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Algorithm Validations

Below you will find LVEF and volume correlations with various gold standards, as well as cross-correlations between algorithms.


QGS LVEF Validation - Papers

Authors Gold Standard n LVEF Isotope Reference
Germano et al. 1st pass 65 r=0.91 99mTc JNM 1995;11:2138
He et al. 1st pass 63 r=0.85 99mTc JNC 1999;4:412
He et al. 1st pass 63 r=0.84 201-Tl JNC 1999;4:412
Inubushi et al. 1st pass 44 r=0.92 I-123 JNM 1999;11:1840
Vallejo et al. 1st pass 365 r=0.74 99mTc JNC 2000;5:461
Everaert et al. MUGA 40 r=0.93 99mTc JNC 1997;6:472
Yoshioka et al. MUGA 21 r=0.87 99mTc JNM 1999;10:1693
Manrique et al. MUGA 55 r=0.94 201-Tl EJNM 2000;6:694
Chua et al. MUGA 62 r=0.94 99mTc JNC 2000;4:301
Kikkawa et al. MUGA 24 r=0.95 99mTc EJNM 2001;5:593
Kumita et al. MUGA 48 r=0.91-0.94 99mTc JNC 2001;8:568
Nakajima et al. MUGA 30 r=0.82 99mTc JNM 2001;42:1571
Higuchi et al. MUGA 52 r=0.90 99mTc EJNM 2001;28:1512
Nanasato et al. MUGA 36 r=0.93 99mTc JNM 2001;42:1747
Nanasato et al. MUGA 36 r=0.91 I-123 JNM 2001;42:1747
Cwajg et al. Echo 180 r=0.72-0.79 201-Tl JNM 1999;11:1857
Bacher-Stier et al. Echo 72 r=0.76-0.86 201-Tl EJNM 1999;12:1533
Nichols et al. Echo 33 r=0.75 99mTc JNM 2000;8:1308
Abe et al. Contrast 229 r=0.78 99mTc JNC 2000;6:569
Vourvouri et al. Contrast 32 r=0.83 99mTc EJNM 2001;28:1610
Atsma et al. Contrast 74 r=0.92 99mTc IJCI 2000;6:447
Vaduganathan et al. MRI 25 r=0.93 99mTc JNC 1999;1:3
Tadamura et al. MRI 20 r=0.94 99mTc JACC 1999;4:991
Tadamura et al. MRI 20 r=0.92 201-Tl JACC 1999;4:991
Tadamura et al. MRI 16 r=0.89 99mTc EJNM 1999;7:705
Bax et al. MRI 22 r=0.90 99mTc AJC 2000;12:1299
Bavelaar-Croon et al. MRI 21 r=0.85 99mTc Radiology 2000;2:572
Faber et al. MRI 30 r=0.72 99mTc JNC 2001;8:645
Thorley et al. MRI 50 r=0.82 99mTc NM Comm 2003;7:763
Lipke et al. MRI 54 r=0.90 99mTc EJNM 2004;31:482
TOTAL 1882 r=0.87

Non-QGS LVEF Validation - Papers & Abstracts

Emory Cardiac Toolbox

Authors Gold Standard n LVEF Isotope Reference
Nakajima et al. MUGA 30 r=0.78 99mTc JNM 2001;42:1571
Higuchi et al. MUGA 25 r=0.88 99mTc JNC 2001;8:S64 (abstr)
Faber et al. 1st pass 79 r=0.82 99mTc JNM 1999;40:650
Nichols et al. echo 33 r=0.72 99mTc JNM 2000;41:1308
Faber et al. MRI 10 r=0.88 99mTc JNM 1999;40:650
Vansant et al. MRI 31 r=0.81 99mTc JNM 2000;8:1308
Faber et al. MRI 30 r=0.70 99mTc JNC 2001;8:645

