Real-time respiratory triggered SPECT myocardial perfusion imaging using CZT technology: impact of respiratory phase matching between SPECT and low-dose CT for attenuation correction
Real-time respiratory triggered SPECT myocardial perfusion imaging using CZT technology: impact of respiratory phase matching between SPECT and low-dose CT for attenuation correction
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DOI：
10.1093/ehjci/jew031
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发表时间：
2017-01-01
影响因子：
6.2
通讯作者：
Kaufmann, Philipp A.
中科院分区：
文献类型：
--
作者：
Clerc, Olivier F.;Fuchs, Tobias A.;Kaufmann, Philipp A.
目的评价单光子发射计算机断层扫描心肌灌注成像（SPECT-MPI）与低剂量计算机断层扫描（CT）在衰减校正（AC）中呼吸相匹配的影响。方法和结果40例患者在镉锌碲化伽马照相机下进行了为期1天的tc -99m-四氟氰胺药理学应激/休息SPECT-MPI。深吸气屏气低剂量CT检查AC。在自由呼吸（FB）时获得一次SPECT-MPI，并在深吸气屏气（BH）时重复一次SPECT-MPI以匹配AC的呼吸相。从这些获取的数据中，我们重建了四个数据集：无AC的自由呼吸SPECT-MPI（非校正；FB- nc），无AC的屏气SPECT-MPI（非校正；BH- nc），有AC的自由呼吸SPECT-MPI （FB-AC）和有AC的屏气SPECT-MPI (BH-AC)，后者代表呼吸相匹配的AC SPECT-MPI。我们比较了半定量的片段示踪剂摄取、视觉诊断、观察者之间的一致性和图像质量。与FB-NC相比，深吸气BH-NC增加了下侧摄取，但减少了间隔摄取。在FB中加入AC可增加下隔摄取，但减少前外侧摄取。憋气MPI与憋气CT AC （BH-AC）联合使用增加了下、外侧和间隔摄取，但减少了根尖摄取，而不影响前外侧摄取，与所有其他方案有显著差异。不同方案的正常扫描频率增加：FB-NC组为10%，BH-NC组为21%，FB-AC组为38%，BHAC组为51%。在所有协议中，BH-AC的图像质量和观察者之间的一致性最高。结论与未校正屏气SPECT-MPI和自由呼吸AC SPECT-MPI相比，呼吸相匹配的AC SPECT-MPI显著影响了节段半定量摄取，增加了正常扫描频率，观察者间一致性最好，显著提高了图像质量。这些发现提示呼吸触发SPECT-MPI在临床常规中的潜在作用。
Aims To assess the impact of respiratory phase matching between single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) and low-dose computed tomography (CT) for attenuation correction (AC).Methods and results Forty patients underwent 1-day Tc-99m-tetrofosmin pharmacological stress/rest SPECT-MPI using a cadmium-zinc-telluride gamma camera. Low-dose CT for AC was performed at deep-inspiration breath-hold. SPECT-MPI was acquired once with free-breathing (FB) and repeated at deep-inspiration breath-hold (BH) to match the respiratory phase of AC. From these acquisitions we reconstructed four data sets: free-breathing SPECT-MPI without AC (non-corrected; FB-NC), breath-hold SPECT-MPI without AC (non-corrected; BH-NC), free-breathing SPECT-MPI with AC (FB-AC), and breath-hold SPECT-MPI with AC (BH-AC), the latter representing respiratory-phase-matched AC SPECT-MPI. We compared semi-quantitative segmental tracer uptake, visual diagnosis, inter-observer agreement, and image quality. Compared with FB-NC, deep-inspiration BH-NC increases inferior and lateral uptake, but decreases septal uptake. Addition of AC to FB increases inferior and septal uptake, but decreases anterolateral uptake. Combining breath-hold MPI with breath-hold CT AC (BH-AC) increases inferior, inferolateral, and septal uptake, but reduces apical uptake, without affecting anterolateral uptake, with significant differences to all other protocols. Frequency of normal scans increases across protocols: 10% with FB-NC, 21% with BH-NC, 38% with FB-AC, and 51% with BHAC. Image quality and inter-observer agreement were highest for BH-AC among all protocols.Conclusion Compared with non-corrected breath-hold SPECT-MPI and with free-breathing AC SPECT-MPI, respiratory-phase matched AC SPECT-MPI significantly affects segmental semi-quantitative uptake, increases the frequency of normal scans, yields the best inter-observer agreement, and significantly improves image quality. These findings suggest a potential role of respiratory triggered SPECT-MPI in clinical routine.