Results from an Australian and New Zealand audit of left ventricular ejection fraction from gated heart pool scan analysis

Abstract

Aim: A voluntary audit was undertaken to compare left ventricular ejection fraction (LVEF) calculations from gated heart pool studies using software packages currently available throughout Australia and New Zealand (ANZ).

Methods: A data set previously developed by a task group of the Institute of Physics and Engineering in Medicine (IPEM) consisting of 12 planar gated studies with LVEF ranging from 17 to 67% was provided to each site with worksheets to record individual technologist's results as well as information about individual department's equipment, software used for calculation of LVEF and experience of the analysers. Data analysis included calculation of an overall mean LVEF and standard deviation (SD) for all patients, which were compared with the mean IPEM LVEF. A comparison among software packages was done to examine differences in mean LVEF.

Results: Results were received from a total of 22 sites using six different software packages, with 187 processed studies included for analysis. Reproducibility of studies 4 and 8 showed good agreement, with an SD of 1.0 EF units (P=0.5290). Good correlation was found between the ANZ mean LVEF and the corresponding IPEM value per patient study, with R=0.98. The ANZ overall mean LVEF was 47%, which was higher that the IPEM mean by 4.9 EF units. The average difference among all software packages was +5.1 EF units.

Conclusion: Differences were found between the IPEM mean and the ANZ mean LVEF. Variability in LVEF values between software packages was demonstrated, with an average of 5.1 EF units. The ANZ overall mean for LVEF was 47.2%, being 4.9 EF units higher than the IPEM value.