Optimization of scatter estimation window setting for quantitative analysis in 111 In-pentetreotide single photon emission computed tomography imaging.

OBJECTIVE: The aim of this study was to validate the optimal scatter correction method and scatter estimation window setting in terms of image quality and quantitative accuracy for quantitative indium-111 (111In)-pentetreotide SPECT imaging. MATERIALS AND METHODS: We used a positron emission tomography/computed tomography (PET/CT) phantom to validate image quality and quantitative accuracy, and the SPECT images were acquired by the multi-energy window (MEW) method. The scatter estimation was performed using four kinds of energy windows (MEW1, MEW2, MEW3, and MEW4). Scatter correction was also performed using a dual-energy window (DEW) for comparison with MEWs. Image quality was assessed using percent contrast (% contrast) and background variability, and quantitative accuracy was assessed using the mean standardized uptake value (SUVmean) with hot spheres. RESULTS: In the quantification, all MEW settings approached the theoretical SUVmean (MEW1, 0.99±0.06; MEW2, 0.99±0.05; MEW3, 1.00±0.08; MEW4, 0.97±0.12) in contrast to DEW (0.88±0.05). The SUVmean value for scatter correction of both photopeaks for a 28 mm sphere showed the smallest difference from the theoretical value. CONCLUSION: The scatter correction method that gave optimal image quality and quantitative accuracy was MEW3 with two 20% energy windows (one over each photopeak) and four adjacent 3% scatter estimation windows (one on each side of the two photopeaks).

Technical Note: Development of an ischemic defect model insert attachable to a commercially available myocardial phantom.

OBJECTIVE: The purpose of this study was to develop a novel myocardial phantom insert model that attaches to commercially available myocardial phantoms and simulates an ischemic area, using three-dimensional printing technology. METHODS: Ischemic inserts were designed to give four levels of absolute percent contrast (Low; 10%, Medium; 20%, High; 35%, and Defect; 100%) using CT images and computer-aided design software. The ischemic insert was composed of multiple slit structures to replicate myocardial ischemia. Myocardial phantom images with developed ischemic inserts were acquired using a SPECT/CT system and were then reconstructed using filtered back projection (FBP) and iterative reconstruction (IR) with various cutoff frequencies of a Butterworth filter. The performance and utility of ischemic inserts were evaluated according to percent contrast and 5-point scoring. RESULTS: The percent contrast and scoring results changed according to the ischemic insert type, cutoff frequency, and reconstruction method. The percent contrast of each insert obtained by FBP with 0.4 cycles/cm was 4.1% (Low), 15.7% (Medium), 17.4% (High), and 36.1% (Defect). Similarly, the percent contrast of each insert obtained by IR with 0.4 cycles/cm was 5.0% (Low), 17.0% (Medium), 21.9% (High), and 47.7% (Defect). CONCLUSIONS: We successfully developed an ischemic insert that attaches to a commercially available myocardial phantom by using CT imaging and 3D printing technology. Our proposed ischemic insert provided several abnormal perfusion patterns on myocardial SPECT images and may be useful for evaluating SPECT image quality.