1
|
Kamiya T, Iimori T, Maeda Y, Yada N, Hayashi N, Iguchi H, Narita M. Administered dosage and effective dose estimated from 81Rb-rubidium hydroxide for lung ventilation scintigraphy using 81mKr noble gas. RADIATION PROTECTION DOSIMETRY 2024; 200:149-154. [PMID: 37987214 DOI: 10.1093/rpd/ncad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
The aim of this study was to estimate the administered dosage of 81mKr noble gas as calculated by the radioactivity of 81Rb-rubidium hydroxide (81RbOH). The administered dosage was regarded as the total amount of 81mKr noble gas. The radioactivity of 81mKr was calculated using the radioactivity of 81RbOH at the examination, the beginning of inhalation, the inhalation duration and the attenuation volume from the generator to the patient for 81mKr noble gas. In addition, we created an Internet survey and asked National University Hospital in Japan to respond to questions regarding the parameters of concern. Survey responses were provided by 38 hospitals (response rate was 90.5%). Twenty-seven hospitals (64.3%) examined lung ventilation scintigraphy using 81mKr noble gas. The mean administered dosage and the effective dose of lung ventilation scintigraphy using 81mKr noble gas were 35.8 ± 22.1 GBq and 0.97 ± 0.60 mSv, respectively.
Collapse
Affiliation(s)
- Takashi Kamiya
- Department of Medical Technology, Osaka University Hospital, Suita 5650871, Japan
| | - Takashi Iimori
- Department of Radiology, Chiba University Hospital, Chiba 2608677, Japan
| | - Yukito Maeda
- Department of Clinical Radiology, Kagawa University Hospital, Kita-gun 7610793, Japan
| | - Nobuhiro Yada
- Department of Radiology, Shimane University Hospital, Izumo 6938501, Japan
| | - Naoya Hayashi
- Department of Medical Technology, Kochi Medical School Hospital, Nankoku 7830043, Japan
| | - Harumi Iguchi
- Department of Radiology, Shiga University of Medical Science Hospital, Otsu 5202192, Japan
| | - Masataka Narita
- Department of Radiology, Hirosaki University Hospital, Hirosaki 0368563, Japan
| |
Collapse
|
2
|
Li Z, Le Roux PY, Callahan J, Hardcastle N, Hofman MS, Siva S, Yamamoto T. Quantitative assessment of ventilation-perfusion relationships with gallium-68 positron emission tomography/computed tomography imaging in lung cancer patients. Phys Imaging Radiat Oncol 2022; 22:8-12. [PMID: 35465222 PMCID: PMC9018442 DOI: 10.1016/j.phro.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022] Open
Abstract
Voxel-wise correlations between gallium-68 (68Ga) positron emission tomography/computed tomography (PET/CT)-measured ventilation and perfusion varied widely among 19 patients with lung cancer (range: 0.26–0.88). 68Ga PET/CT-measured percent gas exchanging lung volume was moderately correlated with diffusing capacity of the lung for carbon monoxide (DLCO) as the reference standard, with the highest correlation coefficient of 0.59 (P < 0.01). 68Ga PET/CT ventilation/perfusion imaging may provide a reasonable surrogate for regional gas exchange.
Pulmonary functional imaging has demonstrated potential to improve thoracic radiotherapy. The purpose of this study was twofold: 1) to quantify ventilation/perfusion relationships in lung cancer patients using a new functional imaging approach, gallium-68 (68Ga)-positron emission tomography/computed tomography (PET/CT); and 2) to compare ventilation/perfusion matching with diffusing capacity of the lung for carbon monoxide (DLCO). Voxel-wise correlations between ventilation and perfusion varied widely among 19 patients (range: 0.26–0.88). 68Ga-PET/CT-measured percent gas exchanging lung volume was moderately correlated with DLCO (≤0.59). Our findings suggested that 68Ga-PET/CT ventilation/perfusion imaging provided complementary information and a reasonable surrogate for gas exchange in lung cancer patients.
Collapse
Affiliation(s)
- Zhuorui Li
- Department of Biomedical Engineering, University of California Davis, Davis, CA, USA
| | - Pierre-Yves Le Roux
- Department of Nuclear Medicine, Brest University Hospital, EA3878 (GETBO), Brest, France
| | - Jason Callahan
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicholas Hardcastle
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Michael S. Hofman
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Shankar Siva
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Tokihiro Yamamoto
- Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
- Corresponding author at: Department of Radiation Oncology, University of California Davis School of Medicine, 4501 X St., Sacramento, CA 95817, USA.
| |
Collapse
|
3
|
Semi-automated Analysis of Ventilation-Perfusion Single-Photon Emission Tomography in the Diagnosis of Pulmonary Embolism – Does it add extra value? Nuklearmedizin 2020; 59:445-453. [DOI: 10.1055/a-1253-7951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Aim Diagnosis of pulmonary embolism using V/P-SPECT may include the application of advanced image-processing techniques to identify V/P-mismatches. Aim of this study was to evaluate the benefit in clinical decision making in the diagnosis of pulmonary embolism.by whether adding to conventional reading a software that automatically calculates and visualizes the ventilation/perfusion-quotient pixel by pixel.
