Abstract
PurposeVentricular function is a powerful predictor of survival in patients with heart failure (HF). However, studies characterizing gated F-18 FDG PET for the assessment of the cardiac function are rare. The aim of this study was to prospectively compare gated F-18 FDG PET and cardiac MRI for the assessment of ventricular volume and ejection fraction (EF) in patients with HF.MethodsEighty-nine patients with diagnosed HF who underwent both gated F-18 FDG PET/CT and cardiac MRI within 3 days were included in the analysis. Left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), and EF were obtained from gated F-18 FDG PET/CT using the Quantitative Gated SPECT (QGS) and 4D-MSPECT software.ResultsLV EDV and LV ESV measured by QGS were significantly lower than those measured by cardiac MRI (both P<0.0001). In contrast, the corresponding values for LV EDV for 4D-MSPECT were comparable, and LV ESV was underestimated with borderline significance compared with cardiac MRI (P = 0.047). LV EF measured by QGS and cardiac MRI showed no significant differences, whereas the corresponding values for 4D-MSPECT were lower than for cardiac MRI (P<0.0001). The correlations of LV EDV, LV ESV, and LV EF between gated F-18 FDG PET/CT and cardiac MRI were excellent for both QGS (r = 0.92, 0.92, and 0.76, respectively) and 4D-MSPECT (r = 0.93, 0.94, and 0.75, respectively). However, Bland-Altman analysis revealed a significant systemic error, where LV EDV (−27.9±37.0 mL) and ESV (−18.6±33.8 mL) were underestimated by QGS.ConclusionDespite the observation that gated F-18 FDG PET/CT were well correlated with cardiac MRI for assessing LV function, variation was observed between the two imaging modalities, and so these imaging techniques should not be used interchangeably.
Highlights
Heart failure (HF) is a severe public health problem with escalating prevalence and high mortality [1]
Several software packages for the quantification of ventricular function are available for clinical practice, including Quantitative Gated SPECT (QGS), 4D-MSPECT, and Emory Cardiac Toolbox (ECTB) [7,11,12]
left ventricular (LV) end-diastolic volume (EDV) measured by cardiac magnetic resonance imaging (MRI) ranged from 88 to 568 mL
Summary
Heart failure (HF) is a severe public health problem with escalating prevalence and high mortality [1]. A variety of non-invasive techniques are available to assess LV volume and function, including 2dimensional (2D) echocardiography, magnetic resonance imaging (MRI), radionuclide ventriculography, and gated single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) [4,5,6,7,8,9,10]. Several software packages for the quantification of ventricular function are available for clinical practice, including Quantitative Gated SPECT (QGS), 4D-MSPECT, and Emory Cardiac Toolbox (ECTB) [7,11,12]. The aim of the study was to investigate the consistency and correlation between gated F-18 FDG PET/CT using QGS and 4D-MSPECT software packages and cardiac MRI for the assessment of LV volume and function in HF patients
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