HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: jnumed.109.063982v1 50/10/1621    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Slomka, P. J. Articles by Germano, G. PubMed PubMed Citation Articles by Slomka, P. J. Articles by Germano, G.

Quantitative Analysis of Myocardial Perfusion SPECT Anatomically Guided by Coregistered 64-Slice Coronary CT Angiography

¹ Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, California; ² Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California; and ³ Cardiovascular Medical Group, Beverly Hills, California

Correspondence: For correspondence or reprints contact: Piotr Slomka, Cedars-Sinai Medical Center, Department of Imaging, #A047 8700 Beverly Blvd., Los Angeles, CA 90048. E-mail: Piotr.Slomka{at}cshs.org

Sequential testing by coronary CT angiography (CTA) and myocardial perfusion SPECT (MPS) obtained on stand-alone scanners may be needed to diagnose coronary artery disease in equivocal cases. We have developed an automated technique for MPS–CTA registration and demonstrate its utility for improved MPS quantification by guiding the coregistered physiologic (MPS) with anatomic CTA information. Methods: Automated registration of MPS left ventricular (LV) surfaces with CTA coronary trees was accomplished by iterative minimization of voxel differences between presegmented CTA volumes and motion-frozen MPS data. Studies of 35 sequential patients (26 men; mean age, 67 ± 12 y) with 64-slice coronary CTA, MPS, and available results of the invasive coronary angiography performed within 3 mo were retrospectively analyzed. Three-dimensional coronary vessels and CTA slices were extracted and fused with quantitative MPS results mapped on LV surfaces and MPS coronary regions. Automatically coregistered CTA images and extracted trees were used to correct the MPS contours and to adjust the standard vascular region definitions for MPS quantification. Results: Automated coregistration of MPS and coronary CTA had the success rate of 96% as assessed visually; the average errors were 4.3 ± 3.3 mm in translation and 1.5 ± 2.6 degrees in rotation on stress and 4.2 ± 3.1 mm in translation and 1.7 ± 3.2 degrees in rotation on rest. MPS vascular region definition was adjusted in 17 studies, and LV contours were adjusted in 11 studies using coregistered CTA images as a guide. CTA-guided myocardial perfusion analysis, compared with standard MPS analysis, resulted in improved area under the receiver-operating-characteristic (ROC) curves for the detection of right coronary artery (RCA) and left circumflex artery (LCX) lesions (0.84 ± 0.08 vs. 0.70 ± 0.11 for LCX, P = 0.03, and 0.92 ± 0.05 vs. 0.75 ± 0.09 for RCA, P = 0.02). Conclusion: Software image coregistration of stand-alone coronary CTA and MPS obtained on separate scanners can be performed rapidly and automatically, allowing CTA-guided contour and vascular territory adjustment on MPS for improved quantitative MPS analysis.

Key Words: myocardial perfusion imaging • CT angiography • image registration • image fusion • coronary artery disease • image quantification • SPECT

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.

Related articles in JNM:

This Month in JNM

JNM 2009 50: 11A-12A. [Full Text]