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Assessment of regional lung functional impairment with co-registered respiratory-gated ventilation/perfusion SPET-CT images: initial experiences

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Abstract

In this study, respiratory-gated ventilation and perfusion single-photon emission tomography (SPET) were used to define regional functional impairment and to obtain reliable co-registration with computed tomography (CT) images in various lung diseases. Using a triple-headed SPET unit and a physiological synchroniser, gated perfusion SPET was performed in a total of 78 patients with different pulmonary diseases, including metastatic nodules (n=15); in 34 of these patients, it was performed in combination with gated technetium-99m Technegas SPET. Projection data were acquired using 60 stops over 120° for each detector. Gated end-inspiration and ungated images were reconstructed from 1/8 data centered at peak inspiration for each regular respiratory cycle and full respiratory cycle data, respectively. Gated images were registered with tidal inspiration CT images using automated three-dimensional (3D) registration software. Registration mismatch was assessed by measuring 3D distance of the centroid of the nine selected round perfusion-defective nodules. Gated SPET images were completed within 29 min, and increased the number of visible ventilation and perfusion defects by 9.7% and 17.2%, respectively, as compared with ungated images; furthermore, lesion-to-normal lung contrast was significantly higher on gated SPET images. In the nine round perfusion-defective nodules, gated images yielded a significantly better SPET-CT match compared with ungated images (4.9±3.1 mm vs 19.0±9.1 mm, P<0.001). The co-registered SPET-CT images allowed accurate perception of the location and extent of each ventilation/perfusion defect on the underlying CT anatomy, and characterised the pathophysiology of the various diseases. By reducing respiratory motion effects and enhancing perfusion/ventilation defect clarity, gated SPET can provide reliable co-registered images with CT images to accurately characterise regional functional impairment in various lung diseases.

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Acknowledgments

This study was supported in part by a Research Grant for Scientific Research (08671033) from the Japanese Ministry of Education.

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Authors and Affiliations

  1. Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, 755-8505, Ube, Yamaguchi, Japan

    Kazuyoshi Suga, Kawakami Yasuhiko, Mohammed Zaki, Tomio Yamashita, Aska Seto, Tsuneo Matsumoto & Naofumi Matsunaga

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  1. Kazuyoshi Suga
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  2. Kawakami Yasuhiko
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  3. Mohammed Zaki
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Correspondence to Kazuyoshi Suga.

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Suga, K., Yasuhiko, K., Zaki, M. et al. Assessment of regional lung functional impairment with co-registered respiratory-gated ventilation/perfusion SPET-CT images: initial experiences. Eur J Nucl Med Mol Imaging 31, 240–249 (2004). https://doi.org/10.1007/s00259-003-1365-0

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  • DOI: https://doi.org/10.1007/s00259-003-1365-0

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