Methods 63 consecutive patients with a clinical suspicion of PE who underwent V/P-SPECT were included in this retrospective study. Images were randomly ordered both for standard as well as for software-assisted reading using V/P-quotients. Studies were read independently by 2 experienced and 2 inexperienced raters. Diagnostic performance and observer agreement of all readers and both reading methods were determined.
Results Expert observers consistently achieved a high diagnostic accuracy both in conventional as well as in software-assisted reporting (sensitivity: 0.94 vs. 0.94, specificity: 0.96 vs. 0.97, LR+: 17.32 vs. 28.86, LR– stayed constant at 0.06). For inexperienced readers, diagnostic performance improved: sensitivity raised from 0.74 to 0.85 and specificity from 0.86 to 0.95, LR+ raised from 5.20 to 15.69, LR– decreased from 0.31 to 0.16. Inter-rater reliability (Fleiss’ κ) improved from 0.63 to 0.86 by using V/P quotient.
Conclusion Benefit from a software-tool that calculates V/P-ratio automatically is only small when used by experienced physicians If inexperienced readers use the software, the diagnostic accuracy increases. Images generated by automated calculation of V/P-mismatches are easy to read and their use might help to standardize and objectify interpretation of V/P-SPECT in the diagnosis of PE.
Collapse
|
4
|
Wang L, Wang M, Yang T, Wu D, Xiong C, Fang W. A Prospective, Comparative Study of Ventilation–Perfusion Planar Imaging and Ventilation–Perfusion SPECT for Chronic Thromboembolic Pulmonary Hypertension. J Nucl Med 2020; 61:1832-1838. [DOI: 10.2967/jnumed.120.243188] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/16/2020] [Indexed: 12/28/2022] Open
|
5
|
Sharifi H, McDonald GC, Lee JK, Ajlouni MI, Chetty IJ, Zhong H. Four-dimensional computed tomography-based biomechanical measurements of pulmonary function and their correlation with clinical outcome for lung stereotactic body radiation therapy patients. Quant Imaging Med Surg 2019; 9:1278-1287. [PMID: 31448213 PMCID: PMC6685808 DOI: 10.21037/qims.2019.07.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/30/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Functional image guided radiotherapy allows for the delivery of an equivalent dose to tumor targets while sparing high ventilation lung tissues. In this study, we investigate whether radiation dose to functional lung is associated with clinical outcome for stereotactic body radiation therapy (SBRT) patients. METHODS Four-dimensional computed tomography (4DCT) images were used to assess lung function. Deformable image registration (DIR) was performed from the end-inhale phase to the end-exhale phase with resultant displacement vectors used to calculate ventilation maps. In addition to the Jacobian-based ventilation we introduce a volumetric variation method (Rv) based on a biomechanical finite element method (FEM), to assess lung ventilation. Thirty NSCLC patients, treated with SBRT, were evaluated in this study. 4DCT images were used to calculate both Jacobian and Rv-based ventilation images. Areas under the receiver operating characteristic curve (AUC) were used to assess the predictive power of functional metrics. Metrics were calculated over the whole lung as well as high and low ventilated regions. RESULTS Ventilation in dose regions between 1 and 5 Gy had higher AUC values compared to other dose regions. Rv based ventilation imaging method also showed to be less spatially variant and less heterogeneous, and the resultant Rv metrics had higher AUC values for predicting grade 2+ dyspnea. CONCLUSIONS Low dose delivered to high ventilation areas may also increase the risk of compromised pulmonary function. Rv based ventilation images could be useful for the prediction of clinical toxicity for lung SBRT patients.
