Comparison of gated SPECT, echocardiography and cardiac magnetic resonance imaging for the assessment of left ventricular ejection fraction and volumes

Background: Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume (ESV) can be determined non-invasively by two-dimensional echocardiography (ECHO), gated single photon emission computed tomography (GSPECT) and cardiac magnetic resonance imaging (CMRI). This study was designed to analyze the concordance between LVEF, EDV and ESV values derived from ECHO, GSPECT and CMRI. Methods: ECHO, GSPECT and CMRI were performed in a group of 21 patients with suspected coronary artery disease. LVEF, EDV and ESV values were calculated. Results: The mean LVEF measured with GSPECT, ECHO and CMRI were 55.9±17.8%, 55.7±16.4% and 56.4±15.7%, respectively. The mean EDV measured with GSPECT, ECHO and CMRI were 109.2±42.4 mL, 127.5±42.2 mL and 91.1±38.0 mL, respectively. The mean ESV measured with GSPECT, ECHO and CMRI were 54.2±41.2 mL, 59.9±37.6 mL and 41.8±26.9 mL, respectively. The results of linear regression analysis showed very good correlation between LVEF and ESV values derived from GSPECT, ECHO and CMRI (r=0.91, r=0.92, r=0.97 for LVEF and r=0.86, r=0.91, r=0.91 for ESV, P< 0.01). Good correlations were found between EDV values obtained from GSPECT, ECHO and CMRI (r=0.71, r=0.68, r=0.73, P< 0.01). Agreement between these techniques in LVEF values was also good, but not in LV volumes, according to Bland-Altman plots. Conclusions: This study showed good overall correlations between LVEF, EDV and ESV values derived from GSPECT, ECHO and CMRI. LVEF obtained from any of these three imaging modalities could be used interchangeably. However, care should be taken in comparing LV volumes