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The production of “gated―cardiac blood pool im
ages for the study of ventricular wall motion was
first achieved using the electrocardiographic (ECG)
signal to turn on a scintillation camera during a fixed
time interval, beginning at a specified time after the
occurrence of an R wave ( 1—5). By recording image
data during this interval over many cardiac cycles,
one obtains an integrated image representing the car
diac blood pool during a small portion of the me
chanical cardiac cycle. More elaborate and expen
FIG. 1. Equipmentarrangementshow
ing electrical waveforms.
sive versions of this technique (6,7) make use of a
gating apparatus and a minicomputer and permit
the setting of two independent intervals referenced to the R wave. This allows simultaneous recording of images during two portions of the cardiac cycle, usually end-systole and end-diastole. However, in
Received June 15, 1976; revision accepted Sept. 24, 1976. For reprints contact : E. A. Silverstein, Sect. of Medical Radiation Physics, Rush-Presbyterian-St. Luke's Medical Center, 1753 W. Congress Parkway, Chicago, IL 60612.
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Volume 18, Number 2 159
jiUn/INSTRUMENTATION AND PHYSICS
Cardiac Blood Pool Imaging over the Complete
Cardiac Cycle with a Multiformat Imager
Edward A. Silverstein, David A. Turner, ErnestW. Fordham, and Anthony Chung-Bin Rush-Presbyterian-St. Luke's Medical Center and Rush Medical College, Chicago, illinois
A new method of obtaining scintigraphic images of the cardiac blood poo for the study of ventricular wall motion is described. The method, which is based upon an inexpensive modification of a commercial multiformat imaging device, yields a set of serial gated images covering the entire car diac cycle. These images may be converted into a film loop to yield a con tinuous motion picture of the mechanical cycle of the heart.
J NuciMed 18: 159—162, 1977
SILVERSTEIN, TURNER, FORDHAM, AND CHUNG-BIN
immediately produces a set of serial images covering
the entire cardiac cycle.
MATERIALS AND METHODS The technique is based on a “multiformat im ager.―* By means of this instrument the complete
cardiac cycle can be displayed on a single 8 X 10-in.
film as a set of serial images, each image representing
To a portion of the cardiac cycle extending over some Mum- Formot preset time interval.
roger In its usual mode of operation, the multiformat
imager records 1, 4, 6, 9, 30, or 42 images on an
8 X 10-in. film. The number of images to be re
corded is selected by a series of push buttons on
the console of the imager. The location on the film
at which images are recorded is automatically ad
vanced internally or by signals from the scintillation
camera. Image recording is returned to the first posi
tion by pressing the RESET button on the console.
For our application, external ADVANCEand RESET lines were added to the imager (Fig. 1 ). A pulse on the ADVANCE line moves the image forward to the next film position. A RESET pulse brings the image back to the starting point (Frame 1). The operation of the system is shown schemati
cally in Fig. 1. The ECG signal is obtained by means
of a monitoring system.t When an R wave is de
tected, the monitor supplies an R-wave trigger signal
(“SYNC―on Fig. 1 ) to the Imager Control Circuit
(ICC), constructed in our laboratory4 Upon receiv
ing a SYNC signal, the ICC resets the multiformat imager to Frame 1. The ICC then produces regular
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FIG.2. Diagramof testingsystem.Scintillationcamera'sde
tector was directly above turntable at distance of 15 cm.
all of these methods all data are lost during the por
tions of the cardiac cycle outside of the one or two
preselected recording intervals. Another approach (8—11 ) allows recording of images of the cardiac blood pool throughout the
cardiac cycle. Scintillation camera data and the ECG
signal are recorded on a suitable medium, such as videotape, computer magnetic tape, or disk. By re playing the data, images of any portion of the cardiac cycle can be obtained. Motion pictures also can be produced. Although no image data are lost with this technique, the procedures involved are relatively complex, expensive, and time-consuming.
This communication describes a
producing gated cardiac blood pool
inexpensive to implement, simple to
new method of images which is use, and which
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shown in Fig. 2. System was run for about 230 cycles.Fixed reference sourceis Counter-clockwise direction of rotation re
denoted by Si and moving source by Sa. suItsfrominversionof filmduring raphy. Dotted circles were drawn in as visual aids.
