Abstract
Objectives
This paper describes a novel approach (same-patient processing, or SPP) aimed at improving left ventricular segmentation accuracy in patients with multiple SPECT studies, and evaluates its performance compared to conventional processing in a large population of 962 patients undergoing rest and stress electrocardiography-gated SPECT MPI, for a total of 5,772 image datasets (6 per patient).
Methods
Each dataset was independently processed using a standard algorithm, and a shape quality control score (SQC) was produced for every segmentation. Datasets with a SQC score higher than a specific threshold, suggesting algorithmic failure, were automatically reprocessed with the SPP-modified algorithm, which incorporates knowledge of the segmentation mask location in the other datasets belonging to the same patient. Experienced operators blinded as to whether datasets had been processed based on the standard or SPP approach assessed segmentation success/failure for each dataset.
Results
The SPP approach reduced segmentation failures from 219/5772 (3.8%) to 42/5772 (0.7%) overall, with particular improvements in attenuation corrected (AC) datasets with high extra-cardiac activity (from 100/962 (10.4%) to 12/962 (1.4%) for rest AC, and from 41/962 (4.3%) to 9/962 (0.9%) for stress AC). The number of patients who had at least one of their 6 datasets affected by segmentation failure decreased from 141/962 (14.7%) to 14/962 (1.7%) using the SPP approach.
Conclusion
Whenever multiple image datasets for the same patient exist and need to be processed, it is possible to deal with the images as a group rather than individually. The same-patient processing approach can be implemented automatically, and may substantially reduce the need for manual reprocessing due to cardiac segmentation failure.
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Abbreviations
- SPP:
-
Same-patient processing
- SPECT:
-
Single photon emission computed tomography
- MPI:
-
Myocardial perfusion imaging
- LV:
-
Left ventricle
- AC:
-
Attenuation corrected
- SQC:
-
Shape quality control
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Acknowledgments
This research was supported in part by Grant R01HL089765 from the National Heart, Lung, and Blood Institute/National Institutes of Health (NHLBI/NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NHLBI/NIH.
Disclosure
Cedars-Sinai Medical Center receives royalties for the licensing of software and algorithms related to the quantitative assessment of perfusion, function and other cardiac parameters, a minority portion of which is distributed to some of the authors of this manuscript (Guido Germano, Paul B. Kavanagh, Daniel S. Berman and Piotr J. Slomka).
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Germano, G., Kavanagh, P.B., Fish, M.B. et al. “Same-Patient Processing” for multiple cardiac SPECT studies. 1. Improving LV segmentation accuracy. J. Nucl. Cardiol. 23, 1435–1441 (2016). https://doi.org/10.1007/s12350-016-0673-2
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DOI: https://doi.org/10.1007/s12350-016-0673-2