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Bourhis D, Robin P, Essayan M, Abgral R, Querellou S, Tromeur C, Salaun PY, Le Roux PY. V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps. Front Med (Lausanne) 2020; 7:143. [PMID: 32411710 PMCID: PMC7198740 DOI: 10.3389/fmed.2020.00143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background: V/Q SPECT/CT is attractive for regional lung function assessment, but accurate delineation and quantification of functional lung volumes remains a challenge. Physiological intra and inter patient non-uniformity of V/Q SPECT images make conventional delineation methods of functional lung volumes inaccurate. In that context it would be of interest to build statistical maps of normal V/Q SPECT to assess the physiological variability of radiotracers. The aim of this study was to generate normal mean and standard deviation maps of regional lung function as assessed with V/Q SPECT/CT, with (AC) and without (NoAC) attenuation correction. Methods: During a 13 month period, 73 consecutive patients referred for suspected acute pulmonary embolism, that had normal V/Q SPECT/CT based on the interpretation of 2 independent nuclear medicine physicians, were selected. Four set of images were reconstructed: perfusion and ventilation images, AC, and NoAC, respectively. Statistical maps were created as follows: all cases were registered to a reference scan using the CT data, first with a rigid then with a non-rigid method. SPECTs reconstructions were then co-registered and normalized, and mean and standard deviation voxel-wise maps were calculated. To assess the consistency of generated maps to lung physiology and the potential impact of non-rigid registration, visual analysis and quantitative comparison with non-registered data were performed in the whole series. Quantitative comparison was also conducted in two randomly sampled independent subsets. Results: Perfusion mean maps showed a continuous negative posterior to anterior gradient, majored on the AC mean map. Perfusion standard deviation maps showed higher variability in the periphery of the lungs, but especially in the posterior areas. The ventilation mean map showed a slightly positive posterior to anterior gradient on NoAC mean ventilation map, while the AC mean map showed no gradient. The NoAC ventilation SD map showed a higher variability in the periphery of the lungs as compared with AC SD map. No statistical difference in the posterior to anterior gradient measurements was found between the generated mean statistical maps and the non-registered data, either in the whole series or across the two independent datasets. Conclusion: We proposed a methodology to create statistical normal maps for V/Q SPECTs. Maps were consistent with the known physiological non-uniformity and showed the impact of attenuation correction on the posterior to anterior gradient. These maps could be used for a Z-score analysis, and a better segmentation of healthy uptake areas.
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Affiliation(s)
- David Bourhis
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France.,EA3878 GETBO, Université de Bretagne Occidentale, Brest, France
| | - Philippe Robin
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France.,EA3878 GETBO, Université de Bretagne Occidentale, Brest, France
| | - Marine Essayan
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France
| | - Ronan Abgral
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France.,EA3878 GETBO, Université de Bretagne Occidentale, Brest, France
| | - Solène Querellou
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France
| | - Cécile Tromeur
- EA3878 GETBO, Université de Bretagne Occidentale, Brest, France.,Service de Pneumologie, Centre Hospitalier Régional Universitaire de Brest, Brest, France
| | - Pierre-Yves Salaun
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France.,EA3878 GETBO, Université de Bretagne Occidentale, Brest, France
| | - Pierre-Yves Le Roux
- Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, France.,EA3878 GETBO, Université de Bretagne Occidentale, Brest, France
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Ishihara M, Onoguchi M, Taniguchi Y, Shibutani T. Comparison of conventional and cadmium-zinc-telluride single-photon emission computed tomography for analysis of thallium-201 myocardial perfusion imaging: an exploratory study in normal databases for different ethnicities. Int J Cardiovasc Imaging 2017; 33:2057-2066. [PMID: 28664481 DOI: 10.1007/s10554-017-1205-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/22/2017] [Indexed: 02/02/2023]
Abstract
The aim of this study was to clarify the differences in thallium-201-chloride (thallium-201) myocardial perfusion imaging (MPI) scans evaluated by conventional anger-type single-photon emission computed tomography (conventional SPECT) versus cadmium-zinc-telluride SPECT (CZT SPECT) imaging in normal databases for different ethnic groups. MPI scans from 81 consecutive Japanese patients were examined using conventional SPECT and CZT SPECT and analyzed with the pre-installed quantitative perfusion SPECT (QPS) software. We compared the summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for the two SPECT devices. For a normal MPI reference, we usually use Japanese databases for MPI created by the Japanese Society of Nuclear Medicine, which can be used with conventional SPECT but not with CZT SPECT. In this study, we used new Japanese normal databases constructed in our institution to compare conventional and CZT SPECT. Compared with conventional SPECT, CZT SPECT showed lower SSS (p < 0.001), SRS (p = 0.001), and SDS (p = 0.189) using the pre-installed SPECT database. In contrast, CZT SPECT showed no significant difference from conventional SPECT in QPS analysis using the normal databases from our institution. Myocardial perfusion analyses by CZT SPECT should be evaluated using normal databases based on the ethnic group being evaluated.
