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Improved Uniformity in Tomographic Myocardial Perfusion Imaging with Attenuation Correction and Enhanced Acquisition and Processing

Division of Cardiology and Nuclear Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Correspondence: For correspondence or reprints contact: Luis I. Araujo, MD, Hospital of the University of Pennsylvania, Rm. 110, Donner Bldg., 3400 Spruce St., Philadelphia, PA 19104.

ABSTRACT

Tissue attenuation results in nonuniform myocardial perfusion images with significant sex differences. New SPECT imaging protocols to correct attenuation are currently under investigation. This study was performed to assess the effects of attenuation correction (AC) on overall image uniformity compared with more conventional imaging protocols in both men and women. Methods: Thirty-nine patients (19 men, 20 women) with less than a 5% likelihood of coronary artery disease were studied. ^99mTc-sestamibi studies were acquired with a triple-head scanner equipped with a simultaneous transmission and emission protocol. Four imaging protocols were compared: a 180° acquisition and filtered backprojection reconstruction (FBP), a 360° acquisition and FBP, a 360° acquisition and iterative reconstruction (IT), and a 360° acquisition with IT and AC. Quantitative analysis was performed to evaluate myocardial tracer uniformity for men and women. Results: 180°, 360° FBP, and 360° IT showed sex differences, with decreased tracer concentration in the anterior wall in women and decreased tracer concentration in the inferior wall in men. AC images showed the greatest uniformity (9.9% coefficient of variation for AC versus 12.5% for IT, P < 0.0001), and no statistically significant differences in uniformity were seen between male and female AC studies. Conclusion: More uniform myocardial perfusion images were obtained with AC, resulting in images with no differences in uniformity between men and women. These techniques are expected to improve specificity and overall diagnostic accuracy.

Key Words: SPECT • myocardial perfusion imaging • attenuation correction

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				E. Fricke, H. Fricke, R. Weise, A. Kammeier, R. Hagedorn, N. Lotz, O. Lindner, D. Tschoepe, and W. Burchert Attenuation Correction of Myocardial SPECT Perfusion Images with Low-Dose CT: Evaluation of the Method by Comparison with Perfusion PET J. Nucl. Med., May 1, 2005; 46(5): 736 - 744. [Abstract] [Full Text] [PDF]