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Determining the Accuracy of Calculating Systolic Wall Thickening Using a Fast Fourier Transform Approximation: A Simulation Study Based on Canine and Patient Data

Division of Nuclear Medicine, Department of Radiology, Emory University School of Medicine, Atlanta, Georgia

Correspondence: For correspondence or reprints contact: C. David Cooke, MSEE, Division of Nuclear Medicine, Emory University Hospital, Atlanta, GA 30322.

ABSTRACT

The high count yields of ^99mTc-sestamibi make possible the acquisition of multiple gated SPECT studies with relatively high count densities. By reorienting these studies into gated short-axis slices, and extracting the three-dimensional myocardial perfusion distribution, we can study wall thickening using an amplitude and phase analysis methodology that examines the change in counts throughout the cardiac cycle. There have been two main concerns raised about this count-based technique: (1) What effect does the sampling rate have on the calculation of systolic wall thickening? and (2) What effect does count density have on the calculation of systolic wall thickening? Methods: We designed a simulation study using myocardial wall thickening data obtained from ultrasonic crystals implanted in the myocardium of a normal canine. This data was modified to produce wall thickening curves with various percent systolic wall thickening measurements, sampling rates and count densities. Results: The results show that using at least eight frames per cardiac cycle, systolic wall thickening can be calculated with enough accuracy to separate normal patients from those with cardiac dysfunction, even in areas of hypoperfused myocardium. Also, the results show the importance of calculating and interpreting phase (onset of contraction) information. Conclusions: This count-based technique continues to show promise as a tool for calculating systolic wall-thickening from multiple gated myocardial perfusion SPECT studies, but needs to be validated in a prospective multi-center trial before being applied in a clinical setting.

Key Words: systolic wall thickening • first harmonic analysis • phase and amplitude analysis • technetium-99m myocardial perfusion studies • fast Fourier transform

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