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J Nucl Med. 2008; 49 (Supplement 1):419P
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Technologist Abstracts

Technologist Papers IV

Quality control procedures to ensure accurate estimation of the left ventricular ejection fraction from planar gated blood pool scans

Greg LeFever1, Amanda Abbott1, Daniel de Vries1, David Israel1, Jeffrey Yap1 and Annick Van den Abbeele1

1 Nuclear Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts

2025

Objectives: Although modern software performs automated post-processing of gated blood pool scans, various factors can contribute to inaccurate estimations of the left ventricular ejection fraction (LVEF). This work will describe the incidental observation of deviations in the generation of ventricular volume curves, resulting in errors in the estimated LVEF, and the quality control procedures that were established to prevent such errors.

Methods: Based on a review of the volume curves obtained from gated blood pool scans acquired on a particular camera, a retrospective analysis of 80 patients was performed. For each scan, the LVEF was calculated by 1) extracting the left ventricle (LV) and background counts from the automated volume curve; 2) manually identifying the end-systolic (ES) and end-diastolic (ED) frames based on the lowest and highest counts in the LV; and 3) applying the standard formula: [(ED-bkg)-(ES-bkg)]/(ED-bkg). The manually calculated LVEF was compared to the semi-automated LVEF using linear regression and graphical analysis.

Results: The comparison of manual versus semi-automatic methods demonstrated statistically significant underestimation of LVEF (range: 2% to -28%, mean: -11%, p<0.00001). Reductions of >10% in LVEF were seen in 68% of patients. Further investigation revealed that the automated processing algorithm was affected by polarity settings on the ECG trigger device.

Conclusions: Semi-automated software processing can miscalculate LVEF. Technologists and physicians should perform a visual quality control of the regions of interest, volume curve analysis, device settings, and ED/ES frame location to ensure the proper estimation of LVEF.





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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by LeFever, G.
Right arrow Articles by Van den Abbeele, A.
PubMed
Right arrow Articles by LeFever, G.
Right arrow Articles by Van den Abbeele, A.