4D-MSPECT

Authors Gold Standard n LVEF Isotope Reference
Nakajima et al. MUGA 30 r=0.69 99mTc JNM 2001;42:1571
Higuchi et al. MUGA 25 r=0.82 99mTc JNC 2001;8:S64 (abstr)
Gayed et al. echo 30 r=0.84-0.86 99mTc JNM 2001;42:177P (abstr)
Ficaro et al. contrast 90 r=0.81 99mTc Circ 1999;100:I26 (abstr)
Chugh et al. contrast 97 r=0.87 unknown JACC 2001;37:394A (abstr)
Cahill et al. MRI 26 r=0.97 99mTc JNM 2003;44:197P (abstr)
Lipke et al. MRI 54 r=0.89 99mTc EJNM 2004;31:482

Yale CQ

Authors Gold Standard n LVEF Isotope Reference
Lam et al. MUGA 24 r=0.88 99mTc JNM 2001;42:93P (abstr)
Lam et al. 1st pass 117 r=0.78 99mTc JNM 2001;42:93P (abstr)

MultiDim

Authors Gold Standard n LVEF Isotope Reference
Everaert et al. MUGA 50 r=0.93 99mTc EJNM 1996;12:1628
Everaert et al. MUGA 40 r=0.94 99mTc JNC 1997;6:472
Vera et al. MUGA 32 r=0.75-0.88 201-Tl JNM 1999;4:513
Vera et al. contrast 32 r=0.26-0.72 201-Tl JNM 1999;4:513

QGS Volumes Validation - Papers

Authors Gold Standard n EDV ESV Isotope Reference
Vaduganathan et al MRI 25 r=0.81 r=0.92 99mTc JNC 1999;6:3
Tadamura et al MRI 20 r=0.92 r=0.97 99mTc JACC 1999;4:991
Tadamura et al MRI 20 r=0.85 r=0.94 201-Tl JACC 1999;4:991
Tadamura et al MRI 16 r=0.89 r=0.93 99mTc EJNM 1999;7:705
Bax et al MRI 22 r=0.84 r=0.87 99mTc AJC 2000;12:1299
Bavelaar-Croon et al MRI 21 r=0.94 r=0.95 99mTc Radiology 2000;2:572
Faber et al MRI 30 r=0.91 r=0.92 99mTc JNC 2001;8:645
Thorley et al MRI 50 r=0.90 99mTc NM Comm 2003;7:763
Lipke et al MRI 54 r=0.92 r=0.96 99mTc EJNM 2004;31:482
Cwajg et al. Echo 180 r=0.88 r=0.88 both JNM 1999;11:1857
Nichols et al. Echo 33 r=0.90 r=0.94 99mTc JNM 2000;8:1308
Zuber et al. Echo 49 r=0.86 r=0.86 99mTc JNC 2000;6:655
Vourvouri et al. Echo 32 r=0.94 r=0.96 99mTc EJNM 2001;28:1610
Yoshioka et al. MUGA 21 r=0.73 r=0.83 99mTc JNM 1999;10:1693
Chua et al. MUGA 62 r=0.88 r=0.95 99mTc JNC 2000;4:301
Nakajima et al. MUGA 30 r=0.88 99mTc JNM 2001;42:1571
Nanasato et al. MUGA 36 r=0.85 r=0.82 99mTc JNM 2001;42:1747
Nanasato et al. MUGA 36 r=0.85 r=0.75 I-123 JNM 2001;42:1747
Abe et al. contrast 229 r=0.67 r=0.79 99mTc JNC 2000;6:569
Iskandrian et al. Thermodil. 24 r=0.89 r=0.94 99mTc JNC 1998;6:574
TOTAL 990 r=0.86 r=0.90

Non-QGS Volumes Validation - Papers & Abstracts

Emory Cardiac Toolbox

Authors Gold Standard n EDV ESV Isotope Reference
Faber et al. MRI 10 r=0.97 r=0.99 99mTc JNM 1999;4:650
Vansant et al. MRI 31 r=0.90 r=0.91 99mTc JNM 1999;40:166P (abstr)
Faber et al. MRI 30 r=0.97 r=0.99 99mTc JNC 2001;8:645
Nichols et al. echo 33 r=0.90 r=0.94 99mTc JNM 2000;8:1308
Nakajima et al. MUGA 30 r=0.89 99mTc JNM 2001;42:1571
Faber et al. 1st pass 79 r=0.85 r=0.91 99mTc JNM 1999;4:650

