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Attenuation correction strategies for myocardial perfusion imaging using dual-gated SPECT

双门控 SPECT 心肌灌注成像的衰减校正策略

基本信息

批准号：
10046939
负责人：
Mingwu Jin
金额：
$ 47.22万
依托单位：
UNIVERSITY OF TEXAS ARLINGTON
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-05 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10046939
关键词：
3-Dimensional Address Adoption Adverse effects Anatomy Arteries Back Breathing Cardiac Clinical Clinical Data Computed Tomography Scanners Computer Simulation Computers Coronary Arteriosclerosis Data Data Set Defect Detection Development Diagnosis Diagnostic Disease Dose Electrocardiogram Evaluation Foundations Generations Heart Diseases Human Hybrids Image Institutes Joints Lead Left Left Ventricular Function Mainstreaming Maps Medical Medical Imaging Medical center Methods Monte Carlo Method Morphologic artifacts Motion Myocardial perfusion Noise Pathologic Patients Performance Perfusion Phase Physiological Protocols documentation Public Health Radiation Reading Reproducibility Research Respiratory Diaphragm Roentgen Rays Solid System Techniques Testing Time Training Underrepresented Students Ventricular Visual X-Ray Computed Tomography algorithm development attenuation base career clinical practice complement C4d cone-beam computed tomography cost denoising design diagnostic accuracy experience image processing image reconstruction imaging modality improved innovation interest novel outcome forecast perfusion imaging programs reconstruction respiratory simulation single photon emission computed tomography spatiotemporal success tool undergraduate student virtual

项目摘要

Summary Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) is a prevalent clinical tool in diagnosis and prognosis of coronal artery disease (CAD). Dual cardiac-respiratory gated SPECT (D-SPECT) has been proposed long ago to eliminate artifacts from patient's cardiac and respiratory motion, but elevated noise and lack of evidence for diagnostic benefit over processing complexity hamper its clinical adoption. Cardiac ECG-gated SPECT (C-SPECT) remains the mainstream enabling the assessment of left-ventricular (LV) functions. Advanced 4D reconstruction with superior denoising ability resurrects interests in D-SPECT recently. Meanwhile, attenuation correction (AC) is essential for quantitative MPI and minimizing false positives. However, AC artifacts can arise when SPECT images are mismatched with attenuation maps derived from the hybrid SPECT/CT scanner. This becomes another major hurdle for D- SPECT because the accompanied cone-beam CT (CBCT) yields only one non-respiratory-gated 3D CT image. To address these issues, we propose a novel SPECT MPI protocol: D-SPECT with motion matched AC (D- SPECT-MAC), which will minimize SPECT MPI artifacts. The motion-matched attenuation maps can be obtained by a general simultaneous motion estimation and image reconstruction (G-SMEIR) method and D- SPECT images without changing low-dose CBCT imaging. Founded on our success on 4D spatiotemporal reconstruction and artifact-correction methods for both SPECT and CBCT and experience collecting D-SPECT data for more than 1,500 patients, with advances in development of realistic computational human phantoms and computer power, it is time to systematically evaluate D-SPECT-MAC using a mass simulation study backed by a patient study to provide the urgently needed evidence for use of D-SPECT. We hypothesize that D-SPECT-MAC can significantly improve perfusion defect detection and LV functional assessment, compared to two other protocols: popular C-SPECT with averaged AC over respiratory cycles (C-SPECT-AAC) and emerging D-SPECT with averaged AC (D-SPECT-AAC). Our hypothesis will be tested through the following specific aims: 1) To evaluate performance of three SPECT MPI protocols using a mass simulation study of 5,000 virtual patients from the XCAT phantom program; 2) To develop D-SPECT-MAC for clinical data and to verify simulation findings using 150 patient data sets retrospectively selected. The success of this project will lead to artifact-free SPECT MPI, which enables use of only one set of faithfully corrected MPI images instead of visual reading both non-corrected and AC images in the current clinical practice, thus significantly improving diagnostic accuracy, reproducibility, and clinical workflow. Furthermore, this project will provide opportunities for under-represented students at the PI's institute to be professionally trained and to gain precious experience on medical imaging research with clinical collaborators at medical institutes, which paves a way for them to pursue a successful biomedical career.

总结使用单光子发射计算机断层扫描（SPECT）进行心肌灌注成像（MPI）是一种冠状动脉疾病（CAD）的诊断和预后的流行的临床工具。双心肺门控SPECT（D-SPECT）很久以前就被提出来消除来自患者心脏的伪影，呼吸运动，但噪音升高，缺乏证据证明诊断益处超过处理复杂性阻碍其临床应用。心脏ECG门控SPECT（C-SPECT）仍然是主流，评估左心室（LV）功能。具有上级去噪能力的高级4D重建最近重新引起了人们对D-SPECT的兴趣。同时，衰减校正（AC）是定量的必要条件。 MPI和最小化误报。然而，当SPECT图像与AC伪影不匹配时，从混合SPECT/CT扫描仪导出的衰减图。这是D的另一个主要障碍- SPECT，因为伴随的锥形束CT（CBCT）仅产生一个非呼吸门控3D CT图像。为了解决这些问题，我们提出了一种新的SPECT MPI协议：具有运动匹配AC（D-SPECT）的D-SPECT。 SPECT-MAC），这将使SPECT MPI伪影最小化。运动匹配衰减图可以是通过一般的同时运动估计和图像重建（G-SMEIR）方法和D- SPECT图像，而不改变低剂量CBCT成像。基于我们在4D时空上的成功 SPECT和CBCT的重建和伪影校正方法以及收集D-SPECT的经验超过1,500名患者的数据，在开发逼真的计算人类幻影方面取得了进展和计算机能力，是时候使用大规模模拟研究系统地评估D-SPECT-MAC了通过一项患者研究，为D-SPECT的使用提供急需的证据。我们假设 D-SPECT-MAC可显著改善灌注缺损检测和左室功能评估，其他两个协议：流行的C-SPECT与呼吸周期平均AC（C-SPECT-AAC）和具有平均AC的新兴D-SPECT（D-SPECT-AAC）。我们的假设将通过以下方式进行检验具体目标：1）使用以下质量模拟研究评估三种SPECT MPI协议的性能：来自XCAT体模项目的5，000名虚拟患者; 2）开发用于临床数据的D-SPECT-MAC，使用回顾性选择的150个患者数据集验证模拟结果。该项目的成功将导致无伪影的SPECT MPI，它可以只使用一组忠实的校正MPI图像，而不是当前临床中未校正和AC图像的视觉阅读实践，从而显着提高诊断的准确性，再现性和临床工作流程。此外，委员会认为，该项目将为PI研究所的代表性不足的学生提供专业学习的机会，培训，并与医学临床合作者一起获得医学影像研究的宝贵经验。研究所，这为他们铺平了道路，追求一个成功的生物医学事业。