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Respiratory motion detection and correction in ECG-gated SPECT: a new approach.

Bitarafan A, Rajabi H, Gruy B, Rustgou F, Sharafi AA, Firoozabady H, Yaghoobi N, Malek H, Pirich C, Langesteger W, Beheshti M - Korean J Radiol (2008 Nov-Dec)

Bottom Line: The percentages of tracer intensity in the inferior, inferoseptal and septal walls as well as the inferior to lateral (I/L) uptake ratio was significantly higher with the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01).Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique.However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Physics, School of Medical Sciences Tarbiat Modares University, Tehran, Iran.

ABSTRACT

Objective: Gated myocardial perfusion single-photon emission computed tomography (GSPECT) has been established as an accurate and reproducible diagnostic and prognostic technique for the assessment of myocardial perfusion and function. Respiratory motion is among the major factors that may affect the quality of myocardial perfusion imaging (MPI) and consequently the accuracy of the examination. In this study, we have proposed a new approach for the tracking of respiratory motion and the correction of unwanted respiratory motion by the use of respiratory-cardiac gated-SPECT (RC-GSPECT). In addition, we have evaluated the use of RC-GSPECT for quantitative and visual assessment of myocardial perfusion and function.

Materials and methods: Twenty-six patients with known or suspected coronary artery disease (CAD)-underwent two-day stress and rest (99m)Tc-Tetrofosmin myocardial scintigraphy using both conventional GSPECT and RC-GSPECT methods. The respiratory signals were induced by use of a CT real-time position management (RPM) respiratory gating interface. A PIO-D144 card, which is transistor-transistor logic (TTL) compatible, was used as the input interface for simultaneous detection of both ECG and respiration signals.

Results: A total of 26 patients with known or suspected CAD were examined in this study. Stress and rest myocardial respiratory motion in the vertical direction was 8.8-16.6 mm (mean, 12.4 +/- 2.9 mm) and 7.8-11.8 mm (mean, 9.5 +/- 1.6 mm), respectively. The percentages of tracer intensity in the inferior, inferoseptal and septal walls as well as the inferior to lateral (I/L) uptake ratio was significantly higher with the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01). In a left ventricular ejection fraction (LVEF) correlation analysis between the use of rest GSPECT and RC-GSPECT with echocardiography, better correlation was noted between RC-GSPECT and echocardiography as compared with the use of GSPECT (y = 0.9654x + 1.6514; r = 0.93, p < 0.001 versus y = 0.8046x + 5.1704; r = 0.89, p < 0.001). Nineteen (19/26) patients (73.1%) showed abnormal myocardial perfusion scans with reversible regional myocardial defects; of the 19 patients, 14 (14/26) patients underwent coronary angiography.

Conclusion: Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique. Moreover, the use of ECG-gated SPECT improved image quality, especially in the inferior and septal regions that are mostly affected by diaphragmatic attenuation. However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases.

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Comparison of percentage of tracer uptake between use of RC-GSPECT and GSPECT in different left ventricular segments for both rest phase (A) and stress phase (B) study is shown. RC-GSPECT = respiratory-cardiac gated single-photon emission computed tomography, GSPECT = gated myocardial perfusion single-photon emission computed tomography.
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Figure 4: Comparison of percentage of tracer uptake between use of RC-GSPECT and GSPECT in different left ventricular segments for both rest phase (A) and stress phase (B) study is shown. RC-GSPECT = respiratory-cardiac gated single-photon emission computed tomography, GSPECT = gated myocardial perfusion single-photon emission computed tomography.

Mentions: Quantitative assessments of regional perfusion are presented in Table 2 and Figure 4. For the stress and rest studies, the percentage of tracer uptake in the inferior, septal, anteroseptal and inferoseptal walls were significantly higher for the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01). The same results were obtained for the inferior to lateral wall uptake ratio (I/L %uptake) (p < 0.01), which was approximately 6% higher for the use of RC-GSPECT, as is illustrated in Figure 5.


Respiratory motion detection and correction in ECG-gated SPECT: a new approach.

