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Journal of Nuclear Cardiology

, Volume 24, Issue 4, pp 1332–1346 | Cite as

Avoiding full corrections in dynamic SPECT images impacts the performance of SPECT myocardial blood flow quantitation

  • Lei Wang
  • Dayong Wu
  • Yong Yang
  • Ing-Jou Chen
  • Chih-Yuan Lin
  • Bailing HsuEmail author
  • Wei FangEmail author
  • Yi-Da TangEmail author
Original Article

Abstract

Introduction

This study investigated the performance of SPECT myocardial blood flow (MBF) quantitation lacking full physical corrections (All Corr) in dynamic SPECT (DySPECT) images.

Methods

Eleven healthy normal volunteers (HVT) and twenty-four patients with angiography-documented CAD were assessed. All Corr in 99mTc-sestamibi DySPECT encompassed noise reduction (NR), resolution recovery (RR), and corrections for scatter (SC) and attenuation (AC), otherwise no correction (NC) or only partial corrections. The performance was evaluated by quality index (R 2) and blood-pool spillover index (FBV) in kinetic modeling, and by rest flow (RMBF) and stress flow (SMBF) compared with those of All Corr.

Results

In HVT group, NC diminished 2-fold flow uniformity with the most degraded quality (15%-18% reduced R 2) and elevated spillover effect (45%-50% increased FBV). Consistently higher RMBF and SMBF were discovered in both groups (HVT 1.54/2.31 higher; CAD 1.60/1.72; all P < .0001). Bland-Altman analysis revealed positive flow bias (HVT 0.9-2.6 mL/min/g; CAD 0.7-1.3) with wide ranges of 95% CI of agreement (HVT NC −1.9-7.1; NR −0.4-4.4; NR + SC −1.1-4.3; NR + SC + RR −0.7-2.5) (CAD NC −1.2-3.8; NR −1.0-2.8; NR + SC −1.0-2.5; NR + SC + RR −1.1-2.6).

Conclusions

Uncorrected physical interference in DySPECT images can extensively impact the performance of MBF quantitation. Full physical corrections should be considered to warrant this tool for clinical utilization.

Keywords

SPECT myocardial blood flow quantitation dynamic SPECT physical interference physical corrections 

Abbreviations

MBF

Myocardial blood flow

SPECT

Single photon emission computed tomography

SPECT/CT

SPECT/computed tomography

DySPECT

Dynamic SPECT

CAD

Coronary artery disease

PET

Position emission tomography

Bq/mL

Becquerel per mini liter

HVT

Healthy normal volunteers

BMI

Body mass index

ECG

Electrocardiographic

AC

Attenuation correction

RAO

Right anterior oblique

LPO

Left posterior oblique

LEHR

Low energy high resolution

NR

Noise reduction

SC

Scatter correction

EE

Resolution recovery

NC

No correction

BP

Blood-pool

Myo

Myocardial

TAC

Time activity curves

SMBF

Stress MBF

RMBF

Rest MBF

MFR

Myocardial flow reserve

LAD

Left anterior descending

LCX

Left circumflex

RCA

Right coronary artery

CI

Confidence interval

Notes

Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Disclosure

All authors listed in this manuscript claim no potential conflict of interests.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© American Society of Nuclear Cardiology 2016

Authors and Affiliations

  1. 1.Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
  2. 2.Department of Medical Physics ResearchBailing Cloud Biomedical Technologies InnovationTaipeiTaiwan
  3. 3.Department of Electro-optical EngineeringNational Taipei University of TechnologyTaipeiTaiwan
  4. 4.Nuclear Science and Engineering InstituteUniversity of Missouri-ColumbiaColumbiaUSA
  5. 5.Coronary Heart Disease Center, Fu Wai Hospital, National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

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