Collapse
Affiliation(s)
- Hoda Sharifi
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- Department of Physics, Oakland University, Rochester, MI, USA
| | - Gary C. McDonald
- Department of Mathematics and Statistics, Oakland University, Rochester, MI, USA
| | - Joon Kyu Lee
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Munther I. Ajlouni
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
| | - Indrin J. Chetty
- Department of Radiation Oncology, Henry Ford Health System, Detroit, MI, USA
- Department of Physics, Oakland University, Rochester, MI, USA
| | - Hualiang Zhong
- Department of Physics, Oakland University, Rochester, MI, USA
- Department of Radiation Oncology, Medical College of Wisconsin, Madison, WI, USA
| |
Collapse
|
6
|
Abstract
Uneven distribution of ventilation, or ventilation heterogeneity, has been observed in asthma for over 60 years using multiple breath nitrogen washout (MBNW) studies. Ventilation heterogeneity has been known to predict airway hyperresponsiveness (the ability of the airways to constrict too easily and by too much) in asthma, which is a core physiological characteristic of this disease. SPECT ventilation imaging allows topographical analysis of changes in ventilation distribution. Technegas as a SPECT ventilation agent has a key advantage as it remains fixed after inhalation, which allows imaging of upright ventilation distribution, analogous of pulmonary function tests. Recent studies using Technegas ventilation SPECT have shown spatial imaging markers also relate to airway hyperresponsiveness in asthma, and are predicted by a MBNW index of peripheral ventilation heterogeneity. It has also been shown that low-ventilation regions induced by bronchoconstriction were also related to peripheral ventilation heterogeneity. Furthermore, this suggests that the function of peripheral airways may determine the topographical pattern of airway narrowing with a more widespread distribution of narrowing. SPECT ventilation adds spatial characterisation information and it should be included in research protocols to enhance the understanding of complex physiological mechanisms in asthma.
Collapse
Affiliation(s)
- Catherine Farrow
- Airway Imaging and Physiology Group, The Woolcock Institute of Medical Research, Glebe NSW 2037; Northern Clinical School, Faculty of Medicine & Health, University of SydneyNSW 2006.
| | - Gregory King
- Airway Imaging and Physiology Group, The Woolcock Institute of Medical Research, Glebe NSW 2037; Department of Respiratory Medicine, Royal North Shore Hospital, Pacific Highway, St Leonards NSW 2065
| |
Collapse
|
7
|
Farrow CE, Salome CM, Harris BE, Bailey DL, Berend N, King GG. Peripheral ventilation heterogeneity determines the extent of bronchoconstriction in asthma. J Appl Physiol (1985) 2017; 123:1188-1194. [PMID: 28798203 DOI: 10.1152/japplphysiol.00640.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 11/22/2022] Open
Abstract
In asthma, bronchoconstriction causes topographically heterogeneous airway narrowing, as measured by three-dimensional ventilation imaging. Computation modeling suggests that peripheral airway dysfunction is a potential determinant of acute airway narrowing measured by imaging. We hypothesized that the development of low-ventilation regions measured topographically by three-dimensional imaging after bronchoconstriction is predicted by peripheral airway function. Fourteen asthmatic subjects underwent ventilation single-photon-emission computed tomography/computed tomography scan imaging before and after methacholine challenge. One-liter breaths of Technegas were inhaled from functional residual capacity in upright posture before supine scanning. The lung regions with the lowest ventilation (Ventlow) were calculated using a thresholding method and expressed as a percentage of total ventilation (Venttotal). Multiple-breath nitrogen washout was used to measure diffusion-dependent and convection-dependent ventilation heterogeneity (Sacin and Scond, respectively) and lung clearance index (LCI), before and after challenge. Forced expiratory volume in 1 s (FEV1) was 87.6 ± 15.8% predicted, and seven subjects had airway hyperresponsiveness. Ventlow at baseline was unrelated to spirometry or multiple-breath nitrogen washout indices. Methacholine challenge decreased FEV1 by 23 ± 5% of baseline while Ventlow increased from 21.5 ± 2.3%Venttotal to 26.3 ± 6.7%Venttotal (P = 0.03). The change in Ventlow was predicted by baseline Sacin (rs = 0.60, P = 0.03) and by LCI (rs = 0.70, P = 0.006) but not by Scond (rs = 0.30, P = 0.30). The development of low-ventilation lung units in three-dimensional ventilation imaging is predicted by ventilation heterogeneity in diffusion-dependent airways. This relationship suggests that acinar ventilation heterogeneity in asthma may be of mechanistic importance in terms of bronchoconstriction and airway narrowing.NEW & NOTEWORTHY Using ventilation SPECT/CT imaging in asthmatics, we show induced bronchoconstriction leads to the development of areas of low ventilation. Furthermore, the relative volume of the low-ventilation regions was predicted by ventilation heterogeneity in diffusion-dependent acinar airways. This suggests that the pattern of regional airway narrowing in asthma is determined by acinar airway function.
