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Spatial and Temporal Registration of CT and SPECT Images: Development and Validation of a Technique for In Vivo Three-Dimensional Semiquantitative Analysis of Bone

Division of Plastic Surgery and Department of Medical Imaging, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

Correspondence: For correspondence or reprints contact: Oleh M. Antonyshyn, MD, Division of Plastic Surgery, Rm. M1-525, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave., Toronto, Ontario, M4N 3M5 Canada.

ABSTRACT

The combined use of postoperative 3-dimensional CT and SPECT imaging provides a means of relating anatomy and physiology for the semiquantitative in vivo analysis of bone. This study focuses on the development and validation of a technique that accomplishes this through the registration of SPECT data to a 3-dimensional volume of interest (VOI) interactively defined on CT images. Methods: Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split-skull bone grafts reconstructed to skull and malar recipient sites. To acquire all images, each specimen was landmarked with 1.6-mm ball bearings and CT scanned. Bone surfaces were coated with ^99mTc-doped paint. The locations of the ball bearings were marked with paint doped with ¹¹¹In. Separate SPECT scans were acquired using the energy windows of ^99mTc and ¹¹¹In. Results: Serial SPECT images aligned with an average root-mean-square (RMS) error of 3.8 mm (i.e., <1 pixel). CT-to-SPECT volume matching aligned with an RMS error of 7.8 mm. Total counts in CT-defined VOIs applied to SPECT data showed a strong linear correlation (r² = 0.86) with true counts obtained from a dose calibrator. Conclusion: The capability of this multimodality registration technique to anatomically localize and quantify radiotracer uptake is sufficiently accurate to warrant further assessment in an in vivo trial.

Key Words: SPECT • 3-dimensional CT • image registration • bone

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