Nuclear Medicine Section, Department of Medicine, University of Chile Clinical Hospital, Santos Dumont 999-1E, Independencia, Santiago, Chile 6531063.
Eur J Nucl Med Mol Imaging. 2010 Apr;37(4):758-64. doi: 10.1007/s00259-009-1290-y. Epub 2009 Nov 14.
Myocardial perfusion SPECT is an excellent tool for the assessment of coronary artery disease (CAD); however, it is affected by several artifacts, such as patient motion during acquisition, which increases false-positive rates. Therefore, the purpose of this work is to analyze changes in perfusion scores after motion-correction software application.
The population included 160 (99m)Tc-sestamibi CAD studies, divided into two groups: with and without perfusion defects, equally divided into subgroups according to movement during standard acquisition. A Siemens ECAM 180 was used for processing without correction and with automatic and manual e.soft 2.5 modalities. Visual interpretation as well as QPS software was compared using Pearson correlation and kappa agreement statistics.
Moderate agreement was observed between SPECT interpretations after motion correction versus the original report, according to the presence of perfusion defects. Manual correction using the software obtained the lowest agreements. Perfusion summed stress scores (SSS) correlation from different processing modalities versus non-corrected studies differed significantly independent of the degree of motion. Mean SSS in 40 patients with no motion was 3.9 + or - 3.9 when no correction was applied; with automatic correction was 8.8 + or - 10 (p = 0.03) and with manual correction was 3.1 + or - 3.5 (p = ns versus non-corrected). Automatic correction was better when applied to patients with mild to moderate motion. In those with mild or no motion, software overestimated or created new perfusion defects.
Motion-correction software must be used with caution when trying to optimize myocardial perfusion SPECT based on individual analysis. Acquisition should be always repeated in cases with severe motion and in no or mild motion it seems preferable to avoid correction.
心肌灌注 SPECT 是评估冠状动脉疾病（CAD）的优秀工具；然而，它受到多种伪影的影响，例如采集过程中的患者运动，这会增加假阳性率。因此，本研究的目的是分析应用运动校正软件后灌注评分的变化。
该人群包括 160 例（99m）Tc- sestamibi CAD 研究，分为有灌注缺损和无灌注缺损两组，根据标准采集过程中的运动情况分为亚组。使用西门子 ECAM 180 进行处理，不校正和自动校正和手动校正 e.soft 2.5 模式。使用 Pearson 相关和 Kappa 一致性统计比较视觉解释和 QPS 软件。
校正前后运动校正后的 SPECT 解释与原始报告之间存在中度一致性，存在灌注缺损。使用软件进行手动校正获得的一致性最低。不同处理模式与未经校正的研究相比，灌注总和应激评分（SSS）相关性差异显著，与运动程度无关。40 例无运动患者的平均 SSS 为 3.9 + 或 - 3.9，未应用校正时为 8.8 + 或 - 10（p = 0.03），自动校正时为 3.1 + 或 - 3.5（p = ns 与未校正）。当应用于轻度至中度运动的患者时，自动校正效果更好。在轻度或无运动的患者中，软件会高估或产生新的灌注缺损。
在尝试根据个体分析优化心肌灌注 SPECT 时，必须谨慎使用运动校正软件。在严重运动的情况下应始终重复采集，在无运动或运动轻微的情况下，似乎最好避免校正。