Collapse
Affiliation(s)
- Catherine E Farrow
- Woolcock Institute of Medical Research, The University of Sydney, Australia.,Department of Respiratory Medicine, Royal North Shore Hospital, St. Leonards Australia
| | - Cheryl M Salome
- Woolcock Institute of Medical Research, The University of Sydney, Australia
| | - Benjamin E Harris
- Department of Respiratory Medicine, Royal North Shore Hospital, St. Leonards Australia
| | - Dale L Bailey
- Department of Respiratory Medicine, Royal North Shore Hospital, St. Leonards Australia.,Department of Nuclear Medicine, Royal North Shore Hospital, St. Leonards Australia; and
| | - Norbert Berend
- Woolcock Institute of Medical Research, The University of Sydney, Australia.,Department of Respiratory Research, George Institute of Global Health, Australia
| | - Gregory G King
- Woolcock Institute of Medical Research, The University of Sydney, Australia; .,Department of Respiratory Medicine, Royal North Shore Hospital, St. Leonards Australia.,NHMRC Centre of Excellence in Severe Asthma, The University of Sydney, Australia
| |
Collapse
|
8
|
Ventilation Series Similarity: A Study for Ventilation Calculation Using Deformable Image Registration and 4DCT to Avoid Motion Artifacts. CONTRAST MEDIA & MOLECULAR IMAGING 2017; 2017:9730380. [PMID: 29097945 PMCID: PMC5623778 DOI: 10.1155/2017/9730380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/18/2017] [Accepted: 08/14/2017] [Indexed: 11/18/2022]
Abstract
The major problem with ventilation distribution calculations using DIR and 4DCT is the motion artifacts in 4DCT. Quite often not all phases would exhibit mushroom motion artifacts. If the ventilation series similarity is sufficiently robust, the ventilation distribution can be calculated using only the artifact-free phases. This study investigated the ventilation similarity among the data derived from different respiration phases. Fifteen lung cancer cases were analyzed. In each case, DIR was performed between the end-expiration phase and all other phases. Ventilation distributions were then calculated using the deformation matrices. The similarity was compared between the series ventilation distributions. The correlation between the majority phases was reasonably good, with average SCC values between 0.28 and 0.70 for the original data and 0.30 and 0.75 after smoothing. The better correlation between the neighboring phases, with average SCC values between 0.55 and 0.70 for the original data, revealed the nonlinear property of the dynamic ventilation. DSC analysis showed the same trend. To reduce the errors if motion artifacts are present, the phases without serious mushroom artifacts may be used. To minimize the effect of the nonlinearity in dynamic ventilation, the calculation phase should be chosen as close to the end-inspiration as possible.
Collapse
|
9
|
Zhang GG, Latifi K, Du K, Reinhardt JM, Christensen GE, Ding K, Feygelman V, Moros EG. Evaluation of the ΔV 4D CT ventilation calculation method using in vivo xenon CT ventilation data and comparison to other methods. J Appl Clin Med Phys 2016; 17:550-560. [PMID: 27074479 PMCID: PMC5874808 DOI: 10.1120/jacmp.v17i2.5985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 11/30/2015] [Accepted: 11/25/2015] [Indexed: 12/25/2022] Open
Abstract
Ventilation distribution calculation using 4D CT has shown promising potential in several clinical applications. This study evaluated the direct geometric ventilation calculation method, namely the ΔV method, with xenon-enhanced CT (XeCT) ventilation data from four sheep, and compared it with two other published meth-ods, the Jacobian and the Hounsfield unit (HU) methods. Spearman correlation coefficient (SCC) and Dice similarity coefficient (DSC) were used for the evaluation and comparison. The average SCC with one standard deviation was 0.44 ± 0.13 with a range between 0.29 and 0.61 between the XeCT and ΔV ventilation distributions. The average DSC value for lower 30% ventilation volumes between the XeCT and ΔV ventilation distributions was 0.55 ± 0.07 with a range between 0.48 and 0.63. Ventilation difference introduced by deformable image registration errors improved with smoothing. In conclusion, ventilation distributions generated using ΔV-4D CT and deformable image registration are in reasonably agreement with the in vivo XeCT measured ventilation distribution.
Collapse
|
10
|
Lau EM, Bailey DL, Bailey EA, Torzillo PJ, Roach PJ, Schembri GP, Corte TJ, Celermajer DS. Pulmonary hypertension leads to a loss of gravity dependent redistribution of regional lung perfusion: a SPECT/CT study. Heart 2013; 100:47-53. [PMID: 24186566 DOI: 10.1136/heartjnl-2013-304254] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Pre-capillary pulmonary hypertension (PHT) is characterised by progressive pulmonary vascular obliteration and loss of vascular reserves. In health, regional lung perfusion redistributes under the influence of gravity due to the presence of recruitable vessels. We investigated a combined single photon emission computed tomography/CT (SPECT/CT) method for assessing the pulmonary circulation by quantifying the gravity dependent redistribution of lung perfusion. DESIGN Characterisation of patients versus healthy controls. PATIENTS 15 patients with pre-capillary PHT and 11 healthy controls. SETTING University hospital clinic. INTERVENTION Regional lung perfusion was measured using SPECT/CT in two different postures (supine vs upright). A perfusion redistribution index (PRI) was used to quantify the cranial-caudal shift in regional lung perfusion resulting from gravitational (postural) change. MAIN OUTCOME MEASURE PRI was compared between cases and controls, and correlated with markers of disease severity in cases. RESULTS Patients with pre-capillary PHT had notably reduced PRI compared to controls (0.02±0.06 vs. 0.28±0.15 normalised perfusion/cm, p<0.0001). PRI was significantly associated with prognostic parameters such as 6 min walk distance (r=0.60, p=0.018), functional class (p=0.008), and tricuspid annular plane systolic excursion (r=0.58, p=0.022). The receiver operating characteristic curve showed that PRI differentiated patients with pre-capillary PHT from controls with AUC=0.94 (p<0.001). CONCLUSIONS With SPECT/CT, gravity dependent redistribution of lung perfusion can be quantified using the PRI derived from supine and upright perfusion analysis. The potential utility of PRI for the non-invasive detection of PHT and assessment of disease severity warrants further study.
