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Three-Dimensional Surface Display of Dynamic Pulmonary Xenon-133 SPECT in Patients with Obstructive Lung Disease

Department of Radiology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan

Correspondence: For correspondence or reprints contact: Kazuyoshi Suga, MD, Department Radiology, Yamaguchi University School of Medicine, 1144 Kogushi, Ube, Yamaguchi, 755 Japan.

ABSTRACT

To better perceive abnormal regional ventilation in patients with obstructive lung disease, a three-dimensional display was applied to dynamic pulmonary ¹³³Xe SPECT. Methods: Dynamic SPECT was performed using a triple-detector SPECT system in 30 patients with obstructive disease, 13 patients with restrictive disease and 7 normal subjects. After reconstructing color-illuminated, surface-rendered three-dimensional images of equilibrium and 3-min wash out (WO₃), a single three-dimensional fusion display was created from these two different time-course image sets in which a three-dimensional WO₃ image indicating ¹³³Xe retention was transparently visible through three-dimensional equilibrium image delineating lung contours. The three-dimensional equilibrium and WO₃ images were created by a 25% threshold of the ¹³³Xe maximal pixel activity (MPA) in equilibrium data. Besides, a three-dimensional WO₃ image with a 18% threshold [mean +2 s.d. ratios (%) of the MPA in WO₃ data to that in equilibrium data in normal subjects] was used for assessing the presence of retention compared to normal lungs. Results: The 18% threshold three-dimensional WO₃ image showed abnormal retention in obstructive diseases but not in restrictive diseases. The three-dimensional fusion display provided an overview of localized retention in obstructive diseases and enhanced the perception of their spatial relationships and extent compared to those on multi-slice tomograms. The extent of retention correlated well with %FEV₁ (r = 0.813) and ¹³³Xe clearance-time (T_1/2)(r = 0.912). Conclusion: This topographic modality for ¹³³Xe SPECT is helpful for the better perception of anatomic distributions of ¹³³Xe retention and inter-study comparisons of ventilation abnormality in patients with obstructive disease.

Key Words: SPECT • xenon-133 gas • lung ventilation • three-dimensional imaging • surface-rendered imaging

This article has been cited by other articles:

				K. Suga, T. Tsukuda, H. Awaya, N. Matsunaga, K. Sugi, and K. Esato Interactions of Regional Respiratory Mechanics and Pulmonary Ventilatory Impairment in Pulmonary Emphysema : Assessment With Dynamic MRI and Xenon-133 Single-Photon Emission CT Chest, June 1, 2000; 117(6): 1646 - 1655. [Abstract] [Full Text] [PDF]