Impact of misregistration between SPECT and CT on attenuation correction of myocardial perfusion imaging / 中华核医学与分子影像杂志

ABSTRACT

Objective To evaluate the effects of misregistration with different directions and magnitudes between SPECT and CT on image quality and semi-quantification of MPI.Methods The data of 19 healthy volunteers (11 males,8 females ; mean age(65.3 ± 9.6) years) were retrospectively analyzed.They all had a low pretest likelihood of coronary artery disease according to exercise and rest 99Tcm-MIBI MPI.The CT attenuation correction (CTAC) was performed on a SPECT/CT system.The CT images were manually shifted by 0.5,1.0,1.5,2.0,2.5,3.0,3.5,4.0,4.5 cm distance along the up/down,left/ right,and anterior/posterior axes respectively by using the system built-in software.The counts of the left ventricle were measured using myocardial Bull's eye generated from the reconstructed CTAC images.The image quality and semi-quantification of the CTAC images reconstructed from the raw data with and without shifting were compared and analyzed.Paired t test was used to analyze the data.Results There was no visible artifact with 0.5 cm shifting.The image quality was deteriorated significantly and the counting difference was significant with shifting distance greater than or equal to 1.0 cm.The image artifact of apex wall was mainly due to the upward shift,anterior and apex wall due to the downward shift,septal wall due to the leftward shift,anterior,apex and lateral wall due to the rightward shift,lateral and infero-posterior wall due to the forward shift,anterior,apex and septal wall due to backward shift.The counting difference caused by the downward shift was significantly more severe than that caused by the upward shift ((-9.68±8.06) ％ and (-2.04±1.83)％,t=6.573,P＜0.01) ; and the rightward shift was more severe than the leftward shift ((-9.02± 8.47) ％ and (-4.38±3.67) ％ ; t =1.987,P＜0.05).The image artifacts in anterior,apex and lateral walls were more severe than those in the infero-posterior and septal walls.Conclusions CTAC image artifacts in myocardial perfusion SPECT/CT studies could be caused by misregistration ≥ 1.0 cm.Different directions and magnitudes of shift could result in different degrees of attenuation artifacts at different locations on the original images.