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      Differential impact of multi-focus fan beam collimation with L-mode and conventional systems on the accuracy of myocardial perfusion imaging: Quantitative evaluation using phantoms

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          A novel IQ-SPECT™ method has become widely used in clinical studies. The present study compares the quality of myocardial perfusion images (MPI) acquired using the IQ-SPECT™ (IQ-mode), conventional (180° apart: C-mode) and L-mode (90° apart: L-mode) systems. We assessed spatial resolution, image reproducibility and quantifiability using various physical phantoms.


          SPECT images were acquired using a dual-headed gamma camera with C-mode, L-mode, and IQ-mode acquisition systems from line source, pai and cardiac phantoms containing solutions of 99mTc. The line source phantom was placed in the center of the orbit and at ± 4.0, ± 8.0, ± 12.0, ± 16.0 and ± 20.0 cm off center. We examined quantifiability using the pai phantom comprising six chambers containing 0.0, 0.016, 0.03, 0.045, 0.062, and 0.074 MBq/mL of 99m-Tc and cross-calibrating the SPECT counts. Image resolution and reproducibility were quantified as myocardial wall thickness (MWT) and %uptake using polar maps.


          The full width at half maximum (FWHM) of the IQ-mode in the center was increased by 11% as compared with C-mode, and FWHM in the periphery was increased 41% compared with FWHM at the center. Calibrated SPECT counts were essentially the same when quantified using IQ-and C-modes. IQ-SPECT images of MWT were significantly improved (P<0.001) over L-mode, and C-mode SPECT imaging with IQ-mode became increasingly inhomogeneous, both visually and quantitatively (C-mode vs. L-mode, ns; C-mode vs. IQ-mode, P<0.05).


          Myocardial perfusion images acquired by IQ-SPECT were comparable to those acquired by conventional and L-mode SPECT, but with significantly improved resolution and quality. Our results suggest that IQ-SPECT is the optimal technology for myocardial perfusion SPECT imaging.

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          Most cited references 20

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          Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.

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            Quantitative accuracy of clinical 99mTc SPECT/CT using ordered-subset expectation maximization with 3-dimensional resolution recovery, attenuation, and scatter correction.

            We present a calibration method of a clinical SPECT/CT device for quantitative (99m)Tc SPECT. We use a commercially available reconstruction package including ordered-subset expectation maximization (OSEM) with depth-dependent 3-dimensional resolution recovery (OSEM-3D), CT-based attenuation correction, and scatter correction. We validated the method in phantom studies and applied it to images from patients injected with (99m)Tc-diphosponate. The following 3 steps were performed to derive absolute quantitative values from SPECT reconstructed images. In step 1, we used simulations to characterize the SPECT/CT system and derive emission recovery values for various imaging parameter settings. We simulated spheres of varying diameters and focused on the dependencies of activity estimation errors on structure size and position, pixel size, count density, and reconstruction parameters. In step 2, we cross-calibrated our clinical SPECT/CT system with the well counter using a large cylinder phantom. This step provided the mapping from image counts to kBq/mL. And in step 3, correction factors from steps 1 and 2 were applied to reconstructed images. We used a cylinder phantom with variable-sized spheres for verification of the method. For in vivo validation, SPECT/CT datasets from 16 patients undergoing (99m)Tc-diphosponate SPECT/CT examinations of the pelvis including the bladder were acquired. The radioactivity concentration in the patients' urine served as the gold standard. Mean quantitative accuracy and SEs were calculated. In the phantom experiments, the mean accuracy in quantifying radioactivity concentration in absolute terms was within 3.6% (SE, 8.0%), with a 95% confidence interval between -19.4% and +12.2%. In the patient studies, the mean accuracy was within 1.1% (SE, 8.4%), with a 95% confidence interval between -15.4% and +17.5%. Current commercially available SPECT/CT technology using OSEM-3D reconstruction, scatter correction, and CT-based attenuation correction allows quantification of (99m)Tc radioactivity concentration in absolute terms within 3.6% in phantoms and 1.1% in patients with a focus on the bladder. This opens up the opportunity of SPECT quantitation entering the routine clinical arena. Still, the imprecision caused by unavoidable measurement errors is a dominant factor for absolute quantitation in a clinical setup.
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              Compared performance of high-sensitivity cameras dedicated to myocardial perfusion SPECT: a comprehensive analysis of phantom and human images.

              Differences in the performance of cadmium-zinc-telluride (CZT) cameras or collimation systems that have recently been commercialized for myocardial SPECT remain unclear. In the present study, the performance of 3 of these systems was compared by a comprehensive analysis of phantom and human SPECT images.

                Author and article information

                [1 ]Program in Health and Welfare, Graduate on School of Comprehensive Scientific Research, Prefectural University of Hiroshima
                [2 ]Program in Biological System Sciences, Graduate on School of Comprehensive Scientific Research, Prefectural University of Hiroshima
                [3 ]Department of Radiology, Kurashiki Central Hospital
                [4 ]Department of Nursing, Hyogo University of Health Sciences
                Author notes
                * Corresponding author: Hideo Onishi, Program in Health and Welfare, Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, 1-1 Gakuenmachi, Mihara, Hiroshima, Japan 723-0053. Tel: +81-848-60-1268; Fax: +81-848-60-1186; E-mail: onisi@
                Asia Ocean J Nucl Med Biol
                Asia Ocean J Nucl Med Biol
                Asia Oceania Journal of Nuclear Medicine and Biology
                Asia Oceania Journal of Nuclear Medicine & Biology (Iran )
                Autumn 2013
                : 1
                : 2
                : 28-34
                27408847 4927048 AOJNMB-1-28
                Copyright: ©

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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