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Published in: European Journal of Nuclear Medicine and Molecular Imaging 6/2008

01-06-2008 | Original article

Optimisation of protocol for low dose CT-derived attenuation correction in myocardial perfusion SPECT imaging

Authors: Rainer Preuss, Reiner Weise, Oliver Lindner, Eva Fricke, Harald Fricke, Wolfgang Burchert

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 6/2008

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Abstract

Purpose

In clinical routine, attenuation correction (AC) using X-ray CT is a relatively new method for reducing attenuation artefacts. We evaluated the quality of attenuation maps generated with very low tube current to minimise exposure due to transmission scanning.

Methods

SPECT/CT acquisitions were performed with a Millenium VG3 gamma camera with the Hawkeye CT device (GE Medical Systems). In phantom studies, determination of linear absorption coefficients (μ) for air, water and Teflon was carried out. The attenuation maps in both stress and resting studies from 62 patients (21 females and 41 males, age 63.7 ± 11.0 years, BMI 30.0 ± 5.7 kg/m2) were compared. All patients underwent exercise or pharmacologic stress testing and a resting study for comparison using Tc-99m MIBI or Tc-99m Tetrofosmin. AC in stress studies was performed using 2.5 mA tube current (set as default), whereas 1.0 mA was used in resting studies.

Results

In both phantom and patient studies, differences of linear absorption coefficients were not significant (p > 0.05). Effective dose decreased from 0.90 mSv down to 0.36 mSv, respectively.

