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AJR. American Journal of Roentgenology Nov 2008The objective of our study was to examine the correlation between CT-based and radionuclide renography-based measures of split renal function in a healthy population of... (Comparative Study)
Comparative Study
OBJECTIVE
The objective of our study was to examine the correlation between CT-based and radionuclide renography-based measures of split renal function in a healthy population of live potential kidney donors using 3D models generated from CT angiography.
MATERIALS AND METHODS
The records of 173 renal donor candidates who had undergone CT and radionuclide renography between March 1, 2005, and February 28, 2006, were retrospectively evaluated; of those 173 patients, 152 met study inclusion criteria. A blinded investigator using 3D models that were created semiautomatically from the unenhanced, arterial, and excretory phase data made measurements of CT renal volumes and attenuations. The mean renal attenuation and volume were used to calculate the net accumulation of contrast material and split renal function for comparison with radionuclide renography. Split function from CT was calculated in the arterial and excretory phases as well as based on split renal volume and the Patlak method.
RESULTS
All four CT-based methods for the calculation of split renal function showed correlation with no significant difference from radionuclide renography (p > 0.05, Student's t test). Pearson's correlation coefficients varied from 0.36 to 0.63 (p < 0.001 for each). Difference scores revealed that the excretory and renal volume splits had the narrowest range and showed a linear, nonzero relationship to the renography splits. Bland-Altman analysis confirmed that the majority of difference scores between each CT method and the radionuclide renography were within the 95% CI of the differences.
CONCLUSION
Split renal function based on 3D CT models can provide a "one-stop" evaluation of both the anatomic and the functional characteristics of the kidneys of living potential kidney donors. The excretory phase data and the split renal volume data show the best correlation and the smallest difference scores compared with radionuclide renography data.
Topics: Adult; Angiography; Female; Gamma Cameras; Humans; Imaging, Three-Dimensional; Kidney Function Tests; Male; Middle Aged; Radiographic Image Enhancement; Radiographic Image Interpretation, Computer-Assisted; Radioisotope Renography; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 18941100
DOI: 10.2214/AJR.07.4023 -
The American Journal of Cardiology Aug 1999Left ventricular (LV) systolic dysfunction, as indicated by a reduced LV ejection fraction (EF) is a potent predictor of cardiovascular mortality. Radionuclide... (Comparative Study)
Comparative Study
Comparison of echocardiography and radionuclide angiography as predictors of mortality in patients with left ventricular dysfunction (studies of left ventricular dysfunction).
Left ventricular (LV) systolic dysfunction, as indicated by a reduced LV ejection fraction (EF) is a potent predictor of cardiovascular mortality. Radionuclide angiography accurately and reproducibly assesses LVEF; however, echocardiography is used more frequently in clinical practice. Whether these methods predict similar mortality has not been fully investigated. We performed a retrospective analysis of patients with baseline radionuclide angiographic (RNA; n = 4,330) and echocardiographic (echo; n = 1,376) based EFs < or =0.35 who were enrolled in the Studies Of Left Ventricular Dysfunction (SOLVD) to address this hypothesis. After adjusting for important prognostic variables, the risk of death (RR 1.15; 95% confidence interval 1.01 to 1.30; p = 0.03) and of cardiovascular death (RR 1.15; 95% confidence interval 1.01 to 1.32; p = 0.04) was higher for patients with ECG-based EFs. To compare the 2 techniques across a range of EF values, we divided the cohort into tertiles of EF. The adjusted risk estimates for all-cause and cardiovascular mortality were similar within each tertile. Of note, the mortality difference in patients with echo- versus RNA-based EFs was most prominent in women. Further, patients with echo-based EFs had significantly higher mortality at sites where this technique was less frequently used to assess the EF. Thus, for a given EF < or =0.35, an echo-based value was associated with a higher risk of death compared with the RNA-based method of measurement. These data suggest that EF values determined by echocardiography and radionuclide angiography predict different mortality and this may, in part, be related to technical proficiency as well as patient characteristics.
