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Cardiovascular: Clinical ScienceNew Software, Hardware and Tracer Development I |
1 Physics, Carleton University, Ottawa, Ontario, Canada; 2 Cardiology, The Ottawa Heart Institute, Ottawa, Ontario, Canada; 3 Nuclear Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
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Objectives: Phase analysis of SPECT blood pool images has been proposed as a means of detecting mechanical dyssynchrony, which is important for selection of cardiac resynchronization therapy candidates. However, the technique requires further development and validation. This study compares two methods of measuring wall motion.
Methods: Two SPECT phase analysis techniques were assessed: a Time-Activity (TA) method which approximated wall motion from the change in counts vs. time at fixed locations around the end-diastolic LV edge, and a Time-Distance method (TD) which measured wall motion by tracking the LV edge vs. time. TA and TD SPECT phase analysis were performed on 31 normal subjects (LVEF>55%, normal wall motion, QRS<120 ms) and 23 left bundle branch block (LBBB) cardiomyopathy patients (LVEF< 30%, abnormal wall motion, QRS>120 ms) using Hermes Medical Solutions software. The ability of the two methods at detecting LBBB was compared using ROC analysis (ROCKIT, U. Chicago) of the phase standard deviation (SD
), and two novel parameters, synchrony (S) and entropy (E).
Results: The sensitivity and specificity of the parameters are given below. No difference in ROC area, between the two methods, was found for either SD or S (p>0.05), but it was found to be different for E (p<0.05).
Conclusions: SPECT phase analysis showed excellent sensitivity and specificity at detecting LBBB. The TA method was found to have better sensitivity and specificity than the TD method.
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