Comprehensive Validation of Cardiac SPECT Reconstruction

描述(申请人提供)：诊断和定量的准确性 心脏SPECT受深度相关的模糊、衰减、散射、 和图像噪音。纠正这些物理影响的方法是 描述了，但在临床上没有广泛使用，主要是由于缺乏 全面验证。我们建议培养领导才能 核心脏病学的研究人员来验证最有希望的技术， 目标1.利用OEM的严格实现，包括 衰减、准直器模糊和移位可变散射的模型(Tsui和 同事)，使用我们自己的方法，虽然不那么严格，但已经产生了 优秀的人体多中心试验结果，作为比较的基线。目标 2.在一系列评估中评估这些方法的定量准确性 计算机模拟和实际幻影：MCAT和NCAT代码产生 不同“缺陷”的一系列模拟(根据位置、大小和 缺血程度)，具有不同程度的衰减、散布和模糊， 以及最新的Data Spectrum心脏模体，它能够“跳动”。 对象中的“真实”活动浓度(即 模拟)或体模将用作比较的基线。目标3.至 在一系列犬类研究中评估这些方法的定量准确性 通过可变冠状动脉建立实验性脑缺血模型 闭塞，有不同的缺血区(就位置和严重程度而言)。 微球测量心肌灌注的真实分布 体外计数，将作为比较的基线。目标4.评估 这些方法对视力诊断准确性的影响 人类多中心临床的解释和极图量化 SPECT在冠心病诊断中的研究结果是 冠状动脉造影术将作为比较的基线。假设： OSEM方法将有更好的诊断性和量化 准确性高于其他方法，在临床上具有重要的意义，尤其是 在轻度疾病患者中。

DESCRIPTION (Provided by Applicant): The diagnostic and quantitative accuracy of cardiac SPECT are limited by depth-dependent blurring, attenuation, scatter, and image noise. Approaches to correct for these physical effects have been described, but are not widely used clinically, primarily due to lack of comprehensive validation. We propose to pooi the talents of leading investigators in nuclear cardiology to validate the most promising techniques, as follows: Aim 1. To utilize a rigorous implementation of OSEM that includes models of attenuation, collimator blur, and shift-variant scatter (Tsui and colleagues), with our own approach, which is less rigorous but has produced excellent human multi-center trial results, as a baseline for comparison. Aim 2. To assess the quantitative accuracy of these approaches in a series of computer simulations and actual phantoms: the MCAT and NCAT code to produce a series of simulations of different "defects" (in terms of location, size, and degree of "ischemia"), with varying degrees of attenuation, scatter, and blur, and the newest Data Spectrum cardiac phantom, which is capable of "beating." The "true" activity concentration in the object (i.e., the model prior to simulation) or phantom will serve as the baseline for comparison. Aim 3. To assess the quantitative accuracy of these approaches in a series of dog studies with a model of experimentally-induced ischemia via variable coronary artery occlusion, with different ischemic regions (in terms of location and severity). The true distribution of myocardial perfusion, as measured by microspheres counted ex vivo, will serve as the baseline for comparison. Aim 4. To assess the effects of these approaches on the diagnostic accuracy of visual interpretation and polar-plot quantification of human multi-center clinical SPECT studies in the diagnosis of coronary artery disease. The results of coronary angiography will serve as the baseline for comparison. Hypotheses: The OSEM approach will have significantly better diagnostic and quantitative accuracy than other approaches, clinically important in magnitude, especially in mild disease patients.