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Affiliation(s)
- Masaru Ishihara
- Department of Radiology, Hyogo Cancer Center, 13-70 Kitaoji, Akashi, Hyogo, 673-8558, Japan.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
| | - Yasuyo Taniguchi
- Department of Cardiology, Hyogo Brain and Heart Center at Himeji, 520 Saisho-ko, Himeji, Hyogo, 670-0981, Japan
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
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Abstract
PURPOSE OF REVIEW Myocardial perfusion imaging (MPI) with SPECT is performed clinically worldwide to detect and monitor coronary artery disease (CAD). MPI allows an objective quantification of myocardial perfusion at stress and rest. This established technique relies on normal databases to compare patient scans against reference normal limits. In this review, we aim to introduce the process of MPI quantification with normal databases and describe the associated perfusion quantitative measures that are used. RECENT FINDINGS New equipment and new software reconstruction algorithms have been introduced which require the development of new normal limits. The appearance and regional count variations of normal MPI scan may differ between these new scanners and standard Anger cameras. Therefore, these new systems may require the determination of new normal limits to achieve optimal accuracy in relative myocardial perfusion quantification. Accurate diagnostic and prognostic results rivaling those obtained by expert readers can be obtained by this widely used technique. SUMMARY Throughout this review, we emphasize the importance of the different normal databases and the need for specific databases relative to distinct imaging procedures. use of appropriate normal limits allows optimal quantification of MPI by taking into account subtle image differences due to the hardware and software used, and the population studied.
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Trägårdh E, Sjöstrand K, Jakobsson D, Edenbrandt L. Small average differences in attenuation corrected images between men and women in myocardial perfusion scintigraphy: a novel normal stress database. BMC Med Imaging 2011; 11:18. [PMID: 21967548 PMCID: PMC3205014 DOI: 10.1186/1471-2342-11-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 10/03/2011] [Indexed: 11/15/2022] Open
Abstract
Background The American Society of Nuclear Cardiology and the Society of Nuclear Medicine state that incorporation of attenuation-corrected (AC) images in myocardial perfusion scintigraphy (MPS) will improve image quality, interpretive certainty, and diagnostic accuracy. However, commonly used software packages for MPS usually include normal stress databases for non-attenuation corrected (NC) images but not for attenuation-corrected (AC) images. The aim of the study was to develop and compare different normal stress databases for MPS in relation to NC vs. AC images, male vs. female gender, and presence vs. absence of obesity. The principal hypothesis was that differences in mean count values between men and women would be smaller with AC than NC images, thereby allowing for construction and use of gender-independent AC stress database. Methods Normal stress perfusion databases were developed with data from 126 male and 205 female patients with normal MPS. The following comparisons were performed for all patients and separately for normal weight vs. obese patients: men vs. women for AC; men vs. women for NC; AC vs. NC for men; and AC vs. NC for women. Results When comparing AC for men vs. women, only minor differences in mean count values were observed, and there were no differences for normal weight vs. obese patients. For all other analyses major differences were found, particularly for the inferior wall. Conclusions The results support the hypothesis that it is possible to use not only gender independent but also weight independent AC stress databases.
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Affiliation(s)
- Elin Trägårdh
- Clinical Physiology and Nuclear Medicine Unit, Skåne University Hospital, Lund University, Malmö, Sweden.
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