Quantitative radionuclide angiocardiography: Detection and quantitation of left to right shunts

doi:10.1016/0002-9149(76)90287-3

The American Journal of Cardiology

Volume 37, Issue 3, 4 March 1976, Pages 382-387

https://doi.org/10.1016/0002-9149(76)90287-3 Get rights and content

Abstract

In 105 patients detection and quantitation of left to right shunts was performed using quantitative radionuclide angiocardiography. The radionuclide angiocardiograms were acquired and analyzed by a gamma camera interfaced to a digital computer system. Pulmonary to systemic flow ( $Qp Qs$ ) ratios were calculated by analysis of pulmonary time-activity histograms using a gamma variate model. All patients were studied with cardiac catheterization, left ventricular angiocardiography and radionuclide angiocardiography. The radionuclide method allowed precise detection and quantitation of left to right shunts with a $Qp Qs$ ratio of 1.2 to 3.0. There was good agreement between the $Qp Qs$ ratio calculated by oximetry at cardiac catheterization and radionuclide angiocardiography (r = 0.94). The information gathered with this nontraumatic method appears sufficiently reliable to be used in the management of patients.

References (3)

DL Maltz et al.
Quantitative radionuclide angiocardiography: determination of Qp:Qs in children
Circulation
(1973)

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Cited by (55)

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First-pass radionuclide angiography (RNA) stands out as the best technology available for the investigation of short duration phenomena, including peak exercise, that affect the left and right ventricles. Perhaps most importantly, the introduction of the Tc-99m sestamibi has made it possible to combine all the measurements of regional and global ventricular function and volume obtainable from first-pass data with high resolution tomographic myocardial perfusion imaging, thus providing the mostcomprehensive noninvasive evaluation ever available of the patient with known or suspected coronary heart disease.
An automated algorithm for radionuclide angiocardiographic quantitation of circulatory shunting
1984, Computers and Biomedical Research
Circulatory shunting may be quantitated by analysis of time-activity curves obtained from radionuclide angiocardiography. A new automated algorithm for performing this analysis is proposed. The algorithm uses mathematical deconvolution techniques to increase the temporal separation of the components of this curve and thereby improves the accuracy of the analysis. The stability of the algorithm to random data errors was assessed by experiments on simulated time-activity curves degraded with pseudorandom noise. Excellent performance was obtained on a set of test problems previously used in the literature. The algorithm was used to quantitate left-to-right shunting in patients undergoing radionuclide angiocardiography during cardiac catheterization. A strong correlation (r = 0.96) was found between pulmonary to systemic flow ratios (Qp : Qs) obtained using the algorithm on radionuclide angiocardiographic data and Qp : Qs values obtained by oximetry at cardiac catheterization.
Effects of age on radionuclide angiographic detection and quantitation of left-to-right shunts
1984, The American Journal of Cardiology
The usefulness of quantitative radionuclide angiography (RNA) in detecting left-to-right shunts and estimating shunt size in young children was assessed. The total population of 88 patients was divided into 2 groups: 23 patients 2 years of age and younger (mean 0.8 ± 0.6 [± standard deviation]) and 65 patients older than 2 years (mean 15 ± 15 years). The accuracy of 2 different RNA shunt estimation techniques, the gamma variate and the Stewart-Hamilton approach, were compared with the estimations obtained at cardiac catheterization using Fick (88 patients) and indocyanine green dye-dilution techniques (20 patients). Automated data processing algorithms were used to determine the RNA estimations, thereby avoiding the effects of operator judgment and subjectivity on shunt estimation. of the 88 patients, 16 had no shunt by Fick data (that is, estimation <20%) but had a left-to-right shunt demonstrated by cardiac catheterization cineangiocardiography. Nine of these patients had no shunt by RNA (that is, estimation <20%). For patients 2 years of age and younger, linear regression analysis of the Fick and gamma variate data provided a slope of 0.63 and a correlation coefficient of 0.82; analysis of the Fick and Stewart-Hamilton data provided a slope of 0.59 and a correlation coefficient of 0.79. For patients older than 2 years, analysis of the Fick and gamma variate data provided a slope of 0.63 and a correlation coefficient of 0.79; analysis of the Fick and Stewart-Hamilton data provided a slope of 0.64 and a correlation coefficient of 0.76. These same analyses for the entire patient population provided correlation coefficients of 0.81 and 0.78, respectively. This study demonstrates that RNA estimation and detection of left-to-right shunt can be performed as successfully and accurately in the infant and young child as in the older patient.

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^☆: This study was supported in part by Grant 5-PO1-HL 10436-07 of the National Heart and Lung Institute, National Institutes of Health, Bethesda, Md.

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MethodQuantitative radionuclide angiocardiography: Detection and quantitation of left to right shunts☆

Abstract

Quantitative radionuclide angiocardiography: determination of Qp:Qs in children

Circulation

Method
Quantitative radionuclide angiocardiography: Detection and quantitation of left to right shunts☆