Comparison of Left Ventricular Ejection Fraction Values from Equilibrium Radionuclide Angiocardiography between Planar and SPECT Techniques in Breast Cancer Patients
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Abstract
Background: Breast cancer patients receiving anthracycline-based chemotherapy are at risk of cardiotoxicity, which may lead to heart failure. Assessing the left ventricular ejection fraction (LVEF) is critical prior to each chemotherapy cycle. Equilibrium radionuclide angiocardiography is a noninvasive imaging technique commonly used for cardiac function evaluation. However, planar imaging may be affected by interference from adjacent tissues, particularly in patients with left-sided breast tumors or postoperative inflammation. SPECT imaging offers a three-dimensional approach that may improve accuracy by minimizing such interference. This study aims to compare the LVEF values obtained from planar and SPECT techniques.
Objective: To compare LVEF values between planar and SPECT imaging techniques in breast cancer patients undergoing nuclear cardiology evaluation.
Methods: A retrospective study was conducted with 160 breast cancer patients who underwent equilibrium radionuclide angiocardiography using 99mTc-RBC radiopharmaceuticals and were imaged with both planar and SPECT techniques on a SPECT/CT scanner. LVEF values of planar and SPECT images were analyzed using Syngo.Via™ and QBS software, respectively. The Wilcoxon Signed-Rank test was used to compare LVEF values, and Pearson’s correlation was employed to assess their relationship.
Results: The mean LVEF from planar imaging was 66.7 ± 6.7%, while that from SPECT was 74.4 ± 9.2%. The difference was statistically significant (p < 0.001), with a strong positive correlation between the two techniques (r = 0.645, p < 0.001).
Conclusion: SPECT imaging yields significantly higher and potentially more accurate LVEF values than planar imaging, particularly in patients where anatomical interference may impact planar results. SPECT should be considered a preferable method for cardiac assessment in breast cancer patients and may serve as a new standard in equilibrium radionuclide angiocardiography.
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