• The Korean Journal of Nuclear Medicine
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• v.17 no.1
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• pp.11-15
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• 1983

Left ventricular volume would be useful in the diagnosis and treatment of patients with various heart diseases. So we measured left ventricular volume index using gated blood pool nuclear cardiac angiography which was easy to perform, non-invasive, and capable of repetitive studies. These left ventricular volume indices were compared with left ventricular volumes by quantitative cardiac cine-angiography and the results were as follows, 1. The correlation coefficient between left ventricular volume indices and left ventricular volumes was 0.829 (p<0.001). 2. The correlation coefficient between left ventricular volume indices and absolute left ventricular volumes which were obtained by measurement of cardiac output of patients. 3. There were good correlation in intraobserver and interobserver analysis.

• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.67-72
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• 1985

The development of paradoxical interventricular septal motion is a common consequence of cardiopulmonary bypass operation. The reason for this postoperative abnormal septal motion is not clear. 41 patients were studied preoperatively and postoperatively with radionuclide blood pool scan to evaluate the frequency of development of paradoxical septal motion with right ventricular volume overload before surgery and the frequency of development of paradoxical septal motion after cardiac surgery with cardiopulmonary bypass, and to evaluate the change of EF related to the development of paradoxical septal motion after cardiac surgery. The results were as follows; 1) 7 of 41 patients with right ventricular volume overload(that is 17%) showed paradoxical septal motion before surgery. But 13 of 34 patients(that is 42%) had paradoxical septal motion after cardiac surgery with cardiopulmonary bypass. So open heart surgery with cardiopulmonary bypass related the development of paradoxical septal motion after surgery. 2) EF significantly decreased in patients who developed paradoxical septal motion after surgery, whereas the EF did not change in the patients who retained normal interventricular septal motion after surgery. So paradoxical septal motion usually reflected some diminution of left ventricular function, immediately after cardiac surgery.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.57-61
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• 2015

Purpose We considered the correlation of Ejection Fraction (EF) which was analyzed by Multi Gated Blood Pool Scan (MUGA) and Echocardiography (ECHO) for the patients who were classified according to the condition of cardiac function. Materials and Methods We analyzed the patients (female 60) who were diagnosed with breast cancer and were examined by both MUGA and ECHO. The 30 patients (age: $58.27{\pm}13.48$) who were analyzed into less than 50% to 70% of EF were categorized as normal group and the other 30 patients (age: $53.70{\pm}8.45$) who were analyzed into less than 50% of EF were categorized as abnormal group. Statistical analysis with SPSS ver. 18 was applied. Results Each of the value of mean and standard deviation of normal group was $66.43{\pm}5.80$ (MUGA), $60.50{\pm}4.93$ (ECHO). There was a significant difference (p<0.001). Each of the value of mean and standard deviation of abnormal group was $41.93{\pm}7.58$ (MUGA), $41.70{\pm}11.49$ (ECHO). There was no significant difference (p>0.001). In the result, all 30 cases of normal group showed the same reading. 8 out of 30 cases in abnormal group showed inconsistency of the reading. Conclusion We could confirm the correlation of the EF in MUGA and ECHO statistically. There was difference between abnormal groups from the result of reading. If we are aware of the result according to the different cardiac function categorization, MUGA and ECHO can be used as even more accurate interchangeable test.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.222-228
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• 2008

Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.27-36
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• 1991

Thirty-one patients with coronary artery disease and twenty-sir normal subjects underwent $^{99m}Tc-GBPS$ before and after coronary vasodilatation was induced by dipyridamle 0.54 mg/kg given IV over 4 min. LVEF, ${\Delta}EF$ and regional wall motion by phase analysis were measured during rest and dipyridamole infusion. The results were as follows: 1) Mean LVEF of normal subjects was significantly higher than that of MI group (p=0.001), but similar to that of angina group during rest. Among MI group, mean LVEF of anterior MI group was significantly lower than that of inferior MI group during rest (p=0.024). 2) The normal subjects had a significaat increase in mean LVEF during dipyridamole infusion $(+12{\pm}3.8)$, while the CAD group had no increase $(+2{\pm}5.0)$ (p<0.001). If an increase of LVEF during stress is less than 5%, it suggests an abnormality. The sensitivity and specificity of LVEF changes after dipyridamole infusion were 81%, 96%, respectively. 3) With phase analysis, LV mean phase angle of normal subjects and CAD patients was $143{\pm}20.5^{\circ},\;132{\pm}20.6^{\circ}$ respectively, durign rest (p=0.049). But an ncrease of LV mean phase angle during dipyridamole infusion in these two groups was not significantly different. Dipyridamole infusion did not affect standard deviation and FWHM of phase angle. 4) Regional wall motion was abnormal in 5 patients (16%) during dipyridamole infusion. 5) Side effects with dipyridamole infusion include; headache, angina pain, chest discomfirt, nausea, weakness sense. In conclusion, dipyridamole GBPS might be useful in detection and follow up of CAD.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.172-176
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• 1994

