Three-dimensional fusion of pulmonary SPECT and CT images using multimodality devices.

进行了体模研究，以评价使用来自外部来源的99 m高锝酸盐（Tc-99 m）的康普顿散射光子进行身体轮廓定义的可行性，以创建CT和SPECT图像的融合图像。将来自1 mCi（37 MBq）Tc-99 m的外部源放置在每个准直器上，使用100 kcV±25%的能量窗口获得身体轮廓SPECT图像，用于检测来自充满水的圆柱形和六边形体模中的身体表面的Tc-99 m的90°和180°康普顿散射光子，以及具有Tc-99 m-avid模拟肺结节和多模态表面标记物的胸部体模。在胸部模型中，使用图像匹配软件将每个经轴SPECT切片与相应的CT切片配准。将配准图像相加得到该体模的三维（3-D）融合图像。该方法在除复杂六边形体模外的所有体模中的所有SPECT切片上清晰地显示了身体轮廓。没有任何迹象表明 ...更多信息 圆柱体模的已知直径和SPECT测量直径之间的显著差异。胸部体模的CT和SPECT图像的拟合在目视检查中以5%的平均对准误差实现，根据所得尺寸差异校正SPECT图像的放大率后，其改善为0.2%。该体模的3-D融合图像有效地显示了肺结节和表面标记的解剖位置。这种简单的方法有效地提供了冷幻影的边界信息。尽管期望进一步改进与CT图像的配准技术，但是通过该方法获得的身体轮廓SPECT图像具有精确地创建与CT图像的3-D融合图像的潜力，并且是预测靶组织的解剖定位的非常可行的方式。除了这些实验研究，三维氙-133 SPECT成像在肺癌患者的肺通气功能障碍的评估和肺气肿患者的肺减容手术的切除目标的评估的有用性进行了临床评价。通过呼吸磁共振（MR）成像和三维Xenon-133 SPECT的研究间比较，还评价了肺气肿中异常膈肌/胸壁运动与区域通气之间的相关性。结果表明，该三维图像可用于肺癌患者通气异常的评估，以及肺气肿患者肺减容术的切除靶点的确定和疗效评价。（MR）成像和三维氙-133 SPECT之间的相关性表明，肺气肿患者的膈肌/胸壁运动的异常活动性或协调性与每侧胸廓的异常通气之间存在密切联系。少

A phantom study was conducted to evaluate the feasibility of body contour definition using Compton scatter photons from external sources of technotium-99m pertechnotate (Tc-99m) to create a fusion image of CT and SPECT images. External sources from 1 mCi (37MBq) Tc-99m were placed on each collimator, and body-contour SPECT images were obtained using an energy window of 100 kcV±25% for detecting 90°and 180°Compton scatter photons of Tc-99m from the body surface in water-filled cylindrical and hexagonal phantoms, and in a chest phantom with a Tc-99m-avid simulated lung nodule and multimodality surface markers. In the chest phantom, each transaxial SPECT slices was registered with the corresponding CT slice using image-matching soft-ware. A summation of the registered images yielded a three-dimensional (3-D) fusion image of this phantom. This method clearly visualized the body contour on all the SPECT slices in all the phantoms except for the complex hexagonal phantom. There was no signif … More icant difference between known and SPECT-measured diameters of the cylindrical phantom. The fit of CT and SPECT images of the chest phantom was achieved with a mean alignment error of 5% in visual inspection, which was improved to 0.2% after correction of the magnification of the SPECT images according to the resultant dimensional differences. The 3-D fusion image of this phantom effectively visualized the anatomic location of the lung nodule and surface markers. This simple method effectively provided boundary information of the cold phantoms. Although further improvements of the regisration technique with CT images are desirable, the body-contour SPECT images obtained by this method has the potential for accurately creating a 3-D fusion image with CT images, and is a very feasible way anticipating the anatomical localization of a target tissue. In addition to these experimental study, the usefulness of three-dimensional Xenon-133 SPECT imaging in the evaluation of lung ventilation impairments in patients with lung cancer and in the assessment of resection targets for lung volume reduction surgery in patients with pulmonary emphysema were clinically evaluated. The associations between abnormal diaphragm/chest wall motions and regional ventilation in pulmonary emphysema was also evaluated by interstudy comparison of breathing magnetic resonance (MR) imaging and three-dimensional Xenon-133 SPECT. The results showed that this three-dimensional image was useful for the evaluation of abnormal ventilation in patients with lung cancer, and for the detection of resection targets and assessments of therapeutic effects of the reduction surgery in patients with pulmonary emphysema. The correlations between (MR) imaging and three-dimensional Xenon-133 SPECT indicate the close associations between abnormal mobility or coordination of diaphragm/chest wall motions and abnormal ventilation in each hemithorax in patients with pulmonary emphysema. Less