Retrospective fractional dose reduction in Tc-99m cardiac perfusion SPECT/CT patients: A human and model observer study
Retrospective fractional dose reduction in Tc-99m cardiac perfusion SPECT/CT patients: A human and model observer study
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DOI：
10.1007/s12350-019-01743-7
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发表时间：
2021-04-01
影响因子：
2.4
通讯作者：
Wernick, Miles N.
中科院分区：
文献类型：
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作者：
Pretorius, P. Hendrik;Ramon, Albert Juan;Wernick, Miles N.
背景 在减少传统 SPECT/CT 系统心脏灌注剂量（注入放射性）的持续努力中，我们进行了一项人类观察者研究，以证实我们的临床模型观察者发现，即采用全剂量（四分之一剂量）25% 的 OSEM（有序子集期望最大化）进行迭代重建在检测混合心脏灌注缺陷方面与全剂量 FBP 具有相似的性能。方法 166 名接受常规静息应激 Tc-99m 塞他米比心脏灌注 SPECT/CT 成像且临床读数正常灌注的患者纳入研究。地面实况是通过正常读取和混合缺陷的插入来建立的。除了使用带有衰减 (AC)、散射 (SC) 和空间分辨率校正 (RC) 的 OSEM 重建 25% 的全剂量数据外，还完成了全剂量 (100%) 下的 FBP 和 OSEM（带有 AC、SC 和 RC）。获得人类观察者和临床模型观察者置信度评分，以在基于任务的图像质量评估中生成受试者工作特征（ROC）曲线。结果 对于全剂量的 FBP、25% 全剂量的 OSEM 和全剂量的 OSEM，人类观察者的平均 AUC（ROC 曲线下面积）值分别为 0.725、0.876 和 0.890。两种 OSEM 策略均显着优于 FBP，P 值分别为 0.003 和 0.01，而 OSEM 方法之间没有显着差异（P = 0.48）。对于人类观察者研究中使用的相同患者病例和处理策略，临床模型观察者结果分别为 0.791、0.822 和 0.879。结论 当人类观察者读取时，使用全剂量 25% 的 OSEM 重建的心脏灌注 SPECT/CT 的 AUC 大于 FBP，并且更接近全剂量 OSEM 的 AUC，有可能在临床读取期间取代更高剂量的研究。
Background In the ongoing efforts to reduce cardiac perfusion dose (injected radioactivity) for conventional SPECT/CT systems, we performed a human observer study to confirm our clinical model observer findings that iterative reconstruction employing OSEM (ordered-subset expectation-maximization) at 25% of the full dose (quarter-dose) has a similar performance for detection of hybrid cardiac perfusion defects as FBP at full dose. Methods One hundred and sixty-six patients, who underwent routine rest-stress Tc-99m sestamibi cardiac perfusion SPECT/CT imaging and clinically read as normally perfused, were included in the study. Ground truth was established by the normal read and the insertion of hybrid defects. In addition to the reconstruction of the 25% of full-dose data using OSEM with attenuation (AC), scatter (SC), and spatial resolution correction (RC), FBP and OSEM (with AC, SC, and RC) both at full dose (100%) were done. Both human observer and clinical model observer confidence scores were obtained to generate receiver operating characteristics (ROC) curves in a task-based image quality assessment. Results Average human observer AUC (area under the ROC curve) values of 0.725, 0.876, and 0.890 were obtained for FBP at full dose, OSEM at 25% of full dose, and OSEM at full dose, respectively. Both OSEM strategies were significantly better than FBP with P values of 0.003 and 0.01 respectively, while no significant difference was recorded between OSEM methods (P = 0.48). The clinical model observer results were 0.791, 0.822, and 0.879, respectively, for the same patient cases and processing strategies used in the human observer study. Conclusions Cardiac perfusion SPECT/CT using OSEM reconstruction at 25% of full dose has AUCs larger than FBP and closer to those of full-dose OSEM when read by human observers, potentially replacing the higher dose studies during clinical reading.