Precision of Myocardial Blood Flow and Flow Reserve Measurement During CZT SPECT Perfusion Imaging Processing: Intra- and Interobserver Variability

The Journal of Nuclear Medicine

article

Matthieu Bailly¹  Frédérique Thibault¹  Gilles Metrard¹  Maxime Courtehoux¹  Denis Angoulvant²  Maria Joao Ribeiro⁴ 

[1]Nuclear Medicine Department

[2]Cardiology Department

[3]EA4245 T2i, Tours University

[4]UMR 1253, iBrain, Université de Tours

关键词: myocardial blood flow;    myocardial flow reserve;    CZT SPECT;    variability;   

DOI  :  10.2967/jnumed.122.264454

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The aim of this study was to evaluate the reproducibility of myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurement in patients referred for dynamic SPECT. Methods: We retrospectively analyzed patients referred for myocardial perfusion imaging. SPECT data were acquired on a cadmium zinc telluride–based pinhole cardiac camera in list mode using a stress (251 ± 15 MBq)/rest (512 ± 26 MBq) 1-d 99mTc-tetrofosmin protocol. Kinetic analyses were done with software using a 1-tissue-compartment model and converted to MBF using a previously determined extraction fraction correction. MFR was analyzed and compared globally and regionally. Motion detection was applied, but not attenuation correction. Results: In total, 124 patients (64 male, 60 female) were included, and SPECT acquisitions were twice reconstructed by the same nuclear medicine board-certified physician for 50 patients and by 2 different physicians for 74. Both intra- and interobserver measurements of global MFR had no significant bias (−0.01 [P = 0.94] and 0.01 [P = 0.67], respectively). However, rest MBF and stress MBF were significantly different in global left ventricular evaluation (P = 0.001 and P = 0.002, respectively) and in the anterior territory (P < 0.0001) on interuser analysis. The average coefficient of variation was 15%–30% of the mean stress MBF if the analysis was performed by the same physician or 2 different physicians and was around 20% of the mean MFR independently of the processing physician. Using the MFR threshold of 2, we noticed good intrauser agreement, whereas it was moderate when the users were different (κ = 0.75 [95% CI, 0.56–0.94] vs. 0.56 [95% CI, 0.36–0.75], respectively). Conclusion: Repeated measurements of global MFR by the same physician or 2 different physicians were similar, with an average coefficient of variation of 20%. Better reproducibility was achieved for intrauser MBF evaluation. Automation of processing is needed to improve reproducibility.

【 授权许可】

CC BY