TECHNICAL ASPECTS OF MYOCARDIAL SPECT IMAGING WITH TC-99M SESTAMIBI
TECHNICAL ASPECTS OF MYOCARDIAL SPECT IMAGING WITH TC-99M SESTAMIBI
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DOI：
10.1016/0002-9149(90)90608-4
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发表时间：
1990-10-16
影响因子：
2.8
通讯作者：
BERMAN, DS
中科院分区：
文献类型：
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作者：
GARCIA, EV;COOKE, CD;BERMAN, DS
迄今为止，大多数使用单光子发射计算机断层扫描（SPECT）与锝-99m (Tc-99m) sestamibi的报道都使用了针对铊-201优化的采集参数。为了充分利用Tc-99m sestamibi优越的成像特性，需要优化该药物的SPECT成像技术。通过仔细选择最佳放射药物剂量、成像序列、采集参数、重建滤波器、灌注量化方法和用于可视化灌注分布的多维方法，可以提高性能。目前的报告描述了理论考虑，幻影研究和初步的患者结果，这些结果导致了埃默里大学和雪松西奈医学中心开发的优化方案，用于当日应激研究，给定现有的仪器和推荐的剂量限制。优化设计适合低剂量高剂量休息应激当日成像方案。与以前的Tc-99m系统协议相比，采集参数的主要变化是使用了高分辨率准直器。该方法在俯卧位和仰卧位都有发展。提出了一种提取心肌计数三维分布的新方法，该方法采用球坐标对心肌顶点区域进行采样，柱坐标对心肌的其余部分进行采样。还描述了在多维度上显示心肌分布的新方法，改进了二维，以及三维和四维（三维加时间）显示。在改进的二维显示中，使用了距离加权和体积加权的极坐标图，它们似乎分别显著改善了缺陷位置和缺陷程度的表示。与目前报道的铊-201和Tc-99m sestamibi研究相比，建立的协议和开发的Tc-99m sestamibi SPECT的采集、定量和显示方法应该提供更好的图像质量和准确性。
Most reports to date using single photon emission computed tomography (SPECT) with technetium-99m (Tc-99m) sestamibi have used acquisition parameters that were optimized for thallium-201. To fully utilize the superior imaging characteristics of Tc-99m sestamibi, there is a need to optimize the technical aspects of SPECT imaging for this agent. Performance can be enhanced through the careful selection of optimal radiopharmaceutical doses, imaging sequences, acquisition parameters, reconstruction filters, perfusion quantification methods and multidimensional methods for visualizing perfusion distribution. The current report describes theoretical considerations, phantom studies and preliminary patient results that have led to optimized protocols, developed at Emory University and Cedars-Sinai Medical Center, for same-day reststress studies, given existing instrumentation and recommended dose limits. The optimizations were designed to fit a low-dose-high-dose rest-stress same-day imaging protocol. A principal change in the acquisition parameters compared with previous Tc-99m sestamibi protocols is the use of a highresolution collimator. The approach is being developed in both prone and supine positions. A new method for extracting a 3-dimensional myocardial count distribution has been developed that uses spherical coordinates to sample the apical region and cylindrical coordinates to sample the rest of the myocardium. New methods for visualizing the myocardial distribution in multiple dimensions are also described, with improved 2-dimensional, as well as 3- and 4-dimensional (3 dimensions plus time) displays. In the improved 2-dimensional display, distance-weighted and volume-weighted polar maps are used that appear to significantly improve the representation of defect location and defect extent, respectively. The protocols established and the methods developed for acquisition, quantification and display of Tc-99m sestamibi SPECT should provide improved image quality and accuracy, compared to current thallium-201 and Tc-99m sestamibi studies reported to date.