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Motion Corrected Hepatic Scintigraphy: An Objective Clinical Evaluation

Rush-Presbyterian-St. Luke's Medical Center and Rush Medical College and the University of Chicago, Chicago, Illinois
Indiana University Medical Center, Indianapolis, Indiana
University of California, San Francisco, California

Correspondence: For reprints contact: David A. Turner, Dept. of Nuclear Medicine, Rush-Presbyterian-St. Luke's Medical Ctr., 1753 W. Congress Parkway, Chicago, IL 60612.

ABSTRACT

An analogue motion-correction device was built for a scintillation camera. Corrected and uncorrected images were simultaneously recorded on Polaroid film during routine hepatic scintigraphy of 1,100 patients, selected without known bias. Autopsy, liver biopsy or inspection at laparotomy (and clinical followup in three patients with neither known malignancy nor benign liver disease) were considered to have established the true state of the livers of 49 patients with hepatic masses and 53 patients with normal livers. Five observers of varying experience in nuclear medicine independently evaluated the scintigrams for the presence of mass lesions, using a five-category rating scale, without knowledge of the true states. Results were expressed as receiver operating characteristic curves. For each observer, performance was better with motion correction, or when interpreting corrected and uncorrected studies together, than when reading the uncorrected studies alone. Analogue motion correction is an effective, inexpensive method for improving hepatic scintigraphy with a scintillation camera. The degree to which motion correction improves the detectability of mass lesions is a function of the size of the lesions, the performance parameters of the imaging system and the display medium, the depth of the subject's respirations, the counting rate, and the count density of the image, as well as of the proper adjustment of the motion-correction device itself.