V. G. Kumar Das, Gouri (2020) A Comparative Study Of Assessing Left Ventricular Ejection Fraction By Two Dimensional Echocardiography With REST Gated Blood Pool Ventriculography Using Conventional Sodium Iodide And Cadmium Zinc Telluride Cameras. Masters thesis, Universiti Sains Malaysia.
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Abstract
Aim: To validate and compare the correlation and agreement between two- dimensional (2D) echocardiography and Rest Gated Blood Pool Ventriculography (GBPV) using both planar sodium iodide (Nal) and cadmium-zinc-telluride (CZT) cameras to measure left ventricular ejection fraction (LVEF). Methodology: A total of 109 breast cancer patients, both receiving (84) and scheduled to receive (25) cardiotoxic cancer treatment, underwent 2D-echocardiography, followed by GBPV using both planar Nal and CZT cameras on the same day at the Cardiology and Nuclear Medicine Department of Hospital Sultanah Aminah, Johor Bahru respectively. For the CZT camera, both automatic and manual processing methods were applied, yielding a total of four different methods for the LVEF analysis in this study. Results: Data from the 109 patients showed the highest mean LVEF was 70.1 ± 10.7%, for CZT manual-processing, and lowest for planar camera with a mean of 58.8 ± 10.0%. The mean LVEF for 2D-echocardiogram and CZT auto-processing were respectively 61.8± 6.1% and 64.3 ± 11.3%. LVEF values were significantly higher for CZT manual-processing compared to planar camera, CZT auto-processing and 2D-echocardiography (p < 0.05). No significant difference in mean LVEF was noted when comparing 2D-echocardiography with CZT auto-processing (p = 0.24) and planar camera (p = 0.10). The mean LVEF derived from CZT auto-processing was also significantly higher than that from planar camera (p < 0.05). Although there was significant correlation (p < 0.01) among all four methods, the correlation strengths were varied. Moderate correlation was seen between 2D-echocardiogram and other modalities: Nal camera (r = 0.56); CZT automatic (r = 0.54); CZT manual (r = 0.56). Strong correlation was registered between planar and CZT (r = 0.71 and 0.72, respectively for manual- and auto-processing). The strongest correlation was between the automatic- and manual-processing methods of CZT (r = 0.94). The Bland-Altman limits of agreement among the three scans were wide and suboptimal. The widest limits were -21.1 to +16.2 (37%) between 2D echocardiography and CZT auto-processing. Good agreement was seen between the auto- and manual-processing methods for CZT camera with a limit agreement of -2.0 to +13.5 (15%). Conclusion: Although there is significant correlation between the four methods of measurement of LVEF, the correlation strength is only moderate between 2D-echocardiography and GBPV using the planar Nal and CZT cameras. All three scans showed suboptimal limits of agreement between them and hence should not be used interchangeably. Any one of the modalities can be used to measure LVEF based on local availability; however, the same method of measurement is advised for serial scans.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine |
| Divisions: | Institut Perubatan & Pergigian Termaju (Advanced Medical & Dental Institute (AMDI)) > Thesis |
| Depositing User: | NOR HASHIMY BIN ABDULLAH |
| Date Deposited: | 19 May 2026 03:03 |
| Last Modified: | 19 May 2026 03:03 |
| URI: | http://eprints.usm.my/id/eprint/64236 |
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