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Assessment of anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema with breath-hold SPECT-CT fusion images

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Abstract

Objective

Anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema was assessed on deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images.

Methods

Subjects were 38 patients with pulmonary emphysema and 11 non-smoker controls, who successfully underwent DIBrH and non-BrH perfusion SPECT using a dual-headed SPECT system during the period between January 2004 and June 2006. DIBrH SPECT was three-dimensionally co-registered with DIBrH CT to comprehend the relationship between lung perfusion defects and CT low attenuation areas (LAA). By comparing the appearance of lung perfusion on DIBrH with non-BrH SPECT, the correlation with the rate constant for the alveolar-capillary transfer of carbon monoxide (DLCO/VA) was compared between perfusion abnormalities on these SPECTs and LAA on CT.

Results

DIBrH SPECT provided fairly uniform perfusion in controls, but significantly enhanced perfusion heterogeneity when compared with non-BrH SPECT in pulmonary emphysema patients (P < 0.001). The reliable DIBrH SPECT-CT fusion images confirmed more extended perfusion defects than LAA on CT in majority (73%) of patients. Perfusion abnormalities on DIBrH SPECT were more closely correlated with DLCO/VA than LAA on CT (P < 0.05).

Conclusions

DIBrH SPECT identifies affected lungs with perfusion abnormality better than does non-BrH SPECT in pulmonary emphysema. DIBrH SPECT-CT fusion images are useful for more accurately localizing affected lungs than morphologic CT alone in this disease.

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Authors and Affiliations

  1. Department of Radiology, St. Hill Hospital, 1462-3 Nishikiwa, Ube, 755-0151, Japan

    Kazuyoshi Suga & Yasuhiko Kawakami

  2. Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan

    Hideyuki Iwanaga, Noriko Hayashi, Akiko Seto & Naofumi Matsunaga

Authors
  1. Kazuyoshi Suga
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  2. Yasuhiko Kawakami
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  3. Hideyuki Iwanaga
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  4. Noriko Hayashi
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  5. Akiko Seto
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  6. Naofumi Matsunaga
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Correspondence to Kazuyoshi Suga.

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Suga, K., Kawakami, Y., Iwanaga, H. et al. Assessment of anatomic relation between pulmonary perfusion and morphology in pulmonary emphysema with breath-hold SPECT-CT fusion images. Ann Nucl Med 22, 339–347 (2008). https://doi.org/10.1007/s12149-007-0137-5

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  • DOI: https://doi.org/10.1007/s12149-007-0137-5

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