Increased accuracy of single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy using iterative reconstruction of images

  • Miloš Ljubomir Stević Center of nuclear medicine, Clinical center Niš
  • Marina Vlajković Center of nuclear medicine, Clinical center Niš
Keywords: angina pectoris, diagnosis, scintigraphy, coronary angiography, technology, medical, methods,

Abstract


Background/Aim. Filtered back projection (FBP) is a common way of processing myocardial perfusion imaging (MPI) studies. There are artifacts in FBP which can cause false-positive results. Iterative reconstruction (IR) is developed to reduce false positive findings in MPI studies. The aim of this study was to evaluate the difference in the number of false positive findings in MPI studies, between FBP and IR processing. Methods. We examined 107 patients with angina pectoris with MPI and coronary angiography (CAG), 77 man and 30 woman, aged 32−82. MPI studies were processed with FBP and with IR. Positive finding at MPI was visualization of the perfusion defect. Positive finding at CAG was stenosis of coronary artery. Perfusion defect at MPI without coronary artery stenosis at CAG was considered like false positive. The results were statistically analyzed with bivariate correlation, and with one sample t-test. Results. There were 20.6% normal, and 79.4% pathologic findings at FBP, 30.8% normal and 69.2% pathologic with IR and 37.4% normal and 62.6% pathologic at CAG. FBP produced 19 false-positive findings, at IR 11 false positive findings. The correlation between FBP and CAG was 0.658 (p < 0.01) and between IR and CAG 0.784 (p < 0.01). The number of false positive findings at MPI with IR was significantly lower than at FBP (p < 0.01). Conclusion. Our study shows that IR processing MPI scintigraphy has less number of false positive findings, therefore it is our choice for processing MPI studies.


 

Author Biography

Miloš Ljubomir Stević, Center of nuclear medicine, Clinical center Niš
Center of nuclear medicine, Nuclear medicine physician

References

Yester MV. SPECT image reconstruction. In: Henkin RE, edi-tor. Nuclear medicine. 2nd ed. Philadelphia, PA: Mosby; 2006. p. 185−95.

Hatton RL, Hutton BF, Angelides S, Choong KK, Larcos G. Im-proved tolerance to missing data in myocardial perfusion SPET using OSEM reconstruction. Eur J Nucl Med Mol Im-aging 2004; 31(6): 857−61.

Nichols K, Bacharach S, Bergmann S, Chen J, Cullom S, Dorbala S, et al. Instrumentation quality assurance and performance. J Nucl Cardiol 2007; 14(6): e61−78.

Hesse B, Tägil K, Cuocolo A, Anagnostopoulos C, Bardiés M, Bax J, et al. EANM/ESC procedural guidelines for myocardial perfu-sion imaging in nuclear cardiology. Eur J Nucl Med Mol Imaging 2005; 32(7): 855−97.

Sajid HS. Myocardial Perfusion Imaging Protocols: Is There an Ideal Protocol. J Nucl Med Technol 2007; 35(1): 3−9.

Henzlova M, Cerqueira M, Mahmarian J, Yao S. Quality Assurance Committee of the American Society of Nuclear Cardiology. Stress protocols and tracers. J Nucl Cardiol 2006; 13(6): e80−90.

Yussoff S, Zakaria A. Relationship between the optimum cut off frequency for Butterworth filter and lung-heart ratio in 99mTc myocardial SPECT. Iran J Radiat Res 2010; 8(1): 17−24.

Iftikhar I, Koutelou M, Mahmarian JJ, Verani MS. Simultaneous perfusion tomography and radionuclide angiography during dobutamine stress. J Nucl Med 1996; 37(8): 1306−10.

Taillefer R, de Puey EG, Udelson JE, Beller GA, Latour Y, Reeves F. Comparative diagnostic accuracy of Tl-201 and Tc-99m ses-tamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women. J Am Coll Cardiol 1997; 29(1): 69−77.

Bourque JM, Beller GA. Stress Myocardial Perfusion Imaging for Assessing Prognosis: An Update. J Am Coll Cardiol Img 2011; 4(12): 1305−19.

Verna E, Ceriani L, Giovanella L, Binaghi G, Garancini S. "False-positive" myocardial perfusion scintigraphy findings in patients with angiographically normal coronary arteries: insights from intravascular sonography studies. J Nucl Med 2000; 41(12): 1935−40.

Yan Y, Zeng GL. Scatter and Blurring Compensation in Inho-mogeneous Media Using a Postprocessing Method. Int J Bio-med Imag 2008: 2008; p. 1−11.

Klocke FJ, Baird MG, Lorell BH, Bateman TM, Messer JV, Berman DS, et al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging-executive summary: a report of the American College of Cardiology/American Heart Associa-tion Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). Circulation 2003; 108(11): 1404−18.

Burrell S, MacDonald A. Artifacts and pitfalls in myocardial per-fusion imaging. J Nucl Med Technol 2006; 34(4): 193−211.

Kitchens CT, Halkar RK, Alazraki NP, Galt J. Difference in fil-tered-back projection and iterative reconstruction in a patient with increased splanchnic uptake. Clin Nucl Med 2005; 30(9): 623−4.

Published
2017/03/07
Section
Short Report