Department of Structural and Functional Biology, Institute of Biosciences of Botucatu, Av. Professor Mário Rubens Guimarães Montenegro, S/N, UNESP Campus de Botucatu, Botucatu, SP, CEP: 18618-687, Brazil.
Medical School, São Paulo State University Julio de Mesquita Filho, Av. Prof. Mário Rubens Guimarães Montenegro, S/N, UNESP Campus de Botucatu, Botucatu, SP, CEP: 18618687, Brazil.
Ann Nucl Med. 2024 Dec;38(12):960-970. doi: 10.1007/s12149-024-01969-7. Epub 2024 Aug 24.
CT images can identify structural and opacity alterations of the lungs while nuclear medicine's lung perfusion studies show the homogeneity (or lack of) of blood perfusion on the organ. Therefore, the use of SPECT/CT in lung perfusion scintigraphies can help physicians to assess anatomical and functional alterations of the lungs and to differentiate between acute and chronic disease.
To develop a computer-aided methodology to quantify the total global perfusion of the lungs via SPECT/CT images and to compare these results with parenchymal alterations obtained in CT images.
39 perfusion SPECT/CT images collected retrospectively from the Nuclear Medicine Facility of Botucatu Medical School's Clinics Hospital in São Paulo, Brazil, were analyzed. Anatomical lung impairments (emphysema, collapsed and infiltrated tissue) and the functional percentage of the lungs (blood perfusion) were quantified from CT and SPECT images, with the aid of the free, open-source software 3D Slicer. The results obtained with 3D Slicer (3D-TGP) were also compared to the total global perfusion of each patient's found on their medical report, obtained from visual inspection of planar images (2D-TGP).
This research developed a novel and practical methodology for obtaining lungs' total global perfusion from SPECT/CT images in a semiautomatic manner. 3D-TGP versus 2D-TGP showed a bias of 7% with a variation up to 67% between the two methods. Perfusion percentage showed a weak positive correlation with infiltration (p = 0.0070 and ρ = 0.43) and collapsed parenchyma (p = 0.040 and ρ = 0.33).
This research brings meaningful contributions to the scientific community because it used a free open-source software to quantify the lungs blood perfusion via SPECT/CT images and pointed that the relationship between parenchyma alterations and the organ's perfusion capability might not be so direct, given compensatory mechanisms.
CT 图像可识别肺部的结构和不透明度改变，而核医学的肺灌注研究则显示器官血液灌注的均一性（或缺乏）。因此，SPECT/CT 在肺灌注闪烁显像中的应用可以帮助医生评估肺部的解剖和功能改变，并区分急性和慢性疾病。
开发一种通过 SPECT/CT 图像定量计算肺部总灌注的计算机辅助方法，并将这些结果与 CT 图像中获得的实质改变进行比较。
对巴西圣保罗博图卡图医学院临床医院核医学科回顾性收集的 39 例灌注 SPECT/CT 图像进行分析。使用免费的开源软件 3D Slicer 从 CT 和 SPECT 图像中量化解剖学肺损伤（肺气肿、塌陷和浸润组织）和肺功能百分比（血液灌注）。3D Slicer（3D-TGP）获得的结果也与从平面图像视觉检查获得的每位患者的总全球灌注（2D-TGP）进行比较。
本研究开发了一种新颖实用的方法，可半自动地从 SPECT/CT 图像中获取肺部总灌注。3D-TGP 与 2D-TGP 相比存在 7%的偏差，两种方法之间的差异最大可达 67%。灌注百分比与浸润（p=0.0070 和 ρ=0.43）和塌陷的实质（p=0.040 和 ρ=0.33）呈弱正相关。
本研究使用免费的开源软件通过 SPECT/CT 图像定量计算肺部血液灌注，为科学界做出了有意义的贡献，并指出实质改变与器官灌注能力之间的关系可能并不那么直接，因为存在代偿机制。
