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Characteristics of images of angiographically proven normal coronary arteries acquired by adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ⋅SPECT with CT attenuation correction changed stepwise

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Abstract

Objective

Although several studies have shown the diagnostic and prognostic value of CT-based attenuation correction (AC) of single photon emission computed tomography (SPECT) images for diagnosing coronary artery disease (CAD), this issue remains a matter of debate. To clarify the characteristics of CT-AC SPECT images that might potentially improve diagnostic performance, we analyzed images acquired using adenosine-stress thallium-201 myocardial perfusion SPECT/CT equipped with IQ⋅SPECT (SPECT/CT-IQ⋅SPECT) from patients with angiographically proven normal coronary arteries after changing the CT attenuation correction (CT-AC) in a stepwise manner.

Methods

We enrolled 72 patients (Male 36, Female 36) with normal coronary arteries according to findings of invasive coronary angiography or CT-angiography within three months after a SPECT/CT study. Projection images were reconstructed at CT-AC values of (−), 40, 60, 80 and 100 % using a CT number conversion program according to our definition and analyzed using polar maps according to sex.

Results

CT attenuation corrected segments were located from the mid- and apical-inferior spread through the mid- and apical-septal regions and finally to the basal-anterior and basal- and mid-lateral regions in males, and from the mid-inferior region through the mid-septal and mid-anterior, and mid-lateral regions in females as the CT-AC values increased. Segments with maximal mean counts shifted from the apical-anterior to mid-anterolateral region under both stress and rest conditions in males, whereas such segments shifted from the apical-septal to the mid-anteroseptal region under both stress and rest conditions in females.

Conclusions

We clarified which part of the myocardium and to which degree CT-AC affects it in adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ⋅SPECT images by changing the CT-AC value stepwise. We also identified sex-specific shifts of segments with maximal mean counts that changed as CT-AC values increased.

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Acknowledgments

We are grateful to Professor Kenichi Nakajima of Kanazawa University Hospital for providing constructive comments regarding our data. We presented these findings in a co-medical oral session (CO-03) at the 77th Annual Scientific Meeting of the Japanese Circulation Society held in Yokohama, Japan in 2013. This study was investigator-initiated. No sponsors played any role in the analysis and interpretation of data or in the preparation of the manuscript, and the authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Radiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Teruyuki Takahashi & Yoshiki Tanakamaru

  2. Department of Cardiology, Miyoshi Central Hospital, 531 Higashisakeya-cho, Miyoshi, Hiroshima, 728-8502, Japan

    Haruki Tanaka

  3. Department of Medical Information Management, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Nami Kozono

  4. Department of Cardiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    Naomi Idei, Norihiko Ohashi, Hideki Ohtsubo, Takenori Okada & Shunichi Kaseda

  5. Department of Cardiology, Miyoshi Medical Association Hospital, Miyoshi, Hiroshima, Japan

    Yuji Yasunobu

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  1. Teruyuki Takahashi
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Correspondence to Haruki Tanaka.

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Takahashi, T., Tanaka, H., Kozono, N. et al. Characteristics of images of angiographically proven normal coronary arteries acquired by adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ⋅SPECT with CT attenuation correction changed stepwise. Ann Nucl Med 29, 256–267 (2015). https://doi.org/10.1007/s12149-014-0935-5

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