Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Physics Research, Bailing Cloud Biomedical Technologies Innovation, Taipei, Taiwan.
J Nucl Cardiol. 2017 Aug;24(4):1332-1346. doi: 10.1007/s12350-016-0513-4. Epub 2016 Jun 23.
This study investigated the performance of SPECT myocardial blood flow (MBF) quantitation lacking full physical corrections (All Corr) in dynamic SPECT (DySPECT) images.
Eleven healthy normal volunteers (HVT) and twenty-four patients with angiography-documented CAD were assessed. All Corr in Tc-sestamibi DySPECT encompassed noise reduction (NR), resolution recovery (RR), and corrections for scatter (SC) and attenuation (AC), otherwise no correction (NC) or only partial corrections. The performance was evaluated by quality index (R ) and blood-pool spillover index (FBV) in kinetic modeling, and by rest flow (RMBF) and stress flow (SMBF) compared with those of All Corr.
In HVT group, NC diminished 2-fold flow uniformity with the most degraded quality (15%-18% reduced R ) and elevated spillover effect (45%-50% increased FBV). Consistently higher RMBF and SMBF were discovered in both groups (HVT 1.54/2.31 higher; CAD 1.60/1.72; all P < .0001). Bland-Altman analysis revealed positive flow bias (HVT 0.9-2.6 mL/min/g; CAD 0.7-1.3) with wide ranges of 95% CI of agreement (HVT NC -1.9-7.1; NR -0.4-4.4; NR + SC -1.1-4.3; NR + SC + RR -0.7-2.5) (CAD NC -1.2-3.8; NR -1.0-2.8; NR + SC -1.0-2.5; NR + SC + RR -1.1-2.6).
Uncorrected physical interference in DySPECT images can extensively impact the performance of MBF quantitation. Full physical corrections should be considered to warrant this tool for clinical utilization.
本研究旨在探讨动态 SPECT（DySPECT）图像中未进行完全物理校正（All Corr）的单光子发射计算机断层扫描（SPECT）心肌血流（MBF）定量的性能。
对 11 名健康志愿者（HVT）和 24 名经血管造影证实为 CAD 的患者进行评估。Tc- sestamibi DySPECT 的 All Corr 涵盖了噪声降低（NR）、分辨率恢复（RR）以及散射（SC）和衰减（AC）校正，否则为无校正（NC）或仅部分校正。通过动力学建模中的质量指数（R）和血池溢出指数（FBV）以及与 All Corr 相比的静息血流（RMBF）和应激血流（SMBF）来评估性能。
在 HVT 组中，NC 使血流均匀性降低了 2 倍，同时质量最差（R 降低 15%-18%），溢出效应最高（FBV 增加 45%-50%）。在两组中均发现更高的 RMBF 和 SMBF（HVT 分别高 1.54/2.31；CAD 高 1.60/1.72；均 P<.0001）。Bland-Altman 分析显示存在正流量偏倚（HVT 为 0.9-2.6mL/min/g；CAD 为 0.7-1.3），其 95%置信区间的一致性范围较宽（HVT NC -1.9-7.1；NR -0.4-4.4；NR+SC -1.1-4.3；NR+SC+RR -0.7-2.5）（CAD NC -1.2-3.8；NR -1.0-2.8；NR+SC -1.0-2.5；NR+SC+RR -1.1-2.6）。
DySPECT 图像中未经校正的物理干扰可广泛影响 MBF 定量的性能。为保证该工具在临床应用中的使用，应考虑进行全面的物理校正。