Topics: Adult; Aged; Aged, 80 and over; Cause of Death; Echocardiography; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Radionuclide Ventriculography; Retrospective Studies; Risk; Stroke Volume; Ventricular Dysfunction, Left
PubMed: 10496439
DOI: 10.1016/s0002-9149(99)00280-5 -
Chest Mar 2009Right ventricular function is a key determinant of exercise capacity and survival in pulmonary arterial hypertension (PAH). We aimed to study the predictors of right...
BACKGROUND
Right ventricular function is a key determinant of exercise capacity and survival in pulmonary arterial hypertension (PAH). We aimed to study the predictors of right ventricular ejection fraction (RVEF) in patients with newly diagnosed PAH.
METHODS
We performed a cross-sectional analysis of a retrospective cohort of consecutive patients with idiopathic, familial, or anorexigen-associated PAH who underwent equilibrium radionuclide angiography for measurement of RVEF at baseline.
RESULTS
Of the 84 patients in the cohort, 63 underwent equilibrium radionuclide angiography and right heart catheterization and were included. The mean age was 41 +/- 13 years, and 79% of the patients were female. The mean RVEF was 30 +/- 8%. RVEF was directly associated with right ventricular stroke volume index and cardiac index, and inversely associated with pulmonary vascular resistance index from right heart catheterization (all p < 0.001). Older age and male sex were associated with lower RVEF (p < 0.05) after adjustment for pulmonary vascular resistance index and left ventricular ejection fraction. Higher plasma von Willebrand factor levels were also independently associated with lower RVEF (p = 0.01) (n = 55). Body size and type of PAH were not associated with RVEF.
CONCLUSIONS
Older patients and males with PAH had lower RVEF at baseline than younger patients and females, even after controlling for left ventricular function and hemodynamics. Higher plasma von Willebrand factor levels, a marker of endothelial dysfunction, were also associated with lower RVEF.
Topics: Adult; Cardiac Catheterization; Cardiac Output; Female; Gated Blood-Pool Imaging; Humans; Hypertension, Pulmonary; Hypertrophy, Right Ventricular; Male; Stroke Volume; Vascular Resistance; Ventricular Function, Right
PubMed: 18849396
DOI: 10.1378/chest.08-1758 -
Journal of Nuclear Medicine : Official... Jun 1998The purpose of this study was to validate the accuracy of the assessment of ventricular function by first-pass radionuclide angiography (FPRNA) with 123I myocardial...
UNLABELLED
The purpose of this study was to validate the accuracy of the assessment of ventricular function by first-pass radionuclide angiography (FPRNA) with 123I myocardial tracers and a multicrystal gamma camera.
METHODS
Left ventricular ejection fraction (LVEF) and right ventricular ejection fraction were measured in 69 patients by FPRNA using 123I myocardial tracers (126 +/- 7 MBq) and 99mTc tracers (541 +/- 141 MBq) on a multicrystal gamma camera with a high-sensitivity collimator. For 44 patients, ejection fraction values measured by 123I-FPRNA were compared to those estimated by equilibrium radionuclide angiography (ERNA). Visual wall-motion analysis was also performed to judge clinical acceptability of 123I-FPRNA images for identification of wall-motion abnormality.
RESULTS
Mean LVEFs (%) estimated by 123I-FPRNA and by 99mTc-FPRNA were 49.6 +/- 13.6 and 49.1 +/- 14.1, respectively (nonsignificant p value). An excellent correlation was found between LVEFs estimated by 123I-FPRNA and 99mTc-FPRNA (r = 0.96, s.e.e. = 1.9%). Values of LVEF measured by 123I-FPRNA also demonstrated excellent correlation with those measured by ERNA (r = 0.95, s.e.e. = 2.2%). A good correlation was also noted between right ventricular ejection fractions measured by 123I-FPRNA and 99mTc-FPRNA (r = 0.72, s.e.e. = 4.0%). The Spearman rank correlation coefficient between 123I-FPRNA and ERNA wall-motion scores was 0.87 (n = 135, p < 0.001).
