Journal Article

Harmonic subtraction for evaluating right ventricle ejection fraction from planar equilibrium radionuclide angiography

Bonta, Dacian V., Alazraki, Naomi P., Grant, Sandra F., Aarsvold, John N.

2017

Overview

We report an initial investigation of a subtraction-based method to estimate right ventricle ejection fraction (RVEF) from ECG-gated planar equilibrium radionuclide angiography (ERNA) data. Twenty-six consecutive patients referred for scintigraphic evaluation of cardiac function prior to chemotherapy had ECG-gated first-pass (FP) imaging and ERNA imaging performed following the same radiotracer injection. RVEF was computed from FP images (RVEF FP ) and separately from ERNA images (RVEF ERNA ). Standard methods for computing ejection fractions were used to obtain RVEF FP values. RVEF ERNA values were obtained using harmonic subtraction of the left ventricular contribution from a biventricular region of interest contoured on the equilibrium images acquired in the shallow right anterior oblique projection. Clinically acquired chest CT data were used to derive information regarding the relative position of the left and right ventricle and about the presence of pulmonary artery enlargement. Computation of RVEF ERNA was successful for each of the 26 patients. Computation of RVEF FP failed for four patients. For the 22 patients for which RVEF was computed using both methods, the average RVEF FP was 49% and the average RVEF ERNA was 51%, with coefficients of variation of 11 and 7.5%, respectively. Low RVEF ERNA values were associated with pulmonary artery dilation. Estimation of RVEF ERNA , using a harmonic subtraction-based method of computation is clinically feasible and accurate in the patient population studied. The results support further investigation in patients with frank heart failure.

• Publisher: Springer Netherlands,Springer Nature B.V
• Subject: Angiography / Cardiac arrhythmia / Cardiac Imaging / Cardiac-Gated Imaging Techniques / Cardiology / Chemotherapy / Coefficient of variation / Computation / Computed tomography / Computed Tomography Angiography / Data acquisition / EKG / Electrocardiography / Enlargement / Equilibrium / Female / Heart / Heart diseases / Heart Ventricles - diagnostic imaging / Heart Ventricles - physiopathology / Humans / Hypertension, Pulmonary - diagnostic imaging / Hypertension, Pulmonary - physiopathology / Image acquisition / Image Interpretation, Computer-Assisted - methods / Image processing / Imaging / Linear Models / Male / Medical imaging / Medicine / Medicine & Public Health / Original Paper / Patients / Population studies / Predictive Value of Tests / Pulmonary arteries / Pulmonary artery / Radiology / Radionuclide Angiography - methods / Radiopharmaceuticals - administration & dosage / Retrospective Studies / Sodium Pertechnetate Tc 99m - administration & dosage / Stroke Volume / Subtraction / Ventricle / Ventricular Dysfunction, Right - diagnostic imaging / Ventricular Dysfunction, Right - physiopathology / Ventricular Function, Left / Ventricular Function, Right