Collapse
Affiliation(s)
- Edmund Mt Lau
- Department of Medicine, Sydney Medical School, University of Sydney, , Camperdown, Australia
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Abstract
Planar ventilation-perfusion (V/Q) scanning is often used to investigate pulmonary embolism; however, it has well-recognized limitations. SPECT overcomes many of these through its ability to generate 3-dimensional imaging data. V/Q SPECT has higher sensitivity, specificity, and accuracy than planar imaging and a lower indeterminate rate. SPECT allows for new ways to display and analyze data, such as parametric V/Q ratio images. Compared with CT pulmonary angiography, SPECT has higher sensitivity, a lower radiation dose, fewer technically suboptimal studies, and no contrast-related complications. Any nuclear medicine department equipped with a modern hybrid scanner can now perform combined V/Q SPECT with CT (using low-dose protocols) to further enhance diagnostic accuracy. V/Q SPECT (with or without CT) has application in other pulmonary conditions and in research.
Collapse
Affiliation(s)
- Paul J Roach
- Department of Nuclear Medicine, Royal North Shore Hospital, and Sydney Medical School, University of Sydney, Sydney, Australia.
| | | | | |
Collapse
|
12
|
Norberg P, Persson HL, Carlsson GA, Bake B, Kentson M, Sandborg M, Gustafsson A. Quantitative lung SPECT applied on simulated early COPD and humans with advanced COPD. EJNMMI Res 2013; 3:28. [PMID: 23597059 PMCID: PMC3706344 DOI: 10.1186/2191-219x-3-28] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 03/15/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Reduced ventilation in lung regions affected by chronic obstructive pulmonary disease (COPD), reflected as inhomogeneities in the single-photon emission computed tomography (SPECT) lung image, is correlated to disease advancement. An analysis method for measuring these inhomogeneities is proposed in this work. The first aim was to develop a quantitative analysis method that could discriminate between Monte Carlo simulated normal and COPD lung SPECT images. A second aim was to evaluate the ability of the present method to discriminate between human subjects with advanced COPD and healthy volunteers. METHODS In the simulated COPD study, different activity distributions in the lungs were created to mimic the healthy lung (normal) and different levels of COPD. Gamma camera projections were Monte Carlo simulated, representing clinically acquired projections of a patient who had inhaled 125 MBq 99mTc-Technegas followed by a 10-min SPECT examination. Reconstructions were made with iterative ordered subset expectation maximisation. The coefficient of variance (CV) was calculated for small overlapping volumes covering the 3D reconstructed activity distribution. A CV threshold value (CVT) was calculated as the modal value of the CV distribution of the simulated normal. The area under the distribution curve (AUC), for CV values greater than CVT, AUC(CVT), was then calculated. Moreover, five patients with advanced emphysema and five healthy volunteers inhaled approximately 75 MBq 99mTc-Technegas immediately before the 20-min SPECT acquisition. In the human study, CVT was based on the mean CV distribution of the five healthy volunteers. RESULTS A significant difference (p < 0.001) was found between the Monte-Carlo simulated normal and COPD lung SPECT examinations. The present method identified a total reduction of ventilation of approximately 5%, not visible to the human eye in the reconstructed image. In humans the same method clearly discriminated between the five healthy volunteers and five patients with advanced COPD (p < 0.05). CONCLUSIONS While our results are promising, the potential of the AUC(CVT) method to detect less advanced COPD in patients needs further clinical studies.
