Reliability of Three Computer Methods in the Analysis of ECG-Gated Radionuclide Left Ventriculography: Interrecording, Interobserver and Intraobserver Variability

Abstract

Three different computer methods for analysis of systolic and diastolic left ventricular function (ejection fraction, peak ejection rate, time to peak ejection rate, peak filling rate, time to peak filling rate, duration of fast filling phase, and fast filling fraction) as derived from ECG-gated radionuclide cardiography were compared in 30 patients with various diseases. The patients had two gamma camera recordings of the left ventricle performed immediately following one another during radionuclide (99mTc) equilibrium (3 x 10(6) counts, 16 frames/cycle, 64 x 64 pixels). Mean ECG R-R interval of the patients remained unchanged from first to second recording. The three computer methods were: (1) end-diastolic (ED) region of interest (ROI) analysis based on manually defined ED-ROI; (2) multi (M) ROI, manually defined ROI for each frame; and (3) semiautomatic (SA) ROI, ROI for each frame defined by an SA edge detection technique. With the 16 frame points as nodes, a 160-point time-activity curve was constructed for each of the three methods by use of a spline function. A tailored multiway analysis of variance showed that the M-ROI method had the highest interindividual range of values of the function parameters and the smallest interrecording, interobserver, and intraobserver variabilities. In theory this implies a better diagnostic sensitivity and specificity for the M-ROI method as compared with the other two methods.

Left Ventricular Performance during Exercise and in the Recovery Period following Extensive Exercise in Athletes

“…All radionuclide recordings were analyzed by the same expe rienced observer. The method described showed a high correlation (r = 0.94) with contrast ventriculography for EF [10], Interobserver, intraobserver, and interrecording studies have shown that our method is reliable (EF: r = 0.993, r=0.994, and r=0.996, respectively; PFR: r = 0.958, r = 0.986, and r = 0.982, respectively) [11],…”

Cardiac function during iron chelation therapy in adult non‐thalassaemic patients with transfusional iron overload

“…Our measure of LVEF has been found to be reliable in intra-observer and inter-recording studies (r=0.994 and r=0.996) (16) and to be highly correlated with contrast ventriculography (r=0.94) (17). The daily variation, as determined by repeated measurements (the same radio-nuclide injection), was 1.8% (16). An LVEF=50% was regarded as the lower reference limit.…”

A prospective comparison of cardiac magnetic resonance imaging and radionuclide ventriculography in the assessment of cardiac function in patients treated with anthracycline-based chemotherapy

“…The procedure has remained unchanged; even the principles of analysis software are still similar, although analysis with modern computers is much faster. A number of studies have shown excellent study-tostudy reproducibility with mean differences of 1-3% units [23][24][25][26][27]. In individual patients, a change of more than 5% units is widely regarded as a clinically significant change.…”