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Myocardial Perfusion Imaging with a Combined X-Ray CT and SPECT System

UCSF Physics Research Laboratory, Department of Radiology, Bioengineering Graduate Group and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California

Correspondence: For correspondence contact: Bruce Hasegawa, PhD, UCSF PHYSICS Research Laboratory, 389 Oyster Point Blvd., Suite 1,So., San Francisco, CA 94080.

ABSTRACT

We evaluated a novel combined x-ray CT and SPECT medical imaging system for quantitative in vivo measurements of ^99mTc-sestamibi uptake in an animal model of myocardial perfusion. Methods: Correlated emission-transmission myocardial images were obtained from 7-to 10-kg pigs. The x-ray CT image was used to generate an object-specific attenuation map that was incorporated into an iterative ML-EM algorithm for reconstruction and attenuation correction of the coregistered SPECT images. The pixel intensities in the SPECT images were calibrated in units of radionuclide concentrations (MBq/g), then compared against in vitro ⁹⁹Tc activity concentration measured from the excised myocardium. In addition, the coregistered x-ray CT image was used to determine anatomical boundaries for quantitation of myocardial regions with low perfusion. Results: The accuracy of the quantitative measurement of in vivo activity concentration in the porcine myocardium was improved by object-specific attenuation correction. However, an additional correction for partial volume errors was required to retrieve the true activity concentration from the reconstructed SPECT images. Conclusion: Accurate absolute SPECT quantitation required object-specific correction for attenuation and partial volume effects. Additional anatomical information from the x-ray CT image was helpful in defining regions of interest for quantitation of the SPECT images.

Key Words: SPECT • quantification • myocardial perfusion • image coregistration

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