Collapse
Affiliation(s)
- Pernilla Norberg
- Department of Medical and Health Sciences, Linköping University, and Center for Medical Image Science and Visualization, and Medical Radiation Physics, County Council of Östergötland, Linköping, SE-581 85, Sweden
| | - Hans Lennart Persson
- Department of Medical and Health Sciences, Linköping University, and Department of Respiratory Medicine, County Council of Östergötland, SE-581 85, Linköping, Sweden
| | - Gudrun Alm Carlsson
- Department of Medical and Health Sciences, Linköping University, and Center for Medical Image Science and Visualization, Linköping, SE-581 85, Sweden
| | - Björn Bake
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, SE-413 46, Sweden
| | - Magnus Kentson
- Division of Pulmonary Medicine, Ryhov Hospital, SE-551 85, Jönköping, Sweden
| | - Michael Sandborg
- Department of Medical and Health Sciences, Linköping University, and Center for Medical Image Science and Visualization, and Medical Radiation Physics, County Council of Östergötland, Linköping, SE-581 85, Sweden
| | - Agnetha Gustafsson
- Department of Medical and Health Sciences, Linköping University, and Center for Medical Image Science and Visualization, and Department of Clinical Physiology, County Council of Östergötland, SE-581 85, Linköping, Sweden
| |
Collapse
|
13
|
Farrow CE, Salome CM, Harris BE, Bailey DL, Bailey E, Berend N, Young IH, King GG. Airway closure on imaging relates to airway hyperresponsiveness and peripheral airway disease in asthma. J Appl Physiol (1985) 2012; 113:958-66. [PMID: 22837168 DOI: 10.1152/japplphysiol.01618.2011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The regional pattern and extent of airway closure measured by three-dimensional ventilation imaging may relate to airway hyperresponsiveness (AHR) and peripheral airways disease in asthmatic subjects. We hypothesized that asthmatic airways are predisposed to closure during bronchoconstriction in the presence of ventilation heterogeneity and AHR. Fourteen asthmatic subjects (6 women) underwent combined ventilation single photon emission computed tomography/computed tomography scans before and after methacholine challenge. Regional airway closure was determined by complete loss of ventilation following methacholine challenge. Peripheral airway disease was measured by multiple-breath nitrogen washout from which S(cond) (index of peripheral conductive airway abnormality) was derived. Relationships between airway closure and lung function were examined by multiple-linear regression. Forced expiratory volume in 1 s was 87.5 ± 15.8% predicted, and seven subjects had AHR. Methacholine challenge decreased forced expiratory volume in 1 s by 23 ± 5% and increased nonventilated volume from 16 ± 4 to 29 ± 13% of computed tomography lung volume. The increase in airway closure measured by nonventilated volume correlated independently with both S(cond) (partial R(2) = 0.22) and with AHR (partial R(2) = 0.38). The extent of airway closure induced by methacholine inhalation in asthmatic subjects is greater with increasing peripheral airways disease, as measured by ventilation heterogeneity, and with worse AHR.
Collapse
Affiliation(s)
- Catherine E Farrow
- Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Amin AM. Iodine-125-terbutaline (125ITB): a new β2-adrenoceptor probe for lung imaging. J Labelled Comp Radiopharm 2012. [DOI: 10.1002/jlcr.2935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. M. Amin
- Labeled Compounds Department; Hot Lab. Center; Atomic Energy Authority; 13759; Cairo; Egypt
| |
Collapse
|
15
|
Smith J, Bartlett M, Thomas P. Histogram matching for the generation of ventilation-perfusion difference images in SPECT lung scanning: A phantom study. Med Phys 2012; 39:3026-30. [DOI: 10.1118/1.4712220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
16
|
Soler X, Hoh CK, Test VJ, Kerr KM, Marsh JJ, Morris TA. Single photon emission computed tomography in chronic thromboembolic pulmonary hypertension. Respirology 2011; 16:131-7. [PMID: 20920137 DOI: 10.1111/j.1440-1843.2010.01867.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE The management of chronic thromboembolic pulmonary hypertension (CTEPH) is largely dependent on the extent of obstruction in the pulmonary arteries. Planar perfusion scans are commonly used to quantify perfusion defects in CTEPH patients. However, planar scans typically under-represent the extent of vascular obstruction in CTEPH. We conducted this study to test the hypothesis that SPECT lung perfusion scans are more accurate than planar scans for determining the location and extent of perfusion defects in patients with CTEPH. METHODS Planar ventilation scans, planar and SPECT perfusion scans were performed preoperatively in patients undergoing pulmonary thromboendarterectomy for treatment of CTEPH. Two clinical experts independently documented the segmental anatomy of the vascular obstructions by reviewing clinical records, pulmonary and CT angiograms, and surgical specimens. A nuclear medicine expert documented the segmental anatomy of the perfusion defects observed by planar and SPECT scans independently. RESULTS Clinical/pathological evaluation disclosed 241 obstructed and 99 unobstructed lung segments in 17 patients. Sensitivity for detecting obstructed segments was significantly higher for SPECT than for planar scanning (63.5 ± 3.1% vs. 42.7 ± 3.2%, respectively; P < 0.01). Specificities of SPECT and planar scanning were not significantly different (62.6 ± 4.8% vs. 76.8 ± 4.2%, respectively; P = 0.092). CONCLUSIONS The SPECT is more sensitive than planar perfusion scanning for identifying obstructed segments in CTEPH. However, even SPECT under-represents the true extent of the vascular occlusions in CTEPH.
