Erwin William D, Jessop Aaron C, Mar Martha V, Macapinlac Homer A, Mawlawi Osama R
aDepartment of Imaging Physics bDepartment of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Nucl Med Commun. 2017 Jan;38(1):35-43. doi: 10.1097/MNM.0000000000000609.
The aim of this study was to assess the feasibility of IQ-SPECT gated blood pool (MUGA) under conditions of decreased scan time (ST).
Ten patients underwent routine 26-min, two-view planar, followed by LEHR and IQ-SPECT MUGA, on a Siemens dual-head Symbia scanner. Six 'back and forth' 4-min SPECT scans were summed into 4-, 8-, 12-, 16-, 20-, and 24-min equivalent scans, and reconstructed iteratively (IQ-SPECT and LEHR) and with FBP (LEHR). Uniformity, contrast, and wall motion were scored on a five-point scale. Linear regressions of left ventricular (LV) ejection fraction (EF) were performed between FBP, Flash 3D, and IQ-SPECT versus planar and Flash 3D and IQ-SPECT versus FBP. Agreement tables between Flash 3D and IQ-SPECT versus FBP LV EF were generated using a normal versus cardiotoxicity threshold of 50%.
IQ-SPECT had the best scores for all STs, and 4, 8, and 16 min IQ-SPECT were judged to be similar to 24-min LEHR FBP, Flash 3D, and planar, respectively. The average LV EF correlation coefficients were 0.69, 0.71, and 0.63 between IQ-SPECT, Flash 3D, and FBP versus planar, respectively; 0.70 between IQ-SPECT and FBP; and 0.88 between Flash 3D and FBP, and all were statistically significant (P<0.05), except for 16-min FBP LEHR versus planar. Agreement tables showed diagnostic equivalence of IQ-SPECT, Flash 3D, and FBP.
These preliminary results suggest that IQ-SPECT is equivalent to LEHR Flash 3D and FBP for MUGA SPECT, and better at reduced ST. A larger patient population study is necessary for a more definitive assessment.
本研究旨在评估在缩短扫描时间(ST)的条件下,智能定量单光子发射计算机断层扫描门控心血池显像(IQ-SPECT)的可行性。
10例患者在西门子双头Symbia扫描仪上接受常规的26分钟双视角平面显像,随后进行低能高分辨准直器(LEHR)和IQ-SPECT门控心血池显像。将6次“往返”4分钟的单光子发射计算机断层扫描(SPECT)图像叠加为等效的4、8、12、16、20和24分钟扫描图像,并分别采用迭代法(IQ-SPECT和LEHR)以及滤波反投影法(FBP,仅用于LEHR)进行重建。对图像的均匀性、对比度和室壁运动进行五分制评分。分别对FBP、Flash 3D和IQ-SPECT与平面显像之间,以及Flash 3D和IQ-SPECT与FBP之间的左心室(LV)射血分数(EF)进行线性回归分析。使用50%的正常与心脏毒性阈值生成Flash 3D和IQ-SPECT与FBP的LV EF之间的一致性表格。
IQ-SPECT在所有扫描时间下的评分最佳,4分钟、8分钟和16分钟的IQ-SPECT分别被判定与24分钟的LEHR FBP、Flash 3D和平面显像相似。IQ-SPECT、Flash 3D和FBP与平面显像之间的平均LV EF相关系数分别为0.69、0.71和0.63;IQ-SPECT与FBP之间为0.70;Flash 3D与FBP之间为0.88,除16分钟FBP LEHR与平面显像之间外,其余均具有统计学意义(P<0.05)。一致性表格显示IQ-SPECT、Flash 3D和FBP具有诊断等效性。
这些初步结果表明,对于门控心血池SPECT,IQ-SPECT与LEHR Flash 3D和FBP等效,且在缩短扫描时间方面表现更佳。需要进行更大规模的患者群体研究以进行更确切的评估。