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Evaluation of the attenuation correction on myocardial perfusion imaging: a phantom study

机译：心肌灌注成像衰减校正的评估：一项幻像研究

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Myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT) is important for risk stratification of coronary artery disease. MPI quantification obtained from available images may not be accurate due to several potential sources of error, being photon attenuation, especially in overweight patients, a significant problem. Attenuation maps derived from X-ray computed tomography (CT) may be used to correct for photon attenuation. The aim of this study was to evaluate the effects of non-attenuation correction (NAC) and attenuation correction (AC) in MPI SPECT imaging using anthropomorphic phantoms simulating patients with different attenuation profiles. Forty-nine SPECT and CT studies of Heart/Thorax phantoms with different attenuation layers were acquired. All SPECT imaging data were reconstructed with and without AC. Quantification of the myocardial signal (uptake) was performed in four regions of interest: septum, anterior wall, inferior wall and apex. This was done both in NAC and AC SPECT images. Qualitative evaluation was performed by a nuclear medicine physician also in NAC and AC SPECT images. The results demonstrated, as expected, statistically lower counts when the thickness of the phantom attenuating material increased and attenuation correction was lacking. On the other hand, when attenuation correction was applied, there were no statistically significant count differences whatever the thickness of the phantom attenuating material. In the qualitative evaluation, the nuclear medicine physician observed small variations in the anterior wall uptake according to the various conditions under test. However, the changes were not statistically significant. In conclusion, there is no evidence that the effects of attenuation in overweight patients are not properly corrected when the MPI SPECT images are reconstructed with CT-based AC. In terms of qualitative visual assessment, there is no significant variation in the classification of myocardial walls uptake with and without AC when the evaluation is done by an experienced physician.
机译：单光子发射计算机断层扫描（SPECT）心肌灌注成像（MPI）对于冠状动脉疾病的危险分层非常重要。从可用图像获得的MPI量化可能由于一些潜在的误差来源（例如光子衰减）而不太准确，尤其是在超重患者中，这是一个重大问题。从X射线计算机断层扫描（CT）得出的衰减图可用于校正光子衰减。这项研究的目的是使用拟人体模模拟具有不同衰减特征的患者，评估MPI SPECT成像中非衰减校正（NAC）和衰减校正（AC）的效果。获得了具有不同衰减层的心/胸模型的49个SPECT和CT研究。在有和没有交流电的情况下，所有SPECT成像数据均得以重建。在四个感兴趣的区域中进行心肌信号（摄取）的定量：隔膜，前壁，下壁和先端。这是在NAC和AC SPECT图像中完成的。核医学医师还在NAC和AC SPECT图像中进行了定性评估。如所预期的，结果表明，当幻像衰减材料的厚度增加并且缺乏衰减校正时，统计上的计数降低。另一方面，当应用衰减校正时，无论幻像衰减材料的厚度如何，在统计上都没有明显的计数差异。在定性评估中，核医学医师根据测试中的各种条件观察到前壁摄取的微小变化。但是，这些变化在统计上并不显着。总之，没有证据表明，当使用基于CT的AC重建MPI SPECT图像时，无法正确校正超重患者的衰减效果。就定性视觉评估而言，由经验丰富的医师进行评估时，有无AC时心肌壁摄取的分类没有显着差异。

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