As the Tc-99m-MIBI myocardial SPECT demonstrated wide application in the diagnosis of myocardial function, the quantitative and severity-dependent information is currently re quired. In this study, we proposed a computerized method for scoring the fixed defects in terms of extent-weighted severity and for identifying the reversibility in ischemic regions. At the first stage of this method, the transverse slices were reconstructed with 0.4 Nyquist freq. and order 5 Butterworth filter. From the oblique/sagittal slices, maximal count per pixel circumferential profiles were extracted for each sector, and then stress/redist. polar maps were normalized and plotted. For reversibility, the stress polar map was subtracted from the de-layed image and positive-valued pixels were categorized into three grades. The extent-weight-ed severity scores were calculated using the assigned grades and their number of pixels. This procedure was done automatically and the reversibility and severity scores were produced for each of the coronary territories (LAD, RCA, LCX) or any combination of these. Clinical ap-plication has shown that the changes In reversibility scores after PTCA were correlated linearly with the pre PTCA scores(r>0.8) in postinfarct cases as well as in angina, and severity scores of persistent defects in stress/rest SPECT study matched to the regional ejection fraction and visual analysis of regional wall motion of gated blood pool scan(r>0.6). We conclude that the computerized severity scoring method for the analysis of myocardial SPECT could be useful in the assessment of the myocardial ischemia and fixed defect.

• The Korean Journal of Nuclear Medicine
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• v.23 no.2
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• pp.175-181
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• 1989

Visual assessment of regional wall motion abnormality (RWMA) by gated blood pol scan (GBPS) serves as an useful parameter in the diagnosis, functional evaluation, and follow up in various clinical settings, but are still subject to some inherent limitations. On important problem may be the interobserver as well as intraobsever variation that may well be present due to the subjective nature of the interpretations. This study was carried out to determine the reliability and reproducibility of visual assessments made in GBPSs, and to observe the degree to which the results would be influenced by observer variation. Fifty two patients with coronary heart disease had resting GBPS and contrast ventriculography within 4 days appall. Contrast ventriculography-showed normal wall motion in 6 patients and the remaining 46 had RWMA in one or more segments. The anterior and left anterolateral views of all 52 GBPSs were analyzed by three independent observers, who selected from 5 scales, their level of confidence that there was RWMA in that segment. Reciever operating characteristic (ROC) curves for each analysis was plotted and the area under the curve $(\theta)$ was used as a parameter representing each observer's performance in his interpretations. The findings of contrast ventriculographies were used as the standard for RWMA. The apical and inferoapical segments showed the best correlation with contrast ventriculography ($\theta=0.90-0.94$, 0.81-0.94, respectively), and the inferior wall showed the poorest correlation $(\theta=0.70-0.74)$. The interpretations of the inferior, septal, apical, and posteroinferior, segments showed no difference between the observers, but there was significantly better performance in assessment by observer A compared to that by B or C for the anterolateral segments ($\theta=0.87$, 0.78, 0.76, respectively. p<0.01 for A vs B, p<0.05 for A vs C), as well as when all segments were considered altogether ($\theta=0.88$, 0.83, 0.82, respectively. both p<0.05). This was also true for the infero-apical segment between A and C ($\theta=0.09$, 0.81, p<0.05). The intraobserver variation, however, did not appear significant, with only the inferior segment for observer B showing any significant difference when observer A and B repeated the analysis 10 days latter. There was no difference in assessing dyskinesia, with all observers showing a high performance ($\theta=0.98$, 0.87, 0.97, respectively). The visual assessment of left ventricular ejection fraction by all three observers correlated well with the calculated value from a semiautomated method (Spearman's r = 0.91, 0.83, 0.83. p<0.01, p<0.05, p < 0.05). The assessment of LV and RV size also correlated well between the three observers (Kendall's w = 0.80, 0.51, p<0.01 for both left and right ventricles). The above findings suggest that RWMA visually assessed by GBPS correlates well with that done by contrast ventriculography. And although the observer's experience or skill may influence the results in certain segments, visual analysis of GBPS may serve as a reliable and reproducible means for evaluating ventricular function.