to have potential clinical consequences, The kappa statistic for visual analysis of concordance between control and arrhythmia readings showed that agreement was "excellent" for perfusion, "good" for motion, and "marginal" for thickening. Conclusions. As with quantitative measurements, thickening is the parameter most prone to error in the presence of arrhythmias. It is important to test data for gating errors to avoid potentially erroneous measurements and visual readings.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 17/09/19 alle ore 22:44:15