4D-MSPECT

Authors Gold Standard n EDV ESV Isotope Reference
Cahill et al. MRI 26 r=0.95 r=0.98 99mTc JNM 2003;44:197P (abstr)
Lipke et al. MRI 54 r=0.89 r=0.96 99mTc EJNM 2004;31:482
Nakajima et al. MUGA 30 r=0.85 99mTc JNM 2001;42:1571

Yale CQ

Authors Gold Standard n EDV ESV Isotope Reference
Liu et al. phantom JNC 2001;8:S61 (abstr)

MultiDim

Authors Gold Standard n EDV ESV Isotope Reference
Vera et al. contrast 32 r=0.90 r=0.92 201-Tl JNM 1999;4:513

Cross-correlations of algorithms

QGS vs. Emory Cardiac Toolbox

Authors n LVEF EDV ESV Isotope Reference
Nichols et al 33 r=0.94 r=0.94 99mTc JACC 1999;2:409A
Nichols et al 246 r=0.90 r=0.91 r=0.95 99mTc JNC 2000;4:S20
Sias et al 97 r=0.72 99mTc JACC 1999;2:436A
Lewis et al 1006 r=0.93 r=0.93 r=0.80 99mTc JNC 2001;8:S18
Santana et al. 50 r=0.87 r=0.89 r=0.92 99mTc JNC 2001;5:166P
Krasnow et al 122 r=0.89 99mTc JNC 2001;8:S138
Nakajima et al 30 r=0.95 r=0.98 99mTc JNM 2001;42:1571
Faber et al 30 r=0.95 99mTc JNC 2001;8:645

QGS vs. 4D-MSPECT

Authors n LVEF EDV ESV Isotope Reference
Dede et al 129 r=0.94 r=0.97 r=0.98 99mTc EJNM 2002;29:S209
Lipke et al 54 r=0.92 r=0.96 r=0.96 99mTc EJNM 2004;31:482

QGS vs. Yale CQ

Authors n LVEF EDV ESV Isotope Reference
Liu et al 110 r=0.87 r=0.90 r=0.90 99mTc JNC 2001;8:S65
Krasnow et al 122 r=0.82 99mTc JNC 2001;8:S138

QGS vs. MultiDim

Authors n LVEF EDV ESV Isotope Reference
Everaert et al 40 r=0.93 r=0.97 r=0.98 99mTc JNC 1997;6:472
Vera et al 43 r=0.86 r=0.96 r=0.97 201-Tl JNC 2000;4:312

Abnormality Thresholds - SPECT LVEF and Volumes

Gender LVEF EDV ESV

Cedars QGS

8 fr, 99mTc
Sharir, JNC 2006		F51%102 ml
(60 ml/m2)		46 ml
(27 ml/m2)
M43%149 ml
(75 ml/m2)		75 ml
(39 ml/m2)

Emory ECT

8 or 16 fr
Garcia, JNC 2007		F+M51%171 ml70 ml

4D-MSPECT

8-16 fr, 99mTc
Ficaro, JNC 2007		F56-60%118-122 ml
(66-68 ml/m2)		42-44 ml
(24-25 ml/m2)
M47-52%183-197 ml
(91-98 ml/m2)		82-91 ml
(41-46 ml/m2)

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Individual applications (QGS, QPS, QBS)

You can find your version number in the "about..." box. Click the About button in the upper right corner of the application.

If using the combined QGS+QPS or AutoQUANT™, the About button is located at the bottom of any of the color scale controls.

AutoQUANT™ users, please see the conversion chart to see which CSMC Cardiac Suite version corresponds to your AutoQUANT™ version.

CSimport

In CSimport (aka CSI), the "about..." box can be displayed from the Help menu in the usual manner.