Collapse
Affiliation(s)
- Xavier Soler
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, UCSD Medical Center, San Diego, California 92103-8377, USA.
| | | | | | | | | | | |
Collapse
|
17
|
Filtering in SPECT Image Reconstruction. Int J Biomed Imaging 2011; 2011:693795. [PMID: 21760768 PMCID: PMC3132528 DOI: 10.1155/2011/693795] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 04/05/2011] [Indexed: 11/17/2022] Open
Abstract
Single photon emission computed tomography (SPECT) imaging is widely implemented in nuclear medicine as its clinical role in the diagnosis and management of several diseases is, many times, very helpful (e.g., myocardium perfusion imaging). The quality of SPECT images are degraded by several factors such as noise because of the limited number of counts, attenuation, or scatter of photons. Image filtering is necessary to compensate these effects and, therefore, to improve image quality. The goal of filtering in tomographic images is to suppress statistical noise and simultaneously to preserve spatial resolution and contrast. The aim of this work is to describe the most widely used filters in SPECT applications and how these affect the image quality. The choice of the filter type, the cut-off frequency and the order is a major problem in clinical routine. In many clinical cases, information for specific parameters is not provided, and findings cannot be extrapolated to other similar SPECT imaging applications. A literature review for the determination of the mostly used filters in cardiac, brain, bone, liver, kidneys, and thyroid applications is also presented. As resulting from the overview, no filter is perfect, and the selection of the proper filters, most of the times, is done empirically. The standardization of image-processing results may limit the filter types for each SPECT examination to certain few filters and some of their parameters. Standardization, also, helps in reducing image processing time, as the filters and their parameters must be standardised before being put to clinical use. Commercial reconstruction software selections lead to comparable results interdepartmentally. The manufacturers normally supply default filters/parameters, but these may not be relevant in various clinical situations. After proper standardisation, it is possible to use many suitable filters or one optimal filter.
Collapse
|
18
|
Meier A, Farrow C, Harris BE, King GG, Jones A. Application of texture analysis to ventilation SPECT/CT data. Comput Med Imaging Graph 2011; 35:438-50. [PMID: 21621384 DOI: 10.1016/j.compmedimag.2011.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Revised: 01/05/2011] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
Abstract
It is demonstrated that textural parameters calculated from functional pulmonary CT data have the potential to provide a robust and objective quantitative characterisation of inhomogeneity in lung function and classification of lung diseases in routine clinical applications. Clear recommendations are made for optimum data preparation and textural parameter selection. A new set of platform-independent software tools are presented that are implemented as plug-ins for ImageJ. The tools allow segmentation and subsequent histogram-based and grey-level co-occurrence matrix based analysis of the regions of interest. The work-flow is optimised for use in a clinical environment for the analysis of transverse Computed Tomography (CT) scans and lung ventilation scans based on SPECT. Consistency tests are made against other texture analysis plug-ins and simulated lung CT data. The same methods are then applied to patient data consisting of a healthy reference group and one patient group each who suffered from asthma, chronic obstructive pulmonary disease (COPD), and COPD plus lung cancer. The potential for disease classification based on computer analysis is evaluated.
Collapse
Affiliation(s)
- Arndt Meier
- Australian Key Centre for Microscopy and Microanalysis, The University of Sydney, Sydney, NSW 2006, Australia
| | | | | | | | | |
Collapse
|
19
|
King GG, Harris B, Mahadev S. V/Q SPECT: utility for investigation of pulmonary physiology. Semin Nucl Med 2011; 40:467-73. [PMID: 20920636 DOI: 10.1053/j.semnuclmed.2010.07.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Single-photon emission computed tomography (SPECT) is being increasingly used as a tool in respiratory research, in particular ventilation SPECT. Much of the basic understanding of pulmonary physiology has been derived from inhaled radioactive inert gases because, as the lung behaves in an asymmetric manner, the nature of regional differences in ventilation is ideally studied with the use of imaging. It is well known to clinicians that ventilation is patchy in patients who have airways disease. However, the relevance to the disease mechanisms itself only started to be studied with the use of 3-dimensional imaging and with advances in quantitative image analysis. The measurements of both ventilation distribution and nonventilation (airway closure) have become very topical in the study of asthma, and accurate quantification of those parameters is of relevance to disease mechanisms. In chronic obstructive pulmonary disease, the drive is towards better characterization of disease groups ("phenotypes") and, again, description of ventilation patterns may prove to be useful. This is a review, therefore, on pulmonary SPECT imaging in respiratory research which includes a focus on methodology in relation to respiratory physiology. There has been relatively little published in this area but there is great potential for advances in the understanding of airways disease to be gained from SPECT imaging.
