Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden. Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Functional Imaging and Technology, Karolinska Institutet, Stockholm, Sweden. Author to whom any corrrespondence should be addressed.
Phys Med Biol. 2019 Dec 5;64(23):235018. doi: 10.1088/1361-6560/ab36ee.
One of the most commonly used imaging techniques for diagnosing pulmonary embolism (PE) is ventilation/perfusion (V/P) scintigraphy. The aim of this study was to evaluate the performance of the currently used imaging protocols for V/P single photon emission computed tomography (V/P SPECT) at two nuclear medicine department sites and to investigate the effect of altering important protocol parameters. The Monte Carlo technique was used to simulate 4D digital phantoms with perfusion defects. Six imaging protocols were included in the study and a total of 72 digital patients were simulated. Six dually trained radiologists/nuclear medicine physicians reviewed the images and reported all perfusion mismatch findings. The radiologists also visually graded the image quality. No statistically significant differences in diagnostic performance were found between the studied protocols, but visual grading analysis pointed out one protocol as significantly superior to four of the other protocols. Considering the study results, we have decided to harmonize our clinical protocols for imaging patients with suspected PE. The administered Technegas and macro aggregated albumin activities have been altered, a low energy all purpose collimator is used instead of a low energy high resolution collimator and the acquisition times have been lowered.
用于诊断肺栓塞 (PE) 的最常用成像技术之一是通气/灌注 (V/P) 闪烁照相术。本研究旨在评估两个核医学部门目前使用的 V/P 单光子发射计算机断层扫描 (V/P SPECT) 成像方案的性能，并研究改变重要方案参数的效果。蒙特卡罗技术用于模拟具有灌注缺陷的 4D 数字体模。研究包括 6 种成像方案，共模拟了 72 名数字患者。6 名经过双重培训的放射科医生/核医学医师审查了图像并报告了所有灌注不匹配的发现。放射科医师还对图像质量进行了视觉分级。研究方案之间的诊断性能没有统计学上的显著差异，但视觉分级分析指出，有一个方案明显优于其他四个方案。考虑到研究结果，我们决定协调我们用于疑似 PE 患者成像的临床方案。已经改变了施用的 Technetium 99m 气体和大颗粒白蛋白的剂量，使用低能通用准直器代替低能高分辨率准直器，并降低了采集时间。
