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KMID : 1143620160200010013
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Korean Journal of Nuclear Medicine Technology
2016 Volume.20 No. 1 p.13 ~ p.19
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Effect of the Angle of Ventricular Septal Wall on Left Anterior Oblique View in Multi-Gated Cardiac Blood Pool Scan
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You Yeon-Wook
Lee Chung-Wun
Seo Yeong-Deok
Choi Ho-Yong
Kim Yun-Cheol
Kim Yong-Geun
Won Woo-Jae
Bang Ji-In
Lee Soo-Jin
Kim Tae-Sung
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Abstract
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Purpose :In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (θ) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view.
Materials and Methods : From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (θ) between ventricular septum
and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of θ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO θ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed.
Results : Mean ± SD of θ on total 253 patients was 37.0 ± 8.5°. Among them, the patients whose difference between 45
and θ degrees were more than ± 10 degrees were 88 patients (29.3 ± 6.1°). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO θ (LVEF 45 = 62.0 ± 6.6% vs. LVEF θ = 64.0 ± 5.6%; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO θ (LVEF 45 = 66.7 ± 7.2% vs. LVEF θ = 69.0 ± 6.4%; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO θ, there was no significant difference statistically.
Conclusion : We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal
view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO θ view.
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KEYWORD
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Multi-gated cardiac blood pool scan (GBP), left anterior oblique (LAO), ventricular septal wall, left ventricular ejection fraction (LVEF)
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