Validation of a new cardiac image fusion software for three-dimensional integration of myocardial perfusion SPECT and stand-alone 64-slice CT angiography
Validation of a new cardiac image fusion software for three-dimensional integration of myocardial perfusion SPECT and stand-alone 64-slice CT angiography
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DOI：
10.1007/s00259-006-0342-9
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发表时间：
2007-07-01
影响因子：
9.1
通讯作者：
Kaufmann, Philipp A.
中科院分区：
文献类型：
--
作者：
Gaemperli, Oliver;Schepis, Tiziano;Kaufmann, Philipp A.
目的将SPECT心肌灌注成像（SPECT- mpi）的功能信息与冠状动脉CT血管造影（CTA）的形态信息相结合，可以更容易地评价冠状动脉狭窄与灌注缺损的空间关系。本研究的目的是验证SPECT-MPI和CTA的三维（3D）图像融合的新软件解决方案。方法采用SPECT-MPI +腺苷应激/休息Tc-99m-tetrofosmin与64层CTA融合治疗15例连续出现单一灌注缺损且单一冠状动脉明显狭窄（>= 50%直径狭窄）的患者。三维融合SPECT/CT图像由两名独立的观察者对狭窄血管与心肌灌注缺陷的叠加进行分析。通过记录狭窄冠状动脉原点和灌注缺陷中心的X、Y、Z坐标并测量两个地标之间的距离来评估观察者间的可变性。结果SPECT-MPI显示7例患者为固定缺损，5例患者为可逆缺损，3例患者为混合性缺损，CTA显示相应的对侧冠状动脉明显狭窄。三维融合SPECT/CT图像显示，每个患者的冠状动脉病变和灌注缺损匹配，融合过程不到15分钟。观察者间可变性对于地标检测非常好（r= 1.00和r= 0.99, p < 0.0001），对于两个地标之间的三维距离非常好（r= 0.94, p < 0.001）。结论三维SPECT/CT图像融合是可行的，可重复性好，并能将SPECT片段正确地叠加到心脏CT解剖上。
Purpose Combining the functional information of SPECT myocardial perfusion imaging (SPECT-MPI) and the morphological information of coronary CT angiography (CTA) may allow easier evaluation of the spatial relationship between coronary stenoses and perfusion defects. The aim of the present study was the validation of a novel software solution for three-dimensional (3D) image fusion of SPECT-MPI and CTA.Methods SPECT-MPI with adenosine stress/ rest Tc-99m-tetrofosmin was fused with 64-slice CTA in 15 consecutive patients with a single perfusion defect and a single significant coronary artery stenosis (>= 50% diameter stenosis). 3D fused SPECT/CT images were analysed by two independent observers with regard to superposition of the stenosed vessel onto the myocardial perfusion defect. Interobserver variability was assessed by recording the X, Y, Z coordinates for the origin of the stenosed coronary artery and the centre of the perfusion defect and measuring the distance between the two landmarks.Results SPECT-MPI revealed a fixed defect in seven patients, a reversible defect in five patients and a mixed defect in three patients and CTA documented a significant stenosis in the respective subtending coronary artery. 3D fused SPECT/CT images showed a match of coronary lesion and perfusion defect in each patient and the fusion process took less than 15 min. Interobserver variability was excellent for landmark detection (r= 1.00 and r= 0.99, p < 0.0001) and very good for the 3D distance between the two landmarks ( r= 0.94, p < 0.001).Conclusion 3D SPECT/CT image fusion is feasible, reproducible and allows correct superposition of SPECT segments onto cardiac CT anatomy.