Absolute myocardial blood flow quantification with SPECT/CT: Is it possible?

Slomka, Piotr J.; Berman, Daniel S.; Germano, Guido

doi:10.1007/s12350-014-0002-6

Cited by 23 publications

(17 citation statements)

References 24 publications

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“…Successive scans on the same patient at different times can provide data on the radiopharmaceutical biokinetics, i.e., the change in the distribution of the radiopharmaceutical in the body over time [1]. There are several nuclear medicine applications that require images that are quantitatively accurate in an absolute sense [2–5]. For example, absolute quantification is needed in the therapeutic use of radiopharmaceuticals, where the purpose is to evaluate the dose-effect relationship [6–9].…”

Section: Introductionmentioning

confidence: 99%

Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification: An IAEA phantom study

Zimmerman

Grošev

Buvat

et al. 2017

Zeitschrift für Medizinische Physik

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Accurate quantitation of activity provides the basis for internal dosimetry of targeted radionuclide therapies. This study investigated quantitative imaging capabilities at sites with a variety of experience and equipment and assessed levels of errors in activity quantitation in Single-Photon Emission Computed Tomography (SPECT) and planar imaging. Participants from 9 countries took part in a comparison in which planar, SPECT and SPECT with X ray computed tomography (SPECT-CT) imaging were used to quantify activities of four epoxy-filled cylinders containing 133Ba, which was chosen as a surrogate for 131I. The sources, with nominal volumes of 2, 4, 6 and 23 mL, were calibrated for 133Ba activity by the National Institute of Standards and Technology, but the activity was initially unknown to the participants. Imaging was performed in a cylindrical phantom filled with water. Two trials were carried out in which the participants first estimated the activities using their local standard protocols, and then repeated the measurements using a standardized acquisition and analysis protocol. Finally, processing of the imaging data from the second trial was repeated by a single centre using a fixed protocol. In the first trial, the activities were underestimated by about 15% with planar imaging. SPECT with Chang’s first order attenuation correction (Chang-AC) and SPECT-CT overestimated the activity by about 10%. The second trial showed moderate improvements in accuracy and variability. Planar imaging was subject to methodological errors, e.g., in the use of a transmission scan for attenuation correction. The use of Chang-AC was subject to variability from the definition of phantom contours. The project demonstrated the need for training and standardized protocols to achieve good levels of quantitative accuracy and precision in a multi-centre setting. Absolute quantification of simple objects with no background was possible with the strictest protocol to about 6% with planar imaging and SPECT (with Chang-AC) and within 2% for SPECT-CT.

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Section: Introductionmentioning

confidence: 99%

Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification: An IAEA phantom study

Zimmerman

Grošev

Buvat

et al. 2017

Zeitschrift für Medizinische Physik

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“…Unlike a dedicated cardiac SPECT camera with solid-state detectors, the conventional two-headed SPECT camera is readily available and widely used in the nuclear medicine community; hence it is possible to reproduce the method on clinically installed systems. 23-25 …”

Section: Discussionmentioning

confidence: 99%

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation

Shrestha

Sciammarella

Alhassen

et al. 2017

Journal of Nuclear Cardiology

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Background The objective of this study was to measure myocardial blood flow (MBF) in humans using 99mTc-tetrofosmin and dynamic single photon emission computed tomography (SPECT). Methods Dynamic SPECT using 99mTc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients were used to determine the flow-extraction curve for 99mTc-tefrofosmin while data from the remaining 7 patients were used for method validation. The nonlinear tracer correction parameters A and B for 99mTc-tefrofosmin were estimated for the 9 patients by fitting the flow-extraction curve K1=Ftrue(1−Aexptrue(−BFtrue)true) for K1 values estimated with 99mTc-tefrofosmin using SPECT and MBF values estimated with 13N-NH3 using PET. These parameters were then used to calculate MBF and coronary flow reserve (CFR) in three coronary territories (LAD, RCA, and LCX) using SPECT for an independent cohort of 7 patients. The results were then compared with that estimated with 13N-NH3 PET. The flow dependent permeability surface-area product (PS) for 99mTc-tefrofosmin was also estimated. Results The estimated flow extraction parameters for 99mTc-tefrofosmin was found to be A=0.91±0.11, B=0.34±0.20 (R2 = 0.49). The range of MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). However, the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The PS for 99mTc-tefrofosmin was (0.091 ± 0.10) * MBF = (0.32 ± 0.16). Conclusions Dynamic cardiac SPECT using 99mTc-tetrofosmin and a clinical two-headed SPECT/CT scanner can be a useful tool for estimation of MBF.

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“…As demonstrated in the simulation studies, reconstruction with body contour substantially reduced bias in the blood pool, which can be a critical factor for achieving absolute quantitative measurement of physiological parameters on this stationary SPECT scanner with dynamic imaging and tracer kinetic modeling. 4,[30][31][32] To illustrate how the method of SPECT image reconstruction might impact on quantitative image analysis, we performed five serial 15-min SPECT scans on one of the human research subjects injected with 123 I-mIBG (5.1 mCi). Listmode SPECT imaging (15 min each) was performed at 0, 15, 90, 120, and 180 min after radiotracer injection.…”

Section: Discussionmentioning

confidence: 99%

The impact of system matrix dimension on small FOV SPECT reconstruction with truncated projections

Chan

Dey

Grobshtein³

et al. 2015

Med. Phys.

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Absolute myocardial blood flow quantification with SPECT/CT: Is it possible?

Cited by 23 publications

References 24 publications

Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification: An IAEA phantom study

Multi-centre evaluation of accuracy and reproducibility of planar and SPECT image quantification: An IAEA phantom study

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation

The impact of system matrix dimension on small FOV SPECT reconstruction with truncated projections

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