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Quantifying Local Lung Perfusion and Ventilation Using Correlated SPECT and CT Data

Departments of Radiotherapy and Nuclear Medicine, The Netherlands Cancer Institute (Antoni van Leeuwenhoek Huis), Amsterdam, The Netherlands

Correspondence: For correspondence or reprints contact: E.M.F. Damen, Department of Radiotherapy, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.

ABSTRACT

A clinically applicable method for quantifying lung perfusion and ventilation on a subregional (local) scale from SPECT scans in order to estimate local lung function in patients with pre-existing pulmonary disease and to monitor local treatment effects was developed and evaluated. Methods: SPECT ^99mTc perfusion and ^81mKr ventilation images were corrected for photon attenuation and scatter effect with a post reconstruction correction method in corporating a variable-effective linear-attenuation coefficient calculated from spatially-correlated CT data. A new algorithm was developed to quantify local ventilation from the SPECT data, which, in contrast with other algorithms, makes no assumptions on ventilation homogeneity over the lung. The quantification procedure was applied to clinical data from patients with a normal lung function and from patients suffering from radiation-induced pulmonary dysfunction. Results: The calculated attenuation correction factors on the observed number of counts in the lung range from 2.0 to 3.0 and 2.3 to 3.5 for ^81mKr and ^99mTc, respectively, showing a systematic increase from the diaphragm to the lung apex. As a result of this correction, the values of local perfusion and ventilation differ 10%–15% from values calculated without attenuation correction. The calculated values of the local ventilation are 10%–50% lower than those found by quantification algorithms which assume homogeneous ventilation. Conclusions: The methods presented here are robust with respect to uncertainties in the input parameters and yield realistic values for perfusion and ventilation distribution in the lung with an intrinsic accuracy (largely determined by count statistics) of about 10%.

Key Words: quantitative SPECT • attenuation • lung perfusion • lung ventilation

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