Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin:: a multicentre study involving 106 hospitals
Inter-institution preference-based variability of ejection fraction and volumes using quantitative gated SPECT with 99mTc-tetrofosmin:: a multicentre study involving 106 hospitals
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DOI：
10.1007/s00259-005-1916-7
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发表时间：
2006-02-01
影响因子：
9.1
通讯作者：
Nishimura, T
中科院分区：
文献类型：
--
作者：
Nakajima, K;Nishimura, T
目的：评估基于机构偏好的门控 SPECT 量化的机构间再现性。当涉及许多医院时，这种变异性对于多中心研究至关重要。方法：共有 106 个机构参与了这项研究，并根据其使用的五种工作站类型进行分组。准备 15 套 Tc-99m-替曲膦门控投影图像，其中射血分数（EF）正常（类似于 70%，A 组，n= 5）、临界低 EF（类似于 50%，B 组，n= 5）和低 EF 伴大灌注缺损（类似于 30%，C 组，n= 5）。投影图像由各研究所的QGS软件根据各自的常规设置进行处理。基于 318 个 QGS 结果，分析各组和工作站的 EF 和容量的重现性。结果：15 例中有 14 例 EF 的重现性良好，标准差 (SD) < 3.6%，所有病例的舒张末期容积 (EDV) 方差系数 < 9.3%。当分析与平均值的偏差时，每个研究所的 EF 与工作站的平均 EF (dEF) 之间的差异显示，每组的 SD 为 2.2 - 3.7%。 EDV 除以平均 EDV (rEDV) 的比率显示每组的 SD 为 0.061 - 0.069。 C 组中的 1 例患者存在较大前部缺损且 EF 较低，在五个工作站之一中显示出双峰 EF 分布。由于 SPECT 重建条件，EF 的 SD 取决于工作站。结论：尽管门控 SPECT 偏好不同，但工作站内 EF 和体积的再现性良好。这项可重复性研究支持在多中心研究中使用门控 SPECT 作为心室功能的标准。
Purpose: Inter-institution reproducibility of gated SPECT quantification based on institutional preferences was evaluated. This sort of variability is crucial for a multicentre study when many hospitals are involved.Methods: A total of 106 institutes participated in this study and were grouped according to their use of five workstation types. Fifteen sets of Tc-99m-tetrofosmin gated projection images with normal ejection fraction (EF) (similar to 70%, group A, n= 5), borderline low EF (similar to 50%, group B, n= 5) and low EF with large perfusion defects (similar to 30%, group C, n= 5) were prepared. The projection images were processed by QGS software in each institute based on its own routine settings. Based on 318 QGS results, the reproducibility of EF and volumes was analysed for each group and workstation.Results: The reproducibility of EF was good in 14 of 15 cases, showing a standard deviation (SD) of < 3.6%, and the coefficient of variance of the end-diastolic volume (EDV) was < 9.3% in all cases. When the deviation from the average value was analysed, the difference between EF at each institute and the average EF of the workstation (dEF) showed an SD of 2.2 - 3.7% for each group. The ratio of the EDV divided by the average EDV (rEDV) showed an SD of 0.061 - 0.069 for each group. One case in group C that had a large anterior defect with low EF showed bimodal EF distribution in one of the five workstations. The SD of EF was workstation dependent, owing to the SPECT reconstruction conditions.Conclusion: The reproducibility in EF and volumes within a workstation was good, even though the gated SPECT preferences varied. This reproducibility study supports the use of gated SPECT as a standard of ventricular function in multicentre studies.