Journal of Nuclear Cardiology

, Volume 9, Issue 2, pp 183–187

Attenuation correction and gating synergistically improve the diagnostic accuracy of myocardial perfusion SPECT

  • Jonathan M. Links
  • E. Gordon DePuey
  • Raymond Taillefer
  • Lewis C. Becker
Article

DOI: 10.1067/mnc.2002.120163

Cite this article as:
Links, J.M., DePuey, E.G., Taillefer, R. et al. J Nucl Cardiol (2002) 9: 183. doi:10.1067/mnc.2002.120163

Abstract

Background

The diagnostic accuracy of myocardial perfusion single photon emission computed tomography is limited by soft tissue attenuation. Artifacts may be reduced by attenuation correction (AC) or compensated for by assessment of wall motion in gated images. We studied the benefit of gating and AC, both separately and combined, in improving accuracy.

Methods and Results

Sixty-six subjects (27 with ≥50% angiographic stenosis, 5 with <50% stenosis, and 34 Bayesian normal volunteers) underwent gated AC single photon emission computed tomography. Images were reconstructed and independently viewed in 4 ways: static with motion correction (MC) only, gated with MC only, static with MC plus blur correction plus AC (referred to as combined corrections [CC]), and gated with CC. Images were interpreted by 2 blinded observers for overall presence of coronary disease and for vascular territory (left anterior descending [LAD], left circumflex [LCx], and right coronary artery [RCA]). Statistical analysis of sensitivity and normalcy was done by means of the Cochran Q test. Overall diagnostic accuracy showed statistically significant improvement (P = .05 for sensitivity, P < .001 for normalcy), progressing from static MC to gated MC to static CC to gated CC (sensitivity/normalcy = 85%/54%, 78%/62%, 93%/77%, and 96%/85%, respectively, for the 4 reconstruction and viewing approaches). Sensitivity was highest in all 3 vascular territories for the combination of gating and CC; normalcy was also highest with the same combination for the LAD and RCA territories; sensitivity/normalcy with this combination was 85%/87% for the LAD, 69%/87% for the LCx, and 89%/87% for the RCA territory.

Conclusions

The combination of gating and CC provides the highest diagnostic accuracy, and gating and AC should thus be considered complementary and synergistic.

Key Words

Attenuation correction gating 

Copyright information

© American Society of Nuclear Cardiology 2002

Authors and Affiliations

  • Jonathan M. Links
    • 1
  • E. Gordon DePuey
    • 2
  • Raymond Taillefer
    • 3
  • Lewis C. Becker
    • 1
  1. 1.Johns Hopkins UniversityBaltimore
  2. 2.Columbia UniversityNew York
  3. 3.Hotel-DieuMontrealCanada
  4. 4.Johns Hopkins School of Public HealthBaltimore

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