Razavi Simin, Ziebarth Blair, Klein Ran, Zeng Wanzhen
Division of Nuclear Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
Nucl Med Commun. 2018 Jan;39(1):3-9. doi: 10.1097/MNM.0000000000000761.
Dual-phase parathyroid scan with Tc-sestamibi is a standardized imaging method for diagnosing parathyroid adenoma and hyperplasia. Conventional planar images using a gamma camera are performed routinely in early and delayed time points, followed by a single SPECT-CT. SPECT-CT on both early and delayed time points, although clinically useful, is not commonly performed to avoid extra radiation exposure from computed tomography (CT). This study explores the feasibility of co-registering early and delayed SPECT-CT from a single CT and evaluates the most effective combination of images for co-registration.
Fourteen retrospective patients with early and delayed planar and SPECT-CT images were recruited for this validation study. Results from contemporaneous early and delayed SPECT-CT, with hardware matched registration, are considered the gold standard. Noncontemporaneous early SPECT with delayed CT and vice versa were also processed with manual alignment by an experienced and a novice operator three times each to evaluate interoperator and intraoperator variability. Maximum standardized uptake values (SUVmax) of the thyroid lobes and parathyroid adenomas were measured, and the results in terms of accuracy and precision from noncontemporaneous SPECT-CT acquisitions were evaluated.
Good image quality from co-registered SPECT-CT acquired at different time points with the results showed no bias (P>0.5). The co-registration of early SPECT and delayed CT showed higher precision than the alternative combination. Overall, the experienced operator achieved better precision and intraoperator variability than the novice operator (reproducibility coefficient=33% SUV vs. reproducibility coefficient=54% SUV, P<0.001).
Quantitative SUV measurement from early and delayed parathyroid SPECT-CT imaging is feasible, with the best result achieved by experienced operators using delayed CT in manual registration.
锝- sestamibi双期甲状旁腺扫描是诊断甲状旁腺腺瘤和增生的标准化成像方法。使用γ相机的传统平面图像通常在早期和延迟时间点进行，随后进行单次SPECT-CT检查。虽然早期和延迟时间点的SPECT-CT在临床上有用，但为避免计算机断层扫描（CT）带来的额外辐射暴露，通常不进行此项检查。本研究探讨了从单次CT共同配准早期和延迟SPECT-CT的可行性，并评估了用于共同配准的最有效图像组合。
招募了14例有早期和延迟平面及SPECT-CT图像的回顾性患者进行这项验证研究。同期早期和延迟SPECT-CT以及硬件匹配配准的结果被视为金标准。非同期早期SPECT与延迟CT以及反之亦然的情况，也由一名经验丰富的操作员和一名新手操作员分别手动对齐处理三次，以评估操作员间和操作员内的变异性。测量甲状腺叶和甲状旁腺腺瘤的最大标准化摄取值（SUVmax），并评估非同期SPECT-CT采集结果在准确性和精密度方面的情况。
在不同时间点采集的共同配准SPECT-CT图像质量良好，结果显示无偏差（P>0.5）。早期SPECT与延迟CT的共同配准显示出比另一种组合更高的精密度。总体而言，经验丰富的操作员比新手操作员实现了更好的精密度和操作员内变异性（再现性系数=33%SUV，而再现性系数=54%SUV，P<0.001）。
早期和延迟甲状旁腺SPECT-CT成像的定量SUV测量是可行的，经验丰富的操作员在手动配准中使用延迟CT可获得最佳结果。