Collapse
Affiliation(s)
- Gregory G King
- Woolcock Institute of Medical Research, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia.
| | | | | |
Collapse
|
20
|
Roach PJ, Bailey DL, Schembri GP, Thomas PA. Transition from Planar to SPECT V/Q Scintigraphy: Rationale, Practicalities, and Challenges. Semin Nucl Med 2010; 40:397-407. [DOI: 10.1053/j.semnuclmed.2010.07.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
21
|
|
22
|
Assessment of cross-sectional lung ventilation–perfusion imbalance in primary and passive pulmonary hypertension with automated V/Q SPECT. Nucl Med Commun 2010; 31:673-81. [DOI: 10.1097/mnm.0b013e328339ea9b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Miles S, Rogers KM, Thomas P, Soans B, Attia J, Abel C, Holt E, D'Este CA, Hensley MJ. A Comparison of Single-Photon Emission CT Lung Scintigraphy and CT Pulmonary Angiography for the Diagnosis of Pulmonary Embolism. Chest 2009; 136:1546-1553. [DOI: 10.1378/chest.09-0361] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
24
|
Stein PD, Freeman LM, Sostman HD, Goodman LR, Woodard PK, Naidich DP, Gottschalk A, Bailey DL, Matta F, Yaekoub AY, Hales CA, Hull RD, Leeper KV, Tapson VF, Weg JG. SPECT in Acute Pulmonary Embolism. J Nucl Med 2009; 50:1999-2007. [DOI: 10.2967/jnumed.109.063958] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
25
|
Is the lung scan alive and well? Facts and controversies in defining the role of lung scintigraphy for the diagnosis of pulmonary embolism in the era of MDCT. Eur J Nucl Med Mol Imaging 2009; 36:505-21. [DOI: 10.1007/s00259-008-1014-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Accepted: 11/07/2008] [Indexed: 11/26/2022]
|
26
|
Roach PJ, Bailey DL, Harris BE. Enhancing Lung Scintigraphy With Single-Photon Emission Computed Tomography. Semin Nucl Med 2008; 38:441-9. [DOI: 10.1053/j.semnuclmed.2008.06.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
27
|
Generation of planar images from lung ventilation/perfusion SPECT. Ann Nucl Med 2008; 22:437-45. [DOI: 10.1007/s12149-007-0120-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Accepted: 12/19/2007] [Indexed: 10/21/2022]
|
28
|
A clinical comparison between traditional planar V/Q images and planar images generated from SPECT V/Q scintigraphy. Nucl Med Commun 2008; 29:323-30. [DOI: 10.1097/mnm.0b013e3282f4a240] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
29
|
Zhang G, Dilling TJ, Stevens CW, Foster KM. Functional Lung Imaging in Thoracic Cancer Radiotherapy. Cancer Control 2008; 15:112-9. [DOI: 10.1177/107327480801500203] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Geoffrey Zhang
- Radiation Oncology Program at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Thomas J. Dilling
- Radiation Oncology Program at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Craig W. Stevens
- Radiation Oncology Program at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Kenneth M. Foster
- Radiation Oncology Program at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| |
Collapse
|
30
|
Thirty year celebration of the contribution of nuclear medicine physicists in Australia. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2008; 30:239-51. [PMID: 18274063 DOI: 10.1007/bf03178433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
31
|
Roach PJ, Thomas P, Bajc M, Jonson B. Merits of V/Q SPECT Scintigraphy Compared with CTPA in Imaging of Pulmonary Embolism. J Nucl Med 2007; 49:167-8; author reply 168. [DOI: 10.2967/jnumed.107.047274] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
32
|
Harris B, Bailey DL, Chicco P, Bailey EA, Roach PJ, King GG. Objective analysis of whole lung and lobar ventilation/ perfusion relationships in pulmonary embolism. Clin Physiol Funct Imaging 2007; 28:14-26. [DOI: 10.1111/j.1475-097x.2007.00767.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Pöppel TD, Krause BJ. Pulmonale Perfusions- und Ventilationsszintigraphie in der Diagnostik der Lungenarterienembolie. Radiologe 2007; 47:698-707. [PMID: 17673969 DOI: 10.1007/s00117-007-1534-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Diagnosis of venous thrombosis and pulmonary embolism is a common clinical problem. Imaging results frequently play a central role in the clinical decision process. This article on nuclear medicine procedures in the diagnosis of suspected pulmonary embolism provides information on pathophysiological basics, commonly used radiopharmaceuticals as well as procedure and interpretation of ventilation-perfusion scintigraphy.
Collapse
Affiliation(s)
- T D Pöppel
- Nuklearmedizinische Klinik, Universitätsklinikum Essen, Hufelandstrasse 44, 45122, Essen, Germany.
| | | |
Collapse
|