QGS+QPS and AutoQUANT™

What is the PlusPack module?

PlusPack groups several useful, advanced quantitative and productivity features in one bundle. These features are:

  • Motion frozen: compensate for cardiac motion to generate sharper perfusion datasets
  • Serial change assessment: directly compare serial studies, bypassing comparisons to statistical databases
  • Prone/Supine SPECT perfusion quantification: help eliminate artifacts by merging information from both acquisition positions
  • Shape index calculation: quantify ventricular remodeling, an early marker of disease
  • Phase analysis: assess mechanical dyssynchrony using powerful quantitative and visual tools
  • Powerpoint export: launch the Cardiac Suite from within Microsoft Powerpoint® for enhanced, more interactive presentations

Click here to open a new page with video tutorials about these features.

Basic Perfusion SPECT Bundle

This bundle includes the following applications and features:

QGS - Quantitative Gated SPECT
This application provides cardiac function quantitation using perfusion datasets: ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in a 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPS - Quantitative Perfusion SPECT
In addition to cardiac parameters, such as chamber volume and wall area, this application provides perfusion analysis of ungated datasets by comparing rest and stress datasets to a database of normal values (also called normal limits) using statistical methods.
This bundle also includes the CSI data management application and the Companion module (AHA 17-segment scoring, diastolic function, eccentricity).

Basic Perfusion + Blood Pool SPECT Bundle

This bundle includes the following applications and features:

QGS - Quantitative Gated SPECT
This application provides cardiac function quantitation using perfusion datasets: ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in a 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPS - Quantitative Perfusion SPECT
In addition to cardiac parameters, such as chamber volume and wall area, this application provides perfusion analysis of ungated datasets by comparing rest and stress datasets to a database of normal values (also called normal limits) using statistical methods.
QBS - Quantitative Blood Pool SPECT
This application provides automatic quantitation of left- and right-ventricular function (ejection fraction, ED and ES volumes, stroke volumes) using gated blood pool SPECT images. It also displays motion polar maps and parametric surfaces.
This bundle also includes the CSI data management application and the Companion module (AHA 17-segment scoring, diastolic function, eccentricity).

Deluxe Perfusion SPECT Bundle

This bundle includes the following applications and features:

QGS - Quantitative Gated SPECT
This application provides cardiac function quantitation using perfusion datasets: ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in a 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPS - Quantitative Perfusion SPECT
In addition to cardiac parameters, such as chamber volume and wall area, this application provides perfusion analysis of ungated datasets by comparing rest and stress datasets to a database of normal values (also called normal limits) using statistical methods.
Compared to the Basic Perfusion SPECT bundle, this package adds the PlusPack module, providing serial change assessment, prone/supine perfusion quantification, shape index calculation, phase analysis, and powerpoint export.
This bundle also includes the CSI data management application and the Companion module (AHA 17-segment scoring, diastolic function, eccentricity).

Deluxe Perfusion + Blood Pool SPECT Bundle

This bundle includes the following applications and features:

QGS - Quantitative Gated SPECT
This application provides cardiac function quantitation using perfusion datasets: ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in a 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPS - Quantitative Perfusion SPECT
In addition to cardiac parameters, such as chamber volume and wall area, this application provides perfusion analysis of ungated datasets by comparing rest and stress datasets to a database of normal values (also called normal limits) using statistical methods.
QBS - Quantitative Blood Pool SPECT
This application provides automatic quantitation of left- and right-ventricular function (ejection fraction, ED and ES volumes, stroke volumes) using gated blood pool SPECT images. It also displays motion polar maps and parametric surfaces.
Compared to the Basic Perfusion + Blood Pool SPECT bundle, this package adds the PlusPack module, providing serial change assessment, prone/supine perfusion quantification, shape index calculation, phase analysis, and powerpoint export.
This bundle also includes the CSI data management application and the Companion module (AHA 17-segment scoring, diastolic function, eccentricity).