CONCLUSION
Resting ventricular function can be reliably measured with 123I-FPRNA in combination with a multicrystal gamma camera. This indicates that the assessment of ventricular function is feasible in conjunction with 123I myocardial imaging without an increase in cost or radiation dose to patients.
Topics: Adult; Aged; Aged, 80 and over; Female; Gamma Cameras; Heart Diseases; Humans; Iodine Radioisotopes; Male; Middle Aged; Myocardial Contraction; Stroke Volume; Ventricular Function; Ventriculography, First-Pass
PubMed: 9627322
DOI: No ID Found -
Clinical Cardiology Sep 1998Previous studies have demonstrated that epirubicin (EPI) has a lower propensity to produce cardiotoxic effects than doxorubicin (DXR) at high doses. (Clinical Trial)
Clinical Trial Comparative Study
BACKGROUND
Previous studies have demonstrated that epirubicin (EPI) has a lower propensity to produce cardiotoxic effects than doxorubicin (DXR) at high doses.
HYPOTHESIS
The aim of the study was to compare the cardiotoxicity induced by low doses of EPI and DXR in patients before and 1 month after the end of chemotherapy.
METHOD
In a prospective study, 99 patients with a mean age of 51 +/- 12 years and without cardiac disease were studied before and 1 month after the end of chemotherapy. Group 1 included 38 patients receiving 246 +/- 96 mg/m2 of DXR and Group 2 included 61 patients receiving EPI with and equivalent dose of 219 +/- 92 mg/m2 of DXR. Ejection fraction (EF) of the left ventricle (LV), peak ejection rate (PER), and peak filling rate (PFR) [expressed in end-diastolic volume/s (EDV/s)] were evaluated by gated radionuclide angiography; PFR/PER were also calculated.
RESULTS
Moderate and similar alterations of left ventricular ejection fraction were shown for low doses of anthracyclines. The EF of the LV decreased from 57 +/- 6% to 54 +/- 6% for DXR group (Group 1) (p = 0.005), and from 58 +/- 5% to 55 +/- 5% for the EPI group (Group 2)(p = 0.001). The PER of the left ventricle fell from 3.08 +/- 0.46 EDV/s to 2.79 +/- 0.49 in Group 1 (p = 0.004) and from 2.98 +/- 0.50 to 2.73 +/- 0.34 EDV/s in Group 2 (p = 0.001). In contrast, no significant alteration of PFR appeared in Group 2 (from 2.72 +/- 0.51 to 2.62 +/- 0.41 EDV/s) for the equivalent dose of anthracycline, while PFR of the LV dropped from 2.82 +/- 0.76 (EDV/s) to 2.41 +/- 0.55 after doxorubicin (p = 0.004). No difference was found between 1 and 12 months after the end of the treatment in 25 patients in Group 1 and 28 patients in Group 2. These results confirm the advantage of EPI over DXR in terms of cardiotoxicity and help explain the relationship of cellular damage mechanisms with the functional parameters of nuclear investigation.
CONCLUSION
A possible explanation for specific alteration after DXR could be the increased production of semiquinone free radicals, which are known to induce membrane damage and, consequently, myocardial edema and diastolic alteration.
Topics: Adult; Aged; Antibiotics, Antineoplastic; Breast Neoplasms; Diastole; Doxorubicin; Epirubicin; Female; Follow-Up Studies; Gated Blood-Pool Imaging; Heart; Humans; Middle Aged; Prospective Studies; Stroke Volume; Technetium; Ventricular Function, Left
PubMed: 9755384
DOI: 10.1002/clc.4960210911 -
Clinical Cardiology Mar 1987Twenty-one normal young male subjects underwent resting and exercise (bicycle) radionuclide angiography in the full supine and 70 degrees upright tilt positions in order...
