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A multicenter evaluation of a new post-processing method with depth-dependent collimator resolution applied to full-time and half-time acquisitions without and with simultaneously acquired attenuation correction

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Journal of Nuclear Cardiology Aims and scope

An Erratum to this article was published on 01 July 2010

Abstract

Background

The field of nuclear cardiology is limited by image quality and length of procedure. The use of depth-dependent resolution recovery algorithms in conjunction with iterative reconstruction holds promise to improve image quality and reduce acquisition time. This study compared the Astonish algorithm employing depth-dependent resolution recovery and iterative reconstruction to filtered backprojection (FBP) using both full-time (FTA) and half-time (HTA) data. Attenuation correction including scatter correction in conjunction with the Astonish algorithm was also evaluated.

Methods

We studied 187 consecutive patients (132 with cardiac catheterization and 55 with low likelihood for CAD) from three nuclear cardiology laboratories who had previously undergone clinically indicated rest/stress Tc-99m sestamibi or tetrofosmin SPECT. Acquisition followed ASNC guidelines (64 projections, 20-25 seconds). Processing of the full-time data sets included FBP and Astonish (FTA). A total of 32 projection data sets were created by stripping the full-time data sets and processing with Astonish (HTA). Attenuation correction was applied to both full-time and half-time Astonish-processed images (FTA-AC and HTA-AC, respectively). A consensus interpretation of three blinded readers was performed for image quality, interpretative certainty, and diagnostic accuracy, as well as severity and reversibility of perfusion and functional parameters.

Results

Full-time and half-time Astonish processing resulted in a significant improvement in image quality in comparison with FBP. Stress and rest perfusion image quality (excellent or good) were 85%/80% (FBP), 98%/95% (FTA), and 95%/92% (HTA), respectively (p < 0.001). Interpretative certainty and diagnostic accuracy were similar with FBP, FTA, and HTA. Left ventricular functional data were not different despite a slight reduction in half-time gated image quality. Application of attenuation correction resulted in similar image quality and improved normalcy (FTA vs. FTA-AC: 76% vs. 95%; HTA vs. HTA-AC: 76% vs. 100%) and specificity (FTA vs. FTA-AC: 62% vs. 78%; HTA vs. HTA-AC: 63% vs. 84%) (p < 0.01 for all comparisons).

Conclusion

Astonish processing, which incorporates depth-dependent resolution recovery, improves image quality without sacrificing interpretative certainty or diagnostic accuracy. Application of simultaneously acquired attenuation correction, which includes scatter correction, to full-time and half-time images processed with this method, improves specificity and normalcy while maintaining high image quality.

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Authors and Affiliations

  1. Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA

    Carmelo V. Venero MD, Gary V. Heller MD, PhD, FACC, Alan W. Ahlberg MA & Deborah Katten RN

  2. University of Connecticut, Farmington, CT, USA

    Gary V. Heller MD, PhD, FACC

  3. Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, USA

    Timothy M. Bateman MD, FACC & A. Iain McGhie MD, FACC

  4. Cardiovascular Imaging Technologies, Kansas City, MO, USA

    Timothy M. Bateman MD, FACC, Staci A. Courter MA, James A. Case PhD & S. James Cullom PhD

  5. Cardiology Associates of Central Connecticut, Wallingford, CT, USA

    Robert J. Golub MD, FACC

Authors
  1. Carmelo V. Venero MD
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  2. Gary V. Heller MD, PhD, FACC
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  3. Timothy M. Bateman MD, FACC
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  4. A. Iain McGhie MD, FACC
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  5. Alan W. Ahlberg MA
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  6. Deborah Katten RN
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  7. Staci A. Courter MA
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  8. Robert J. Golub MD, FACC
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  9. James A. Case PhD
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  10. S. James Cullom PhD
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Corresponding author

Correspondence to Gary V. Heller MD, PhD, FACC.

Additional information

This research was supported in part by an unrestricted clinical research grant from Philips Medical Systems, Milpitas, CA.

An erratum to this article can be found at http://dx.doi.org/10.1007/s12350-010-9269-4

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Venero, C.V., Heller, G.V., Bateman, T.M. et al. A multicenter evaluation of a new post-processing method with depth-dependent collimator resolution applied to full-time and half-time acquisitions without and with simultaneously acquired attenuation correction. J. Nucl. Cardiol. 16, 714–725 (2009). https://doi.org/10.1007/s12350-009-9106-9

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  • DOI: https://doi.org/10.1007/s12350-009-9106-9

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