Deluxe Perfusion PET Bundle

This bundle includes the following applications and features:

QGS-PET - Quantitative Gated PET
This application provides cardiac function quantitation using perfusion datasets: ED and ES volumes, ejection fraction. The image data can be viewed in a variety of modes, from selected slices in a 2D view to a rendered 3D surface of the myocardium with function maps (perfusion, motion, thickening and regional EF).
QPET - Quantitative PET
The new PET Kinetics module provides the calculation of Coronary Flow Reserve (CFR) and Myocardial Blood Flow (MBF).
This application also provides automatic segmentation, quantification and analysis of static and gated myocardial perfusion PET, with support for both short axis and transverse datasets.
This bundle is designed for the processing of PET data only and can be purchased at a substantial discount with a SPECT bundle for a complete PET/SPECT processing solution.
This bundle also includes the CSI data management application, the PlusPack module (serial change assessment, prone/supine perfusion quantification, shape index calculation, phase analysis, powerpoint export), the Fusion/CT module (3D display and automatic registration of coronary trees, fused image display), and the Companion module (AHA 17-segment scoring, diastolic function, eccentricity).

The Automated Report Generator (ARG) Add-On

ARG - Automated Report Generator
The Cedars-Sinai reporting system can substantially improve the workflow in your nuclear cardiology department. Its two components are Automated Report Generator (ARG) and QARG.
This add-on provides a reporting server, integration with QPS and QGS, as well as the standalone data entry tool QARG that can be used in the stress lab or anywhere else to enter patient demographics, ECG info, etc...

Automated Reconstruction (AutoRecon) Add-On

AutoRecon
This application offers several automatic processing modules for single-photon emission computed tomography (SPECT) studies.

This add-on provides a full-fledged reconstruction program with the following features:

  • automated reconstruction limits selection
  • automated motion correction
  • filtered backprojection and iterative reconstruction.
  • automatic reorientation of the transaxial data into short axis images

Breathe new life into your old camera by freeing yourself from antiquated workstations!

Motion Correction (MoCo) Add-On

MoCo - Motion Correction
This application provides automatic and manual correction of SPECT acquisition artifacts.

A cost effective solution to benefit from motion correction while using your workstation's reconstruction software.

What is in the Companion module?

The Companion includes several useful features that were added after the initial release of the quantitative cardiac suite. These features are:

  • AHA model 17-segment scoring
  • Eccentricity calculation: a measure of ventricular sphericity to assess ventricular remodeling
  • Diastolic function: ventricular filling and emptying parameters are extracted from interpolated time-volume curves

What is the Fusion/CT module?

The Fusion/CT module adds features related to coronary CT angiography (CTA) and multi-modality registration. These features are:

  • 3D display of coronary trees extracted by a variety of software packages
  • Automated registration of coronary trees (especially useful for non-hybrid systems)
  • Fused image display to assess or correct image registration (for CTA and attenuation CT data)

The Fusion/CT module is standard with the Deluxe PET bundle, and available as an option for SPECT bundles.

What is the Fusion/CT module?

The Fusion/CT module adds features related to coronary CT angiography (CTA) and multi-modality registration. These features are:

  • 3D display of coronary trees extracted by a variety of software packages
  • Automated registration of coronary trees (especially useful for non-hybrid systems)
  • Fused image display to assess or correct image registration (for CTA and attenuation CT data)

The Fusion/CT module is standard with the Deluxe PET bundle, and available as an option for SPECT bundles.

What is the CSI data browser?

Our software packages are designed to be installed on your computer, not on vendor workstations. To use the quantitative applications studies need to be transferred from your acquisition systems to your computer with the Cedars-Sinai software.

CSI allows you to transfer studies and manages the datasets on your computer. Its main features include:

  • Pull data from DICOM Query/Retrieve and FTP servers as well as legacy systems
  • Push data from DICOM systems to your computer
  • Import data from CDs or other removable media, or from a network share
  • Simple, intuitive data management lets you organize data in folders to manage clinical and research projects
  • One-click anonymized mode hides patient identification so you can use the software in interactive lectures

Click here to open a new page with video tutorials about some of these features.