(^160) JOURNAL OF NUCLEAR MEDICINE
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SILVERSTEIN, TURNER, FORDHAM, AND CHUNG-BIN
The techniques described herein can be applied
to other situations, particularly to respiratory gating.
For example, with a suitable transducer, images of
the liver in various phases of the respiratory cycle
could be recorded.
ACKNOWLEDGMENTS The authors wish to express their gratitude to Lee Roenigk
of Ohio-Nuclear,Inc., for findinga simple method of mak
ing electrical connections to the Ultimat multiformat imager and for installing the ADVANCE and RESET lines. We are also grateful to Elaine D. Salter for secretarial assistance.
FOOTNOTES
- Ohio-Nuclear Series 100-I I Ultimat (Solon, Ohio). t Spacelabs Model 3003 Patient Monitoring System (Chatsworth, Calif.). t Circuit details will be furnished upon request. REFERENCES
1. ZARET BL, STRAUSS HW, HURLEY PJ, et al. : Left yen tricular ejection fraction and regional myocardial perform ance in man without cardiac catheterization. Circulation 42: Suppl 3; 120, 1970 2. ZARET BL, STRAUSS HW, HURLEY PJ, et al. : A non invasive scintiphotographic method for detecting regional ventricular dysfunction in man. N Engl I Med 284: 1165— 1170, 1971 3. STRAUSS HW, ZARET BL, HURLEY PJ, et al. : A scinti
photographic method for measuring left ventricular ejection fraction in man without cardiac catheterization. Am I Car diol28:575—580, 1971
- Rico P, MURRAY M, TAYLOR DR. et al. : Right yen tricular dysfunction detected by gated scintiphotography in patients with acute inferior myocardial infarction. Circula _tio,i52:268—274, 1975
- BERMAN DS, SALEL AF, DENARDO GL, et al. : Clinical_ assessment of left ventricular regional contraction patterns and ejection fraction by high-resolution gated scintigraphy. I NuclMed 16:865—874, 1975 6. PARKERJA, SECKER-WALKERR, HILL R, et al. : A new technique for the calculation of left ventricular ejection _fraction.JNuclMed 13: 649—651, 1972
- SECKER-WALKER RH, RESNICK L, KUNZ H, et al.:_ Measurement of left ventricular ejection fraction. I Nuci _Med 14:798—802, 1973
- MASON DT, ASHBURN WL, HARBERT JC, et al. : Rapid_ sequential visualization of the heart and great vessels in man utilizing the wide-field Anger scintillation camera. Cir _culation 39: 19—28,
- KOSTUK WJ, EHSANI AA, KARLINER JS, et al. : Left_ ventricular performance after myocardial infarction assessed by radioisotope angiocardiography. Circulation 47 : 242— 249, 1973 JO. GREEN MV, Osmow HG, DOUGLASMA, et al. : High temporal resolution ECG-gated scintigraphic angiocardiog raphy.I Nucl Med 16: 95—98, 1975 11. REESE IC, MISHKIN FS: Technique for producing cardiac radionuclide motion images. I Nuci Med 16: 368— 369, 1975
162 JOURNAL OF NUCLEAR MEDICINE
MID-EASTERNCHAPTER SOCIETY OF NUCLEAR MEDICINE 7th ANNUAL MEETING April 21—23,1977 Stouffer's Hotel Arlington, Virginia
ANNOUNCEMENT AND CALL FOR ABSTRACTS
The 7th Annual Meeting of the SNM Mid-Eastern Chapter will include two full days of scientific con tributions, including both teaching sessionsand selected papers. Prizes will be awarded for the three best individual presentations. Category 1 credit is applicable.
The Program Committee invites the submission of abstracts relevant to all fields of nuclear medicine for consideration by the Committee. Please send abstract (and three copies) containing less than 300 words with suitable supporting data to: Gerald S. Johnston, M.D. Director of Nuclear Medicine National Institutes of Health Room 1B37, Building 10 9000 Rockville Pike Bethesda, Maryland 20014 Co-directors, Scientific Program Committee: Peter T. Kirchner, M.D., and Gerald S. Johnston, M.D. Deadline for abstracts: February 15th, 1977.
