Assessment of the accuracy of SPECT-CT and Echocardiography in assessing ejection fraction measurements - comparison with ejection fraction measurements of cardiac MRI in patients with borderline LVEF measurements.

Project aim The primary objective of this study is to assess the accuracy of the ejection fraction (LVEF) measurements obtained by SPECT-CT (Nuclear Medicine Myocardial Perfusion Imaging: NM-MPI) and Echocardiography compared to Cardiac Magnetic Resonance Imaging (cMR) over a wide range of LVEF values. The emphasis will be on borderline LVEF measurements (values between 40 and 50) to determine the accuracy and the inter-modality variability. Research methodology This is a prospective study exploring the objectives stated above in which a sample of 57 patients was calculated and found to to be suitable for this study - see sample size justification in section "2.Justification of sample size and statistical analysis" under "Methodology". The patient will come for a routine NM-MPI scan and the Nuclear Medicine physician will review the scan and decide on the suitability of the patient according to the inclusion and exclusion criteria of the study. Image optimisation will be performed for the NM-PMI scans and LVEF measurements obtained by optimised NM-MPI and Echocardiography will be compared with those obtained with cMR considered as a reference standard. Expected outcomes The major expected outcome from this study is: a better understanding of the accuracy and reliability of NM-MPI and Echocardiography based on cMR as reference standard, in particular in cases of borderline LVEF values. Hence, provide the referring clinician with the best suited modality depending on the individual patient's medical conditions.