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Evaluation of the effect of reducing administered activity on assessment of function in cardiac gated SPECT

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

We previously optimized several reconstruction strategies in SPECT myocardial perfusion imaging (MPI) with low dose for perfusion-defect detection. Here we investigate whether reducing the administered activity can also maintain the diagnostic accuracy in evaluating cardiac function.

Methods

We quantified the myocardial motion in cardiac-gated stress 99m-Tc-sestamibi SPECT studies from 163 subjects acquired with full dose (29.8 ± 3.6 mCi), and evaluated the agreement of the obtained motion/thickening and ejection fraction (EF) measures at various reduced dose levels (uniform reduction or personalized dose) with that at full dose. We also quantified the detectability of abnormal motion via a receiver-operating characteristics (ROC) study. For reconstruction we considered both filtered backprojection (FBP) without correction for degradations, and iterative ordered-subsets expectation-maximization (OS-EM) with resolution, attenuation and scatter corrections.

Results

With dose level lowered to 25% of full dose, the obtained results on motion/thickening, EF and abnormal motion detection were statistically comparable to full dose in both reconstruction strategies, with Pearson’s r > 0.9 for global motion measures between low dose and full dose.

Conclusions

The administered activity could be reduced to 25% of full dose without degrading the function assessment performance. Low dose reconstruction optimized for perfusion-defect detection can be reasonable for function assessment in gated SPECT.

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Abbreviations

SPECT:

Single-photon emission computed tomography

MPI:

Myocardial perfusion imaging

FBP:

Filtered backprojection

OS-EM:

Ordered-subsets expectation-maximization

AC:

Attenuation correction

SC:

Scatter correction

RC:

Resolution correction

AUC:

Area under the ROC curve

CAD:

Coronary-artery disease

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Acknowledgements

This work was supported by the National Institutes of Health (NIH) Grant R01-HL122484. P.S. was also supported by NIH Grant R01-HL089765. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Disclosure

The University of Massachusetts had a research agreement with Philips Healthcare at the time some of this work was performed.

Author information

Authors and Affiliations

  1. Medical Imaging Research Center, Illinois Institute of Technology, Chicago, IL, USA

    Albert Juan Ramon MSc, Yongyi Yang PhD & Miles N. Wernick PhD

  2. Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA

    P. Hendrik Pretorius PhD, Karen L. Johnson BS, CNMT & Michael A. King PhD

  3. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Piotr J. Slomka PhD

Authors
  1. Albert Juan Ramon MSc
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  2. Yongyi Yang PhD
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  3. Miles N. Wernick PhD
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  4. P. Hendrik Pretorius PhD
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  5. Karen L. Johnson BS, CNMT
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  6. Piotr J. Slomka PhD
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  7. Michael A. King PhD
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Correspondence to Yongyi Yang PhD.

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Juan Ramon, A., Yang, Y., Wernick, M.N. et al. Evaluation of the effect of reducing administered activity on assessment of function in cardiac gated SPECT. J. Nucl. Cardiol. 27, 562–572 (2020). https://doi.org/10.1007/s12350-018-01505-x

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  • DOI: https://doi.org/10.1007/s12350-018-01505-x

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