Experimental validation of absolute SPECT/CT quantification for response monitoring in patients with coronary artery disease
EJNMMI Physics, vol. 8, pp. 48
Abstract
Abstract Background Quantitative SPECT enables absolute quantification of uptake in perfusion defects. The aim of this experimental study is to assess quantitative accuracy and precision of a novel iterative reconstruction technique (Evolution; GE Healthcare) for the potential application of response monitoring using 99mTc-tetrofosmin SPECT/CT in patients with coronary artery disease (CAD). Methods Acquisitions of an anthropomorphic torso phantom with cardiac insert containing defects (with varying sizes), filled with 99mTc-pertechnetate, were performed on a SPECT/CT (Discovery 670 Pro, GE Healthcare). Subsequently, volumes of interest of the defects were manually drawn on CT to assess the recovery coefficient (RC). Bull’s eye plots were composed to evaluate the uptake per segment. Finally, 99mTc-tetrofosmin SPECT/CT scans of 10 CAD patients were used to illustrate clinical application. Results The phantom study indicated that Evolution showed convergence after 7 iterations and 10 subsets. The average repeatability deviation of all configurations was 2.91% and 3.15% (%SD mean) for filtered (Butterworth) and unfiltered data, respectively. The accuracy after post-filtering was lower compared to the unfiltered data with a mean (SD) RC of 0.63 (0.05) and 0.70 (0.07), respectively (p < 0.05). More artificial defects were found on Bull’s eye plots created with the unfiltered data compared to filtered data. Eight out of ten patients showed significant changes in uptake before and after treatment (p < 0.05). Conclusion Quantification of 99mTc-tetrofosmin SPECT/CT seems feasible for CAD patients when 7 iterations (10 subsets), Butterworth post-filtering (cut off frequency 0.52 in cycles/cm, order of 5) and manual CT-delineation are applied. However, future prospective patient studies are required for clinical application.
Authors 7
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Alina van de Burgt corresponding Aachen Department of Radiology Section of Nuclear Medicine Department of Radiology Section of Nuclear Medicine
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. l.oei@utwente.nl
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Affiliation as printed
Technical Medical Center, University of Twente, Enschede, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center · University of Twente
Affiliation as printed
Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
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