The Effect of Misregistration Between CT-Attenuation and PET-Emission Images in 13N-Ammonia Myocardial PET/CT.

UNLABELLED: In 2-dimensional cardiac PET/CT, misregistration between the PET and CT images due to respiratory and cardiac motion causes tracer uptake to appear substantially reduced. The resolution and quality of the images have been considerably improved by the use of 3-dimensional (3D) PET acquisitions. In the current study, we investigated the impact that misregistration between PET and CT images has on myocardial (13)N-ammonia uptake in images reconstructed with 3D ordered-subset expectation maximization combined with time-of-flight and point-spread-function modeling. METHODS: Eight healthy volunteers (7 men and 1 woman; mean age ± SD, 53 ± 19 y) underwent (13)N-ammonia cardiac PET/CT at rest. First, any misregistration between the PET and CT images was manually corrected to generate reference images. Then, the images were intentionally misregistered by shifting the PET images from the reference images by a degree of 1, 2, 3, 4, 5, 10, and 15 mm along both the x-axis (left) and the z-axis (cranial). For each degree of misregistration, the PET images were reconstructed using the CT-attenuation images. The left ventricular short-axis PET/CT images were divided into 4 segments: anterior wall, inferior wall, lateral wall, and septum. The erroneous decrease in myocardial uptake in basal, mid, and apical slices was visually graded using a 4-point scale (0 = none, 1 = mild, 2 = moderate, and 3 = severe). Wall-to-septum uptake ratios were evaluated for the anterior, inferior, and lateral walls in the basal, mid, and apical slices. RESULTS: A statistically significant reduction in myocardial (13)N-ammonia uptake in the anterior (P < 0.01) and lateral (P < 0.05) walls was observed when misregistration was 10 mm or more. The uptake ratios for the anterior, lateral, and inferior walls in the reference images were 1.00 ± 0.04, 0.96 ± 0.08, and 0.91 ± 0.03, respectively. The ratios for the anterior and lateral walls significantly decreased when misregistration exceeded 10 mm (anterior wall, 0.80 ± 0.06, P < 0.0001; lateral wall, 0.82 ± 0.07, P < 0.01), whereas the ratio for the inferior wall was relatively small at all 7 degrees of misregistration (0.86 ± 0.05 at 15-mm misregistration, P = 0.06). CONCLUSION: In PET/CT images reconstructed with 3D ordered-subset expectation maximization combined with time-of-flight and point-spread-function modeling, we found a statistically significant artifactual reduction in tracer uptake in heart regions overlapping lung when misregistration between PET and CT exceeded 10 mm.

[Development of the software package of the nuclear medicine data processor for education and research].

The objective of this study was to develop a personal computer-based nuclear medicine data processor for education and research in the field of nuclear medicine. We call this software package "Prominence Processor" (PP). Windows of Microsoft Corporation was used as the operating system of this PP, which have 1024 × 768 image resolution and various 63 applications classified into 6 groups. The accuracy was examined for a lot of applications of the PP. For example, in the FBP reconstruction application, there was visually no difference in the image quality as a result of comparing two SPECT images obtained from the PP and GMS-5500A (Toshiba). Moreover, Normalized MSE between both images showed 0.0003. Therefore the high processing accuracy of the FBP reconstruction application was proven as well as other applications. The PP can be used in an arbitrary place if the software package is installed in note PC. Therefore the PP is used to lecture and to practice on an educational site and used for the purpose of the research of the radiological technologist on a clinical site etc. widely now.

Attenuation correction of myocardial SPECT by scatter-photopeak window method in normal subjects.

OBJECTIVE: Segmentation with scatter and photopeak window data using attenuation correction (SSPAC) method can provide a patient-specific non-uniform attenuation coefficient map only by using photopeak and scatter images without X-ray computed tomography (CT). The purpose of this study is to evaluate the performance of attenuation correction (AC) by the SSPAC method on normal myocardial perfusion database. METHODS: A total of 32 sets of exercise-rest myocardial images with Tc-99 m-sestamibi were acquired in both photopeak (140 keV +/- 10%) and scatter (7% of lower side of the photopeak window) energy windows. Myocardial perfusion databases by the SSPAC method and non-AC (NC) were created from 15 female and 17 male subjects with low likelihood of cardiac disease using quantitative perfusion SPECT software. Segmental myocardial counts of a 17-segment model from these databases were compared on the basis of paired t test. RESULTS: AC average myocardial perfusion count was significantly higher than that in NC in the septal and inferior regions (P < 0.02). On the contrary, AC average count was significantly lower in the anterolateral and apical regions (P < 0.01). Coefficient variation of the AC count in the mid, apical and apex regions was lower than that of NC. CONCLUSIONS: The SSPAC method can improve average myocardial perfusion uptake in the septal and inferior regions and provide uniform distribution of myocardial perfusion. The SSPAC method could be a practical method of attenuation correction without X-ray CT.

Quantitative analysis of first-pass contrast-enhanced myocardial perfusion MRI using a Patlak plot method and blood saturation correction.

