Journal of Nuclear Cardiology

, Volume 15, Issue 4, pp 547–563 | Cite as

Ordered subset expectation maximization and wide beam reconstruction “half-time” gated myocardial perfusion SPECT functional imaging: A comparison to “full-time” filtered backprojection

  • E. Gordon DePuey
  • Ramesh Gadiraju
  • John Clark
  • Linda Thompson
  • Frank Anstett
  • Shuli C. Shwartz
Original Articles

Abstract

Objectives: Compared to filtered back projection (FBP), OSEM with resolution recovery (OSEM-RR) and wide beam reconstruction (WBR)(UltraSPECT Ltd.), which resolve resolution and suppress noise simultaneously during reconstruction, have been shown to maintain/improve myocardial perfusion SPECT quality, even with low count density half-time acquisitions. We postulated that their characteristics would be advantageous for gated SPECT, where each frame is only 1/8th the count density of the summed perfusion images.

Methods: An 9 mCi rest/32 mCi (333/1184 MBq) stress Tc99m sestamibi protocol was used. 15-min FBP, and additional 7-min OSEM-RR and WBR post-stress 8-frame/cardiac cycle SPECT scans were acquired with 90°-angled dual-headed detectors equipped with high resolution collimators in 156 patients. In 82 patients (48F, 34M) (123–252 lbs) with perfusion defects gated image quality was graded visually: 1 (poor)-5 (excellent) Regional LV wall motion (WM) was scored: 0 (normal)- 4 (dyskinesis) in a total of 50 vascular territories with defects. Using Myometrix® software (GE Healthcare), post-stress EDV, ESV, and EF were calculated for each method. Additionally, for purposes of comparison, the FBP gated tomograms were processed with other commercially available packages, Emory Toolbox® and Cedars QGS®.

Results: Despite half-time acquisitions, compared to FBP, image quality increased marginally with OSEM-RR (P=.09) but very significantly with WBR (P=1.9×10−21). The WM score was greater only for WBR (P=4.8×10−8). Although quantitative parameters correlated well with those determined by FBP (all EF r’s>0.85; all volume r’s>0.93), EFs were significantly lower (P=.0001 for OSEM-RR, 3.4×10−14 for WBR), primarily due to a decrease in EDV with OSEM-RR (P=7.3×10−13) and an increase in ESV with WBR (P=9.2×10−5). However, inter-method differences in these parameters were of similar magnitude to differences encountered among the commercially available software methods.

Conclusions: Half-time OSEM-RR and particularly WBR improve gated SPECT diagnostic quality compared to full-time FBP due to increased resolution and reduced noise. However, these attributes, which affect endocardial edge detection, result in a systematic offset in EDV, ESV, and EF.

Keywords

Single Photon Emission Compute Tomography Nuclear Cardiology Single Photon Emission Compute Tomography Image Filter Back Projection Gated Single Photon Emission Compute Tomography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© American Society of Nuclear Cardiology 2008

Authors and Affiliations

  • E. Gordon DePuey
    • 1
    • 2
  • Ramesh Gadiraju
    • 1
    • 2
  • John Clark
    • 1
    • 2
  • Linda Thompson
    • 1
    • 2
  • Frank Anstett
    • 3
  • Shuli C. Shwartz
    • 1
    • 2
    • 3
  1. 1.Department of Radiology, Division of Nuclear MedicineSt Luke’s-Roosevelt HospitalUSA
  2. 2.Columbia University College of Physicians and SurgeonsNew York
  3. 3.GE HealthcareWaukesha

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