Original articleClinical validation of SPECT attenuation correction using x-ray computed tomography–derived attenuation maps: Multicenter clinical trial with angiographic correlation
Section snippets
Phantoms
An anthropomorphic torso phantom with cardiac, lung, and spine inserts (ECT/TOR/P and ECT/CAR/I; Data Spectrum, Hillsborough, NC) was used to evaluate the effect of AC on the homogeneity of SPECT images of normal phantoms. The left ventricle (LV) was simulated by a cardiac insert consisting of 2 concentric cylinders. The inner cylinder (“cavity” of LV) was filled with water, and the space between the two cylinders (left ventricular “myocardium”) was filled with a uniform technetium-99m solution
Homogeneity of Cardiac Phantom Images With and Without AC
Figure 1 shows the mean percent variability of circumferential count profiles from short-axis phantom images acquired with NC and AC by use of 180° and 360° orbits. With AC, the percent variability of circumferential count profiles of normal phantoms was significantly reduced, indicating greater image homogeneity (11% ± 2% vs 5% ± 1% [P < .001] for 180° orbit and 13% ± 2% vs 6% ± 1% [P < .001] for 360° orbit).
Patient Lower Limits of Normal With and Without AC
Figure 2 shows examples of midventricular lower limit–of–normal curves for men, women,
Discussion
This study shows that CT-based AC improves the homogeneity of SPECT images of normal cardiac phantoms and of normal subjects. Moreover, AC consistently improved the diagnostic yield of SPECT imaging for detecting significant angiographic CAD (≥50% stenosis), as well as the normalcy rate. Our study also indicates that the degree of diagnostic gain by AC may vary among readers. This depends on a reader’s interpretive attitude (ie, reading style) and experience. The blinded readers in our study
Acknowledgment
We gratefully acknowledge the dedication and efforts of Jan Davey, MSN, APRN, in recruiting normal volunteers for this study.
Drs Wackers and Liu receive royalties from sales of WLCQ quantitative software. At the time of this study, Frank Anstett and Aharon Peretz were employed by GE Healthcare. The other authors have indicated they have no financial conflict of interest. This study was an investigator-initiated study. The sponsor had no role in the analysis and interpretation of data or in the
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This study was supported in part by an educational grant from GE Healthcare.