Twenty-one normal young male subjects underwent resting and exercise (bicycle) radionuclide angiography in the full supine and 70 degrees upright tilt positions in order to examine the effects of position on left ventricular size and performance, hemodynamics, and exercise duration. All subjects also underwent full (90 degrees) upright bicycle ergometry with respiratory gas analysis to establish the level of maximal exercise capacity for each. Body position significantly (p less than 0.05) affected resting and exercise cardiovascular parameters. End-diastolic and endsystolic left ventricular volumes and stroke volume were larger in the supine position, both at rest and during exercise. The cardiac output at rest and during exercise were comparable for the two positions; an increase in resting and exercise heart rate in the 70 degrees tilt position compensated for the reduced stroke volume of this posture. At maximal exercise, the 70 degrees upright position was associated with a greater response in left ventricular ejection fraction, otherwise this parameter was not position related. Exercise capacity, in terms of duration and workload, was significantly higher in the supine (1870 +/- 390 s) and full upright (1830 +/- 250 s) positions than in the 70 degrees tilt position (1730 +/- 260 s). Changes in body position significantly alter parameters of ventricular, cardiovascular, and exercise performance.
Topics: Adult; Blood Pressure; Cardiac Output; Cardiovascular Physiological Phenomena; Cardiovascular System; Exercise Test; Heart Rate; Humans; Male; Oxygen Consumption; Posture; Radionuclide Angiography; Reference Values
PubMed: 3829483
DOI: 10.1002/clc.4960100302 -
Journal of Nuclear Medicine : Official... Mar 1988A portable multiwire gamma camera (MWGC) with enhanced imaging characteristics relative to conventional sodium iodide camera has been evaluated with 178Ta, a... (Comparative Study)
Comparative Study
A portable multiwire gamma camera (MWGC) with enhanced imaging characteristics relative to conventional sodium iodide camera has been evaluated with 178Ta, a short-lived, generator-produced radioisotope (half-life 9.3 min). First-pass radionuclide angiography (FPRA) was performed and results were compared to those obtained with FPRA using a multicrystal camera (MCC) and 99mTc in 38 patients. The overall left ventricular count sensitivity (counts/mCi/sec/millisteradians [msr]) was significantly higher with MWGC/178Ta (176 +/- 132 versus 108 +/- 49, p less than 0.001) yielding images of higher statistics with higher resolution collimation (31 versus 63 msr). Left ventricular ejection fraction was 0.54 +/- 0.18 by MWGC and 0.54 +/- 0.18 by MCC with an excellent correlation between the two techniques (r = 0.94, s.e.e. = 0.06). The detection of wall motion abnormality was virtually identical with the two techniques. Intra- and interobserver reproducibility by MWGC was excellent (r = 0.99 and 0.99, respectively). Thus, this new technology provides first-pass studies of higher statistical quality and improved resolution, affording more precise assessment of left ventricular performance and likelihood of further substantial improvement by use of even higher doses of 178Ta.
Topics: Adult; Aged; Aged, 80 and over; Coronary Disease; Female; Humans; Male; Middle Aged; Myocardial Contraction; Radioisotopes; Radionuclide Angiography; Stroke Volume; Tantalum; Technetium
PubMed: 3346739
DOI: No ID Found -
Journal of Nuclear Medicine : Official... Oct 2004In addition to providing quantitative ventricular function information, gated SPECT and radionuclide angiocardiographic studies can evaluate regional wall motion and... (Comparative Study)
Comparative Study Review
In addition to providing quantitative ventricular function information, gated SPECT and radionuclide angiocardiographic studies can evaluate regional wall motion and ventricular volumes. This review focuses on the combined assessment of myocardial perfusion and left ventricular function. Two clear roles for nuclear imaging in clinical practice include the diagnosis of coronary artery disease and assessment of prognosis in patients with known coronary artery disease. Ventricular function information can help differentiate an attenuation artifact from an infarct and is helpful in diagnosing 3-vessel coronary disease. Additionally, several studies have highlighted the prognostic benefit to combined assessment of myocardial perfusion and ventricular function. Several new modalities have recently been reported that promise to continue to solidify the place of nuclear imaging in the diagnosis and prognosis of coronary artery disease.
