Authors: Timothy M Bateman Gary V Heller A Iain McGhie Staci A Courter Robert A Golub James A Case S James Cullom
Publish Date: 2009/06/23
Volume: 16, Issue: 5, Pages: 726-735
Abstract
New iterative algorithms for scatter compensation SC noise suppression and depthdependent collimator resolution RR can shorten rest and stress SPECT acquisitions by 50 while maintaining quality and accuracy equivalent to conventional scans Fulltime stressonly myocardial perfusion SPECT is accurate and efficient when combined with linesource attenuation correction LSAC We investigated the potential for halftime stressonly LSACSPECT by comparing this to conventional rest/stress SPECT in patients imaged for suspected CAD at three different centersOne hundred and ten patients 58 men 53 exercise had 64 projection rest/stress Tc99m ECGgated SPECT with simultaneous Gd153 LSAC 18 had ≤5 CAD likelihood and 92 had coronary angiography The stress scans were retrospectively ‘stripped’ to create equally spaced 32 projection “halftime” HT scans for the emission and transmission TX projections Astonish Philips Milpitas CA processing with AC SC and RR was applied to the HT data with the HT TX maps reconstructed using a Bayesian iterative method The conventional rest/stress image sets processed using filtered back projection and without AC and the HTAC stressonly images were interpreted in random sequence by consensus of two readers blinded to clinical information in separate reading sessionsComparing rest/stress FBP and HTLSAC stress perfusion quality was excellent/good in 82 and 89 P = 13 interpretive certainty definitely normal or abnormal was 88 and 95 P = 14 sensitivity was 77 and 83 P = 38 specificity was 67 and 71 P = 65 normalcy was 94 and 100 P = 10 SSS for CAD pts was 74 vs 78 and for nonCAD pts was 07 vs 0 P = 44 and 16 respectively Mean stress LVEF was 60 in both groupsStressonly imaging with HTLSAC using the Astonish acquisition/processing method provides results equivalent to conventional rest/stress scanning This new approach has the potential to significantly improve operational efficiency without sacrificing accuracyThe authors would like to recognize Ryan Phillips MS Kyle Robison MS and Jan Bryngelson BSN for their assistance in gathering data and conducting the blinded reads Julie Assel BA for her editorial assistance and Kevin Kennedy MA for statistical support This research was supported in part by an unrestricted clinical research grant from Philips Medical Systems Milpitas CA TMB SJC and JAC receive royalties from the sale of attenuation correction software
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