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



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.


SPECT myocardial blood flow quantitation dynamic SPECT physical interference physical corrections 



Myocardial blood flow


Single photon emission computed tomography


SPECT/computed tomography


Dynamic SPECT


Coronary artery disease


Position emission tomography


Becquerel per mini liter


Healthy normal volunteers


Body mass index




Attenuation correction


Right anterior oblique


Left posterior oblique


Low energy high resolution


Noise reduction


Scatter correction


Resolution recovery


No correction






Time activity curves


Stress MBF


Rest MBF


Myocardial flow reserve


Left anterior descending


Left circumflex


Right coronary artery


Confidence interval


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

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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