Chono Taiki, Onoguchi Masahisa, Shibutani Takayuki, Hashimoto Akiyoshi, Nakata Tomoaki, Yama Naoya, Tsuchihashi Kazufumi, Hatakenaka Masamitsu
Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, S-1, W-16, Chuo-Ku, Sapporo, Japan.
Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kodatsuno 5-11-80, Kanazawa, Ishikawa, 920-0942, Japan.
Ann Nucl Med. 2017 Feb;31(2):181-189. doi: 10.1007/s12149-016-1146-z. Epub 2016 Dec 24.
An iterative reconstruction method in combination with resolution recovery, attenuation and scatter corrections (IR-RASC) can improve image quality. It, however, is undetermined whether this technique can improve the detection of coronary artery disease (CAD) when automated quantitative analysis is used. This study evaluated diagnostic values of IR-RASC in combination with automated quantitative analysis in stress myocardial perfusion imaging (MPI) in the CAD detection.
This study enrolled consecutive 64 patients (mean age 66.2 ± 17.3 years, 39 males) who had undergone both Tc-labeled tetrofosmin stress MPI and coronary angiography within 3 months. Stress MPI abnormalities quantified as summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) by Heart Risk View-S (HRV-S) and Quantitative Perfusion SPECT (QPS) softwares using IR-RASC images were compared with those by using conventional filtered back-projection method (FBP) images and angiographic findings.
Based on expert visual assessment, SSS and SRS by HRV-S/QPS softwares with IR-RASC were significantly lower than those by HRV-S/QPS softwares with FBP at mid- and basal left ventricular segments. Receiver-operating characteristics analysis showed that areas under the curve assessed by HRV-S (0.687) and QPS (0.678) with IR-RASC were nearly identical to those (0.717-0.724) by expert assessment with FBP, and were significantly (P < 0.05) greater than those by HRV-S (0.505) and QPS (0.522) with FBP. When HRV-S was used, the specificity and diagnostic accuracy of IR-RASC in the CAD detection were significantly greater than those of FBP: 90.3 versus 51.6%, P < 0.0001 and 79.7 versus 54.7%, P = 0.0027, respectively. Likewise, when QPS was used, the specificity and diagnostic accuracy of IR-RASC in the CAD detection were significantly greater than those of FBP: 80.6 versus 41.9%, P < 0.0001, and 78.1 versus 51.6%, P = 0.0018, respectively. There, however, were no significant differences in sensitivity between IR-RASC and FBP images.
IR-RASC can improve diagnostic accuracy of the CAD detection using an automated scoring system compared to FBP, by reducing false positivity due to artefactual appearance.
结合分辨率恢复、衰减和散射校正的迭代重建方法（IR-RASC）可提高图像质量。然而，当使用自动定量分析时，该技术能否改善冠状动脉疾病（CAD）的检测尚不确定。本研究评估了IR-RASC结合自动定量分析在负荷心肌灌注成像（MPI）中对CAD检测的诊断价值。
本研究连续纳入64例患者（平均年龄66.2±17.3岁，男性39例），这些患者在3个月内均接受了锝标记的替曲膦负荷MPI和冠状动脉造影。使用IR-RASC图像，通过心脏风险视图-S（HRV-S）和定量灌注SPECT（QPS）软件将负荷MPI异常量化为负荷总分（SSS）、静息总分（SRS）和差值总分（SDS），并与使用传统滤波反投影法（FBP）图像及血管造影结果进行比较。
基于专家视觉评估，在左心室中部和基底节段，采用IR-RASC的HRV-S/QPS软件得出的SSS和SRS显著低于采用FBP的HRV-S/QPS软件得出的结果。受试者操作特征分析表明，采用IR-RASC的HRV-S（0.687）和QPS（0.678）评估的曲线下面积与采用FBP的专家评估结果（0.717 - 0.724）相近，且显著高于采用FBP的HRV-S（0.505）和QPS（0.522）评估的结果（P < 0.05）。当使用HRV-S时。IR-RASC在CAD检测中的特异性和诊断准确性显著高于FBP：分别为90.3%对51.6%，P < 0.0001和79.7%对54.7%，P = 0.0027。同样，当使用QPS时，IR-RASC在CAD检测中的特异性和诊断准确性也显著高于FBP：分别为80.6%对41.9%，P < 0.0001，以及78.1%对51.6%，P = 0.0018。然而，IR-RASC和FBP图像之间的敏感性无显著差异。
与FBP相比，IR-RASC可通过减少伪影外观导致的假阳性，提高使用自动评分系统检测CAD的诊断准确性。
Zotero 插件