The purpose of this study was to compare a routine bone SPECT/CT protocol using CT reconstructed with filtered backprojection (FBP) with an optimized protocol using low-dose CT images reconstructed with adaptive statistical iterative reconstruction (ASiR). Methods: In this prospective study, enrolled patients underwent bone SPECT/CT, with 1 SPECT acquisition followed by 2 randomized CT acquisitions: FBP CT (FBP; noise index, 25) and ASiR CT (70% ASiR; noise index, 40). The image quality of both attenuation-corrected SPECT and CT images was visually (5-point Likert scale, 2 interpreters) and quantitatively (contrast ratio [CR] and signal-to-noise ratio [SNR]) estimated. The CT dose index volume, dose-length product, and effective dose were compared. Results: Seventy-five patients were enrolled in the study. Quantitative attenuation-corrected SPECT evaluation showed no inferiority for contrast ratio and SNR issued from FBP CT or ASiR CT (respectively, 13.41 ± 7.83 vs. 13.45 ± 7.99 and 2.33 ± 0.83 vs. 2.32 ± 0.84). Qualitative image analysis showed no difference between attenuation-corrected SPECT images issued from FBP CT or ASiR CT for both interpreters (respectively, 3.5 ± 0.6 vs. 3.5 ± 0.6 and 3.6 ± 0.5 vs. 3.6 ± 0.5). Quantitative CT evaluation showed no inferiority for SNR between FBP and ASiR CT images (respectively, 0.93 ± 0.16 and 1.07 ± 0.17). Qualitative image analysis showed no quality difference between FBP and ASiR CT images for both interpreters (respectively, 3.8 ± 0.5 vs. 3.6 ± 0.5 and 4.0 ± 0.1 vs. 4.0 ± 0.2). Mean CT dose index volume, dose-length product, and effective dose for ASiR CT (3.0 ± 2.0 mGy, 148 ± 85 mGy⋅cm, and 2.2 ± 1.3 mSv) were significantly lower than for FBP CT (8.5 ± 3.7 mGy, 365 ± 160 mGy⋅cm, and 5.5 ± 2.4 mSv). Conclusion: The use of 70% ASiR blending in bone SPECT/CT can reduce the CT radiation dose by 60%, with no sacrifice in attenuation-corrected SPECT and CT image quality, compared with the conventional protocol using FBP CT reconstruction technique.
A 72-year-old patient with type 2 diabetes mellitus underwent F-FDG PET/CT for diabetic foot infection. No increased focal uptake was seen. F-FDG uptake was absent in the second, third, and fourth toes of the right foot. Angiography demonstrated severe stenosis in the proximal anterior tibial artery and segmental stenosis on the posterior tibial artery. The patient was diagnosed as having dry gangrene of the second to fourth toes of the right foot due to ischemia. He underwent a selective amputation because of the lack of revascularization possibilities.
Its widespread availability, cost effectiveness, safety in terms of radiation exposure, and ability to significantly improve myocardial perfusion imaging specificity and accuracy make gated SPECT a self-sufficient modality for coronary artery disease screening and follow-up, whereas CT-AC should be discussed on a case-by-case basis.
Assessment of both left and right ventricular functions by count-based GBPS with CT-AC showed higher volumes and lower EF. Differences were slight, especially for the range of normal to subnormal ventricular volumes.
The influence of temperature on the acid-base status of normal human deoxygenated whole blood was studied in open systems (variable total CO2 content). (1) When the temperature was raised from 26 degrees C to 42 degrees C, the apparent buffering value of deoxygenated whole blood for CO2 increased by 7% of its value at 26 degrees C; this increase was not statistically significant. (2) Comparing the present data with those obtained previously from oxygenated whole blood in the same temperature range (Castaing & Pocidalo, 1979) indicates that arterial and venous blood have slightly different buffering capacities for CO2 in the 26 to 42 degrees C temperature range. It also suggests that, at physiological SO2 levels (SO2 greater than or equal to 30%), the apparent buffering value of venous blood for CO2 would be increased by at least 10% of its value at 26 degrees C when the temperature is raised to 42 degrees C. (3) It is concluded that pH stability would be reduced upon CO2 uptake within tissues with a high metabolism and therefore a high temperature.
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