Quantitative polar representation of left ventricular myocardial perfusion, function and viability using SPECT and cardiac magnetic resonance: initial results

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Abstract
Background: The clinical management of patients with coronary artery disease (CAD) often involves a complex assessment of the extent and severity of changes in left ventricular (LV) myocardial perfusion, function and viability. We aimed to explore the feasibility of integrative quantitative representation of LV perfusion, function and viability in adjacent polar plots. In order to assess the clinical usefulness of the quantitative methods, we also explored the relationship and determined the agreement between visual scoring and quantitative measurement of regional perfusion and function. Methods: Ten patients with CAD underwent rest and stress 99mTc‐tetrofosmin single photon emission computed tomography (SPECT) and cardiac magnetic resonance (CMR) imaging. Software was developed in‐house for generating polar plots from semi‐automatic quantification of rest and stress perfusion from SPECT, function from cine CMR and viability from delayed contrast enhancement (DE) CMR. The agreement between visual assessment and quantification of both perfusion and function was tested by Kendall's coefficient of concordance (W). Results: Polar plots were created using quantitative data from the semi‐automatic analysis of perfusion, function and viability. Kendall's W for agreement between quantitative measurement and visual scoring was 1·0 (PP<0·001) for function. Conclusions: Side‐by‐side quantitative polar representation of LV perfusion, function and viability is feasible and may aid in the complex assessment of these parameters. The agreement between quantitative measurement and visual scoring was very good for both perfusion and function.

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