End-expiration respiratory gating for a high-resolution stationary cardiac SPECT system.
End-expiration respiratory gating for a high-resolution stationary cardiac SPECT system.
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DOI：
10.1088/0031-9155/59/20/6267
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发表时间：
2014-10-21
影响因子：
3.5
通讯作者：
Liu C
中科院分区：
文献类型：
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作者：
Chan C;Harris M;Le M;Biondi J;Grobshtein Y;Liu YH;Sinusas AJ;Liu C
呼吸和心脏运动会降低心肌灌注SPECT（MPS）图像质量，降低缺陷检测和定量准确性。在这项研究中，我们开发了一个双呼吸和心脏门控系统的高分辨率全固定心脏SPECT扫描仪，以提高图像质量和缺陷检测。使用连接到双呼吸-心脏门控盒的压缩传感器枕监测呼吸运动，该双呼吸-心脏门控盒仅在呼气末阶段将心脏触发发送到SPECT扫描仪上的单个心脏触发输入。将列表模式数据回顾性重新分组到呼气末帧中，以减少呼吸运动，或仅在呼气末阶段进行8次心脏门控，以补偿呼吸和心脏运动。所提出的方法首先在存在和不存在多个灌注缺陷的运动体模上进行验证，然后应用于11例有和无灌注缺陷的患者研究。在正常体模研究中，呼气末门控SPECT（EXG-SPECT）减少了呼吸运动模糊，并增加了心肌血池对比度的51.2%相比，非门控图像。所提出的方法还产生了心肌缺损对比度的平均增加11.2%相比，非门控图像在体模研究与灌注缺陷。在患者研究中，与非门控图像相比，EXG-SPECT显著改善了心肌与血池对比度（p<0.005），平均提高了24%，并改善了正常患者极图上各节段的灌注均匀性。对于1例缺损患者，EXG-SPECT改善了缺损对比度和清晰度。与EXG SPECT相比，双心室-心脏门控进一步降低了模糊效应，心肌与血池对比度显著增加了36%（p<0.05），并进一步改善了缺损特征和精细结构的可视化，但以缺损患者的噪声增加为代价。实验结果表明，该方法能有效地减少由呼吸和心脏运动引起的图像运动模糊，从而提高缺陷检测和量化的准确性。这种方法可以很容易地适用于目前可用的商业系统的常规临床实践。
Respiratory and cardiac motions can degrade myocardial perfusion SPECT (MPS) image quality and reduce defect detection and quantitative accuracy. In this study, we developed a dual-respiratory and cardiac gating system for a high resolution fully stationary cardiac SPECT scanner in order to improve the image quality and defect detection. Respiratory motion was monitored using a compressive sensor pillow connected to a dual respiratory-cardiac gating box, which sends cardiac triggers only during end-expiration phases to the single cardiac trigger input on the SPECT scanners. The listmode data were rebinned retrospectively into end-expiration frames for respiratory motion reduction or 8 cardiac gates only during end-expiration phases to compensate for both respiratory and cardiac motions. The proposed method was first validated on a motion phantom in the presence and absence of multiple perfusion defects, and then applied on 11 patient studies with and without perfusion defects. In the normal phantom studies, the end-expiration gated SPECT (EXG-SPECT) reduced respiratory motion blur and increased myocardium to blood pool contrast by 51.2% as compared to the ungated images. The proposed method also yielded an average of 11.2% increase in myocardium to defect contrast as compared to the ungated images in the phantom studies with perfusion defects. In the patient studies, EXG-SPECT significantly improved the myocardium to blood pool contrast (p<0.005) by 24% on average as compared to the ungated images, and led to improved perfusion uniformity across segments on polar maps for normal patients. For a patient with defect, EXG-SPECT improved the defect contrast and definition. The dual respiratory-cardiac gating further reduced the blurring effect, increased the myocardium to blood pool contrast significantly by 36% (p<0.05) compared to EXG SPECT, and further improved defect characteristics and visualization of fine structures at the expense of increased noise on the patient with defect. The results showed that the proposed methods can effectively reduce motion blur in the images caused by both respiratory and cardiac motions, which may lead to more accurate defect detection and quantifications. This approach can be easily adapted in routine clinical practice on currently available commercial systems.