Avoiding full corrections in dynamic SPECT images impacts the performance of SPECT myocardial blood flow quantitation
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This study investigated the performance of SPECT myocardial blood flow (MBF) quantitation lacking full physical corrections (All Corr) in dynamic SPECT (DySPECT) images.
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.
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).
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.
KeywordsSPECT myocardial blood flow quantitation dynamic SPECT physical interference physical corrections
Myocardial blood flow
Single photon emission computed tomography
Coronary artery disease
Position emission tomography
Becquerel per mini liter
Healthy normal volunteers
Body mass index
Right anterior oblique
Left posterior oblique
Low energy high resolution
Time activity curves
Myocardial flow reserve
Left anterior descending
Right coronary artery
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.
All authors listed in this manuscript claim no potential conflict of interests.
Informed consent was obtained from all individual participants included in the study.
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