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Year : 2020  |  Volume : 19  |  Issue : 4  |  Page : 446

Cardiac volumes and left ventricular ejection fraction on myocardial perfusion scintigraphy

1 Department of Medical Imaging, The Prince Charles Hospital, Chermside; Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
2 Faculty of Medicine, University of Queensland, Herston, Queensland, Australia

Date of Submission15-Jan-2020
Date of Decision06-Mar-2020
Date of Acceptance18-Mar-2020
Date of Web Publication14-Sep-2020

Correspondence Address:
Dr. Joseph C Lee
Department of Medical Imaging, The Prince Charles Hospital, Chermside, Queensland 4032
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_8_20

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How to cite this article:
Lee JC, Chong JW. Cardiac volumes and left ventricular ejection fraction on myocardial perfusion scintigraphy. World J Nucl Med 2020;19:446

How to cite this URL:
Lee JC, Chong JW. Cardiac volumes and left ventricular ejection fraction on myocardial perfusion scintigraphy. World J Nucl Med [serial online] 2020 [cited 2022 Aug 18];19:446. Available from: http://www.wjnm.org/text.asp?2020/19/4/446/295163

Dear Editor,

Our understanding of cardiac volumes – end-diastolic volume (EDV) and end-systolic volume (ESV) – and left ventricular ejection fraction (LVEF) was constructively and productively enhanced from reading the work of Mardanshahi et al.[1] It was very thought-provoking that there could be such a degree of difference from varying the filter cutoffs during reconstruction in myocardial perfusion scintigraphy (MPS) with single-photon emission computed tomography (SPECT). Being able to provide information such as ESV, EDV, and LVEF is a great advantage of MPS over some other noninvasive cardiac imaging modalities and should be regarded as a possible unintended benefit as it is far from the primary objective.[2]

We wonder if the values differ – and would the interpretation be different – using different software packages to calculate the EDV, ESV, and LVEF values. These can have significant differences. Just this week, we found that one patient was assessed by four Dimension Myocardial SPECT (Vital Images, Minnetonka, MN, USA) as having EDV, ESV, and LVEF of 43ml, 26ml, and 60%, respectively. By contrast, Quantitative Perfusion SPECT (Cedars-Sinai, Los Angeles, CA, USA) assessed these as 38ml, 15ml and 40%. The referring clinician would have a vastly different impression based on the differences in the information provided.

Beyond the anecdote, it has been discussed in greater detail in the literature. While some studies and articles suggest reasonable correlation such as Schaefer et al.,[3] others[4],[5] have differed. In this context, the questions that we pose are:

  1. How can we apply the findings to the different software?
  2. How much weight can we place on this set of data given the discrepancies shown between the software most commonly used?

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Conflicts of interest

There are no conflicts of interest.

   References Top

Mardanshahi AR, Alavi A, Yazdani J, Hosseinimehr SJ, Khoshakhlagh M, Dabirian M, et al. The correlation between myocardial perfusion scintigraphy and three-dimensional echocardiography in ejection fraction and cardiac volumes for determination of the nearest filtering parameters. World J Nucl Med 2019;18:373-7.  Back to cited text no. 1
[PUBMED]  [Full text]  
Lee JC, West MJ, Khafagi FA. Myocardial perfusion scans. Aust Fam Physician 2013;42:564-7.  Back to cited text no. 2
Schaefer WM, Lipke CS, Standke D, Kühl HP, Nowak B, Kaiser HJ, et al. Quantification of left ventricular volumes and ejection fraction from gated 99mTc-MIBI SPECT: MRI validation and comparison of the Emory Cardiac Tool Box with QGS and 4D-MSPECT. J Nucl Med 2005;46:1256-63.  Back to cited text no. 3
Ather S, Iqbal F, Gulotta J, Aljaroudi W, Heo J, Iskandrian AE, et al. Comparison of three commercially available softwares for measuring left ventricular perfusion and function by gated SPECT myocardial perfusion imaging. J Nucl Cardiol 2014;21:673-81.  Back to cited text no. 4
Lavender FM, Meades RT, Al-Nahhas A, Nijran KS. Factors affecting the measurement of left ventricular ejection fraction in myocardial perfusion imaging. Nucl Med Commun 2009;30:350-5.  Back to cited text no. 5


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