The objectives of this study were to develop a method for quantifying myocardial K(1) and blood flow (MBF) with minimal operator interaction by using a Patlak plot method and to compare the MBF obtained by perfusion MRI with that from coronary sinus blood flow in the resting state. A method that can correct for the nonlinearity of the blood time-signal intensity curve on perfusion MR images was developed. Myocardial perfusion MR images were acquired with a saturation-recovery balanced turbo field-echo sequence in 10 patients. Coronary sinus blood flow was determined by phase-contrast cine MRI, and the average MBF was calculated as coronary sinus blood flow divided by left ventricular (LV) mass obtained by cine MRI. Patlak plot analysis was performed using the saturation-corrected blood time-signal intensity curve as an input function and the regional myocardial time-signal intensity curve as an output function. The mean MBF obtained by perfusion MRI was 86 +/- 25 ml/min/100 g, showing good agreement with MBF calculated from coronary sinus blood flow (89 +/- 30 ml/min/100 g, r = 0.74). The mean coefficient of variation for measuring regional MBF in 16 LV myocardial segments was 0.11. The current method using Patlak plot permits quantification of MBF with operator interaction limited to tracing the LV wall contours, registration, and time delays.

Simultaneous 3-dimensional resolution correction in SPECT reconstruction with an ordered-subsets expectation maximization algorithm.

UNLABELLED: Collimators are used for the improvement of information about the positions of sources by limiting the incidence direction of gamma-rays and characteristic x-rays to detectors. In this study, we attempted to improve the spatial resolution of (201)Tl myocardial SPECT by using simultaneous 3-dimensional distance-dependent resolution correction (DRC) incorporated into the ordered-subsets expectation maximization algorithm. METHODS: Simulation was performed with various sizes of balls, and measurement with a line-source phantom was performed at different source-detector distances. Imaging of a hot-rod phantom, the defect area of a myocardial phantom, and the myocardial thickness and cardiac lumen in a human study by (201)TlCl myocardial SPECT was evaluated before and after DRC. RESULTS: We performed simulation by using 5 sizes of balls and found marked improvement in resolution in all x-, y-, and z-axis directions. In the line-source phantom, when the radial distance was very long (30.5 cm), the correction effects were slightly low. However, when the distance was similar to the clinically used rotation radius (22.5 cm), the correction effects were good in the hot-rod and myocardial phantoms and in the human study. CONCLUSION: DRC markedly improved the spatial resolution of SPECT images, suggesting that this method is useful for the quantification of infarcted areas by myocardial SPECT.

[Simultaneous spatial resolution correction in SPECT reconstruction using OS-EM algorithm].

Single photon emission computed tomography (SPECT) is widely used for Nuclear Medicine. The low spatial resolution is mainly due to the limited collimator resolution. We have developed ordered subsets-expectation maximization (OS-EM) algorithm incorporating three dimensional spatial resolution correction (3D-SRC;horizontal and vertical direction) for distance-dependent blurring. In this paper we evaluate the fundamental properties of OS-EM algorithm including distance-dependent resolution correction using some phantoms (cubic phantom, cardiac and brain phantoms) and 12 patients performed 99mTc-tetrofosmin myocardial SPECT. In cubic phantom, the resolution in transaxial, coronal and sagital images are significantly improved by 3D-SRC. In short axial images of cardiac phantom, 3D-SRC shows more excellent images than no correction. In brain phantom, the blurring at the edge of the brain structure is improved by using OS-EM algorithm with 3D-SRC. In patients, the resolution in transaxial and short axial images is significant improved. These results suggest that this method improves the resolution in SPECT images and 3D-SRC is especially available in SPECT images of other axes in addition to transaxis. This method has advantage that both reconstruction and resolution correction are simultaneously performed. In the near future, we think that OS-EM algorithm incorporating attenuation, scatter and resolution correction will be used for quantitative SPECT images.

Differences in fatty acid metabolic disorder between ischemic myocardium and doxorubicin-induced myocardial damage: assessment using BMIPP dynamic SPECT with analysis by the Rutland method.

UNLABELLED: Dynamic myocardial SPECT data acquired with 15-(123)I-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) were analyzed by the Rutland method. The relative time-activity curves generated from dynamic SPECT in normal control subjects were compared with similar curves from patients with established ischemic heart disease (IHD) and doxorubicin-induced myocardial damage (DxMD). Comparison of such time-activity curves may provide some indirect information concerning qualitative differences in BMIPP metabolism. METHODS: Thirteen patients with various malignancies who received doxorubicin, 16 patients with IHD, and 15 normal control subjects were examined. Immediately after the bolus injection of BMIPP, dynamic data acquisition with a 3-head SPECT system was started and continued for 15 min. Using the time-activity curves of the myocardium as the output function (Mo(t)) and the time-activity curves of the left ventricular cavity as the input function (B(t)), the Rutland equation was calculated: Mo(t)/B(t) = F + K integral B(t)dt/B(t), where F is the blood - background subtraction factor and K is the uptake constant. The duration of the linear portion in this equation and the K values were evaluated. RESULTS: Mo(t)/B(t) was plotted against integral B(t)dt/B(t). Mo(t)/B(t) showed a good linear correlation with integral B(t)dt/B(t) from 30 s to 230 +/- 57 s in normal control subjects. The duration of this linearity was prolonged to 317 +/- 79 s in DxMD (P = 0.0014) and shortened to 182 +/- 58 s in IHD (P = 0.039). The mean K value was 0.0740 +/- 0.0184 in normal control subjects, significantly higher than the K values of 0.0599 +/- 0.0148 in DxMD patients (P = 0.026) and 0.0497 +/- 0.0189 (P = 0.0020) in IHD patients. CONCLUSION: Analysis of BMIPP dynamic SPECT data by the Rutland method is useful for detecting qualitative differences in BMIPP metabolism in various types of myocardial damage. It is speculated that the fatty acid metabolic disorder is characterized by a delay in metabolism in DxMD and by increased backdiffusion in IHD.