Bitarafan A, Rajabi H, Gruy B, Rustgou F, Sharafi AA, Firoozabady H, Yaghoobi N, Malek H, Pirich C, Langesteger W, Beheshti M - Korean J Radiol (2008 Nov-Dec)

Comparison of percentage of tracer uptake between use of RC-GSPECT and GSPECT in different left ventricular segments for both rest phase (A) and stress phase (B) study is shown. RC-GSPECT = respiratory-cardiac gated single-photon emission computed tomography, GSPECT = gated myocardial perfusion single-photon emission computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627236&req=5

Figure 4: Comparison of percentage of tracer uptake between use of RC-GSPECT and GSPECT in different left ventricular segments for both rest phase (A) and stress phase (B) study is shown. RC-GSPECT = respiratory-cardiac gated single-photon emission computed tomography, GSPECT = gated myocardial perfusion single-photon emission computed tomography.
Mentions: Quantitative assessments of regional perfusion are presented in Table 2 and Figure 4. For the stress and rest studies, the percentage of tracer uptake in the inferior, septal, anteroseptal and inferoseptal walls were significantly higher for the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01). The same results were obtained for the inferior to lateral wall uptake ratio (I/L %uptake) (p < 0.01), which was approximately 6% higher for the use of RC-GSPECT, as is illustrated in Figure 5.

Bottom Line: The percentages of tracer intensity in the inferior, inferoseptal and septal walls as well as the inferior to lateral (I/L) uptake ratio was significantly higher with the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01).Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique.However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Physics, School of Medical Sciences Tarbiat Modares University, Tehran, Iran.

ABSTRACT

Objective: Gated myocardial perfusion single-photon emission computed tomography (GSPECT) has been established as an accurate and reproducible diagnostic and prognostic technique for the assessment of myocardial perfusion and function. Respiratory motion is among the major factors that may affect the quality of myocardial perfusion imaging (MPI) and consequently the accuracy of the examination. In this study, we have proposed a new approach for the tracking of respiratory motion and the correction of unwanted respiratory motion by the use of respiratory-cardiac gated-SPECT (RC-GSPECT). In addition, we have evaluated the use of RC-GSPECT for quantitative and visual assessment of myocardial perfusion and function.

Materials and methods: Twenty-six patients with known or suspected coronary artery disease (CAD)-underwent two-day stress and rest (99m)Tc-Tetrofosmin myocardial scintigraphy using both conventional GSPECT and RC-GSPECT methods. The respiratory signals were induced by use of a CT real-time position management (RPM) respiratory gating interface. A PIO-D144 card, which is transistor-transistor logic (TTL) compatible, was used as the input interface for simultaneous detection of both ECG and respiration signals.

Results: A total of 26 patients with known or suspected CAD were examined in this study. Stress and rest myocardial respiratory motion in the vertical direction was 8.8-16.6 mm (mean, 12.4 +/- 2.9 mm) and 7.8-11.8 mm (mean, 9.5 +/- 1.6 mm), respectively. The percentages of tracer intensity in the inferior, inferoseptal and septal walls as well as the inferior to lateral (I/L) uptake ratio was significantly higher with the use of RC-GSPECT as compared to the use of GSPECT (p < 0.01). In a left ventricular ejection fraction (LVEF) correlation analysis between the use of rest GSPECT and RC-GSPECT with echocardiography, better correlation was noted between RC-GSPECT and echocardiography as compared with the use of GSPECT (y = 0.9654x + 1.6514; r = 0.93, p < 0.001 versus y = 0.8046x + 5.1704; r = 0.89, p < 0.001). Nineteen (19/26) patients (73.1%) showed abnormal myocardial perfusion scans with reversible regional myocardial defects; of the 19 patients, 14 (14/26) patients underwent coronary angiography.

Conclusion: Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique. Moreover, the use of ECG-gated SPECT improved image quality, especially in the inferior and septal regions that are mostly affected by diaphragmatic attenuation. However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases.

Show MeSH
Related in: MedlinePlus