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 DePueyEmail author
  • Ramesh Gadiraju
  • John Clark
  • Linda Thompson
  • Frank Anstett
  • Shuli C. Shwartz
Original Articles


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.


Single Photon Emission Compute Tomography Nuclear Cardiology Single Photon Emission Compute Tomography Image Filter Back Projection Gated Single Photon Emission Compute Tomography 
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  1. 1.
    DePuey EG, Rozanski A. Using gated technetium-99m-sestamibi SPECT to characterize fixed myocardial defects as infarct or artifact. J Nucl Med 1995;36:952–5.PubMedGoogle Scholar
  2. 2.
    Thomas GS, Miyamoto MI, Morello AP, Majmundar H, Thomas JJ, Sampson CH, et al. Technetium 99m sestamibi myocardial perfusion imaging predicts clinical outcome in the community outpatient setting. The Nuclear Utility in the Community (NUC) Study. J Am Coll Cardiol 2004;43:213–23.PubMedCrossRefGoogle Scholar
  3. 3.
    DePuey EG, Taillefer R, Gadiraju R, Anstett F. A clinical evaluation of two resolution recovery methods for reduced scan time of gated MPI SPECT. Presented at the Annual Meeting of the American Society of Nuclear Cardiology, Montreal, September 8, 2006. Available from: URL: Scholar
  4. 4.
    Borges-Neto S, Pagnanelli RA, Shaw LK, Honeycutt E, Shwartz SC, Adams GL, et al. Clinical results of a novel wide beam reconstruction method for shortening scan time of Tc-99m cardiac SPECT perfusion studies. J Nucl Cardiol 2007;14:555–65.PubMedCrossRefGoogle Scholar
  5. 5.
    Metz CE, Atkins FB, Beck RN. The geometric transfer function component for scintillation camera collimators with straight parallel holes. Phys Med Biol 1980;25:1059–70.PubMedCrossRefGoogle Scholar
  6. 6.
    Tsui BMW, Gullberg GT. The geometric transfer function for cone and fan beam collimators. Phys Med Biol 1990;35:81–93.PubMedCrossRefGoogle Scholar
  7. 7.
    Tsui BMW, Hu H-B, Gillard DR, Gullberg GT. Implementation of simultaneous attenuation and detector response correction in SPECT. IEEE Trans Nucl Sci 1988;35:778–83.CrossRefGoogle Scholar
  8. 8.
    Tsui BMW, Frey EC, Zhao X, Lalush DS, Johnston RE, McCartney WH. The importance and implementation of accurate 3D compensation methods for quantitative SPECT. Phys Med Biol 1994;39:509–30.PubMedCrossRefGoogle Scholar
  9. 9.
    Tsui BMW, Zhao XD, Frey EC, Gullberg GT. Characteristics of reconstructed point response in three-dimensional spatially variant detector response compensation in SPECT. In: Grangeat P, Amands J-L, editors. Three-dimensional image reconstruction in radiology and nuclear medicine. Norwell (MA): Kluwer Academic Publishers; 1996. p. 149–162.Google Scholar
  10. 10.
    Philipe P, Bruyant J. Analytic and iterative reconstruction algorithms in SPECT. J Nucl Med 2002;43:1343–58.Google Scholar
  11. 11.
    Green PJ. Bayesian reconstruction from emission tomography data using a modified EM algorithm. IEEE Trans Med Imaging 1990;9:84–93.PubMedCrossRefGoogle Scholar
  12. 12.
    Alenius S, Ruotsalainen U. Bayesian image reconstruction for emission tomography based on median root prior. Eur J Nucl Med 1997;24:258–65.PubMedGoogle Scholar
  13. 13.
    Farkash G, Kenig K, Grabnic M, Yuzefovich B, Sachs J, Bocher M. Volumetric quantitation of left ventricular perfusion and function from myocardial perfusion SPECT: Validation of a new algorithm [abstract]. J Nucl Cardiol 2006;13:S5.Google Scholar
  14. 14.
    Taillefer R, Primeau M, Costi P, Lambert R, Leville J, Latour Y. Technetium-99m-sestamibi myocardial perfusion imaging: Comparison between a short (8 minutes) and standard (21 minutes) data acquisition time in diagnosis of coronary artery disease [abstract]. J Nucl Med 1992;33:855.Google Scholar
  15. 15.
    DePuey EG, Nichols KJ, Slowikowski JS, Scarpa WJ, Smith C, Melancon S. Fast stress and rest acquisitions for technetium-99msestamibi separate-day SPECT. J Nucl Med 1995;36:569–74.PubMedGoogle Scholar
  16. 16.
    Basso D, Passmore G, Holman M, Rogers W, Walters L. A clinical evaluation of a wide beam reconstruction method for shortening scan time of gated cardiac rest/stress SPECT [abstract]. J Nucl Med 2006;47:534P.Google Scholar
  17. 17.
    Pena H, Cantinho G, Shwartz SC, Pinhero M, Goncalves P, Godinho F. Has wide beam reconstruction technology for myocardial perfusion SPECT any impact on functional cardiac parameters [abstract]? Eur J Nucl Med Mol Imaging 2006;33(Suppl 2):S221.Google Scholar
  18. 18.
    Cantinho G, Pena H, Shwartz SC, Montiero J, Pereira L, Cerquiera D, et al. Wide beam reconstruction technology: Does it respect myocardial perfusion SPECT functional parameters [abstract]? J Nucl Cardiol 2007;14:S56.Google Scholar
  19. 19.
    Johnson LL, Verdesca SA, Aude WY, Xavier RC, Nott LT, Campanella MW, et al. Postischemic stunning can affect left ventricular ejection fraction and regional wall motion on post-stress gated sestamibi tomograms. J Am Coll Cardiol 1997;30:1641–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Sharir T, Bacher-Stier C, Dhar S, Lewin HC, Miranda R, Friedman JD, et al. Identification of severe and extensive coronary artery disease by postexercise regional wall motion abnormalities in Tc-99m sestamibi gated single-photon emission computed tomography. Am J Cardiol 2000;86:1171–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Emmett L, Iwanochko RM, Freeman MR, Barolet A, Lee DS, Husain M. Reversible regional wall motion abnormalities on exercise technetium-99m-gated cardiac single photon emission computed tomography predict high-grade angiographic stenoses. J Am Coll Cardiol 2002;39:991–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Navare SM, Wackers FJT, Liu YH. Comparison of 16-frame and 8-frame gated SPET imaging for determination of left ventricular volumes and ejection fraction. Eur J Nucl Med Mol Imaging 2003;30:1330–7.PubMedCrossRefGoogle Scholar

Copyright information

© American Society of Nuclear Cardiology 2008

Authors and Affiliations

  • E. Gordon DePuey
    • 1
    • 2
    Email author
  • 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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