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Journal of Nuclear Cardiology

, Volume 25, Issue 6, pp 2117–2128 | Cite as

Investigation of dose reduction in cardiac perfusion SPECT via optimization and choice of the image reconstruction strategy

  • Albert Juan Ramon
  • Yongyi Yang
  • P. Hendrik Pretorius
  • Piotr J. Slomka
  • Karen L. Johnson
  • Michael A. King
  • Miles N. Wernick
Original Article

Abstract

Background

We investigated the extent to which the administered dose (activity) level can be reduced without sacrificing diagnostic accuracy for three reconstruction strategies for SPECT-myocardial perfusion imaging (MPI).

Methods

We optimized the parameters of the three reconstruction strategies for perfusion-defect detection over a range of simulated administered dose levels using a set of hybrid studies (derived from 190 subjects) consisting of clinical SPECT-MPI data modified to contain realistic simulated lesions. The optimized strategies we considered are filtered backprojection (FBP) with no correction for degradations, ordered-subsets expectation-maximization (OS-EM) with attenuation correction (AC), scatter correction (SC), and resolution correction (RC), and OS-EM with scatter and resolution correction only. Each study was evaluated using a total perfusion deficit (TPD) score computed by the Quantitative Perfusion SPECT (QPS) software package. We conducted a receiver operating characteristics (ROC) study based on the TPD scores for each dose level and reconstruction strategy.

Results

For FBP, the achieved optimum values of the area under the ROC curve (AUC) at 100%, 50%, 25%, and 12.5% of standard dose were 0.75, 0.74, 0.72, and 0.70, respectively, compared to 0.81, 0.79, 0.76, and 0.74 for OS-EM with AC–SC–RC and 0.78, 0.77, 0.74, 0.72 for OS-EM with SC–RC.

Conclusions

Our results suggest that studies reconstructed by OS-EM with AC–SC–RC could possibly be reduced, on average, to 25% of the originally administered dose without causing diagnostic accuracy (AUC) to decrease below that of FBP.

Keywords

SPECT Myocardial perfusion imaging dose reduction optimization 

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

TPD

Total perfusion deficit

CAD

Coronary artery disease

Notes

Acknowledgements

This work was supported by the National Institutes of Health (NIH) Grant No. R01-HL122484. P.S. was also supported by the National Institutes of Health (NIH) Grant No. R01-HL089765. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. A preliminary version of this work was presented in part at the IEEE Medical Imaging Conference, Strasbourg, 2016, and published in the conference proceedings.28

Disclosure

The University of Massachusetts had a research agreement with Philips Healthcare at the time some of this work was performed. Cedars-Sinai Medical Center receives royalties for the quantitative assessment of function, perfusion, and viability, a portion of which is distributed to some of the authors of this manuscript (P.S.). A.J.R., Y.Y. and M.N.W. from the Illinois Institute of Technology have nothing to disclose.

Supplementary material

12350_2017_920_MOESM1_ESM.pptx (1.6 mb)
Supplementary material 1 (PPTX 1664 kb)

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Copyright information

© American Society of Nuclear Cardiology 2017

Authors and Affiliations

  • Albert Juan Ramon
    • 1
  • Yongyi Yang
    • 1
  • P. Hendrik Pretorius
    • 2
  • Piotr J. Slomka
    • 3
  • Karen L. Johnson
    • 2
  • Michael A. King
    • 2
  • Miles N. Wernick
    • 1
  1. 1.Illinois Institute of TechnologyMedical Imaging Research CenterChicagoUSA
  2. 2.Department of RadiologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA

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