Topics: Coronary Artery Disease; Heart Ventricles; Humans; Image Enhancement; Prognosis; Radionuclide Angiography; Subtraction Technique; Tomography, Emission-Computed, Single-Photon; Ventricular Dysfunction, Left
PubMed: 15471840
DOI: No ID Found -
The American Journal of Cardiology Aug 1989This study compared the results of stress and rest single-photon emission computed tomography imaging of myocardial perfusion using technetium-99m isonitrile (RP-30A)... (Comparative Study)
Comparative Study
Use of technetium-99m isonitrile (RP-30A) in assessing left ventricular perfusion and function at rest and during exercise in coronary artery disease, and comparison with coronary arteriography and exercise thallium-201 SPECT imaging.
This study compared the results of stress and rest single-photon emission computed tomography imaging of myocardial perfusion using technetium-99m isonitrile (RP-30A) with the results of stress and redistribution tomographic thallium imaging and the results of coronary arteriography in 39 patients, 11 without and 28 with coronary artery disease (CAD). Each patient underwent 2 exercise studies at identical workload, heart rate and double product. In a subset of 13 patients, concomitant evaluation of left ventricular (LV) function using first-pass radionuclide angiography with a multi-crystal camera also was performed with bolus injections of isonitrile. Isonitrile had similar sensitivity (82 vs 82%, difference not significant), a slightly--but not significantly--higher specificity (100 vs 82%) and similar predictive accuracy (87 vs 82%) to thallium-201. The tracer uptake was assessed in 20 segments/study. There was concordance between the isonitrile and thallium-201 images in 723 of the 780 segments (93%) (kappa = 0.83 +/- 0.02). In general, the isonitrile images were considered of better quality than the thallium-201 images. All 10 patients with CAD who underwent concomitant first-pass radionuclide angiography had either perfusion abnormalities or an abnormal ejection fraction response to exercise. Thus, technetium-99m isonitrile provides a reliable method of assessment of CAD with a sensitivity, specificity and predictive accuracy comparable to that of exercise thallium-201 imaging. Additional advantages include better image quality and the ability to obtain concomitant assessment of LV function with the use of first-pass radionuclide angiography.
Topics: Angiography; Coronary Angiography; Coronary Disease; Exercise Test; Female; Heart; Humans; Male; Middle Aged; Myocardial Contraction; Organometallic Compounds; Radionuclide Angiography; Technetium; Technetium Tc 99m Sestamibi; Thallium Radioisotopes; Tomography, Emission-Computed
PubMed: 2526991
DOI: 10.1016/0002-9149(89)90518-3 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Oct 2012Left ventricular ejection fraction (LVEF) is the most important measurement of the left ventricular function and the most commonly used parameter in clinical cardiac... (Review)
Review
Left ventricular ejection fraction (LVEF) is the most important measurement of the left ventricular function and the most commonly used parameter in clinical cardiac imaging. LVEF can be measured with different cardiac imaging techniques: left ventricular contrast angiography by catheterization, echocardiography, radionuclide ventriculography, cardiac magnetic resonance imaging and cardiac computed tomography. In this article, we reviewed the specifics of each of the cardiac imaging modality, their strength and pitfalls. We also compared the consistency and variance between them. The selection of a specific cardiac imaging modality in clinical practice should depend on the indications, local expertise and the historic data of the patient. In general, these cardiac imaging modalities correlate well, but the variance and standard deviation are large so the measurement numbers should not be used interchangeably.
Topics: Echocardiography; Humans; Magnetic Resonance Imaging; Radionuclide Ventriculography; Tomography, X-Ray Computed; Ventricular Function, Left
PubMed: 23073577
DOI: No ID Found