Conclusion

Our results indicate that reliable attenuation maps (μ-maps) of the thorax can be obtained even with the use of very low tube current. In our study, radiation exposure in CT-based AC for myocardial perfusion SPECT was substantially lowered (60% reduction). This is of particular importance in high-risk patients who may have to undergo follow-up scans and in research studies on volunteers. The procedure introduced is relatively simple and can be transferred to other SPECT/CT devices, which allow adjustment of tube current.
Literature
1.
go back to reference Bateman TM, Cullom SJ. Attenuation correction single-photon emission computed tomography myocardial perfusion imaging. Semin Nucl Med. 2005;35:37–51.PubMedCrossRef Bateman TM, Cullom SJ. Attenuation correction single-photon emission computed tomography myocardial perfusion imaging. Semin Nucl Med. 2005;35:37–51.PubMedCrossRef
2.
go back to reference Blankespoor SCWX, Kalki K, et al. Attenuation correction of SPECT using x-ray CT on an emission-transmission CT system. IEEE Trans Nucl Science. 1996;43:2263–74.CrossRef Blankespoor SCWX, Kalki K, et al. Attenuation correction of SPECT using x-ray CT on an emission-transmission CT system. IEEE Trans Nucl Science. 1996;43:2263–74.CrossRef
3.
go back to reference Delbeke D, Coleman RE, Guiberteau MJ, et al. Procedure guideline for SPECT/CT imaging 1.0. J Nucl Med. 2006;47:1227–34.PubMed Delbeke D, Coleman RE, Guiberteau MJ, et al. Procedure guideline for SPECT/CT imaging 1.0. J Nucl Med. 2006;47:1227–34.PubMed
4.
go back to reference Heller G, Links J, Bateman T, et al. American Society of Nuclear Cardiology and Society of Nuclear Medicine joint position statement: Attenuation correction of myocardial perfusion SPECT scintigraphy. J Nucl Cardiol. 2004;11:229.PubMedCrossRef Heller G, Links J, Bateman T, et al. American Society of Nuclear Cardiology and Society of Nuclear Medicine joint position statement: Attenuation correction of myocardial perfusion SPECT scintigraphy. J Nucl Cardiol. 2004;11:229.PubMedCrossRef
5.
go back to reference Masood Y, Liu YH, Depuey G, et al. Clinical validation of SPECT attenuation correction using x-ray computed tomography-derived attenuation maps: Multicenter clinical trial with angiographic correlation. J Nucl Cardiol. 2005;12:676–86.PubMedCrossRef Masood Y, Liu YH, Depuey G, et al. Clinical validation of SPECT attenuation correction using x-ray computed tomography-derived attenuation maps: Multicenter clinical trial with angiographic correlation. J Nucl Cardiol. 2005;12:676–86.PubMedCrossRef
6.
go back to reference Nosske DMV, Brix G. Establishment and application of diagnostic reference levels for nuclear medicine procedures in Germany (in German). Nuklearmedizin. 2004;43:79–84.PubMed Nosske DMV, Brix G. Establishment and application of diagnostic reference levels for nuclear medicine procedures in Germany (in German). Nuklearmedizin. 2004;43:79–84.PubMed
7.
go back to reference Bocher M, Balan A, Krausz Y, et al. Gamma camera-mounted anatomical x-ray tomography: Technology, system characteristics and first images. Eur J Nucl Med. 2000;27:619–27.PubMedCrossRef Bocher M, Balan A, Krausz Y, et al. Gamma camera-mounted anatomical x-ray tomography: Technology, system characteristics and first images. Eur J Nucl Med. 2000;27:619–27.PubMedCrossRef
8.
go back to reference Fricke H, Fricke E, Weise R, et al. A method to remove artifacts in attenuation-corrected myocardial perfusion SPECT introduced by misalignment between emission scan and CT-derived attenuation maps. J Nucl Med. 2004;45:1619–25.PubMed Fricke H, Fricke E, Weise R, et al. A method to remove artifacts in attenuation-corrected myocardial perfusion SPECT introduced by misalignment between emission scan and CT-derived attenuation maps. J Nucl Med. 2004;45:1619–25.PubMed
9.
go back to reference Fricke E, Fricke H, Weise R, et al. Attenuation correction of myocardial SPECT perfusion images with low-dose CT: Evaluation of the method by comparison with perfusion PET. J Nucl Med. 2005;46:736–44.PubMed Fricke E, Fricke H, Weise R, et al. Attenuation correction of myocardial SPECT perfusion images with low-dose CT: Evaluation of the method by comparison with perfusion PET. J Nucl Med. 2005;46:736–44.PubMed
10.
go back to reference McNitt-Gray MF. AAMP/RSNA physics tutorial for residents: Topics in CT: Radiation dose in CT. Radiographics. 2002;22:1541–53.PubMedCrossRef McNitt-Gray MF. AAMP/RSNA physics tutorial for residents: Topics in CT: Radiation dose in CT. Radiographics. 2002;22:1541–53.PubMedCrossRef
11.
go back to reference Jessen KA, Shrimpton PC, Geleijns J, Panzer W, Tosi G. Dosimetry for optimisation of patient protection in computed tomography. Appl Radiat Isot. 1999;50:165–72.PubMedCrossRef Jessen KA, Shrimpton PC, Geleijns J, Panzer W, Tosi G. Dosimetry for optimisation of patient protection in computed tomography. Appl Radiat Isot. 1999;50:165–72.PubMedCrossRef
12.
go back to reference Society of Nuclear Medicine. Procedure guideline for myocardial perfusion imaging (version 3.0). 2002. Society of Nuclear Medicine. Procedure guideline for myocardial perfusion imaging (version 3.0). 2002.
13.
go back to reference Thompson RC, Cullom SJ. Issues regarding radiation dosage of cardiac nuclear and radiography procedures. J Nucl Cardiol. 2006;13:19–23.PubMedCrossRef Thompson RC, Cullom SJ. Issues regarding radiation dosage of cardiac nuclear and radiography procedures. J Nucl Cardiol. 2006;13:19–23.PubMedCrossRef
14.
go back to reference DePuey GE, American Society of Nuclear Cardiology. Imaging guidelines for nuclear cardiology procedures. J Nucl Cardiol 2006;13:e1–151.CrossRef DePuey GE, American Society of Nuclear Cardiology. Imaging guidelines for nuclear cardiology procedures. J Nucl Cardiol 2006;13:e1–151.CrossRef
15.
go back to reference Zaidi H. Is MR-guided attenuation correction a viable option for dual-modality PET/MR imaging? Radiology. 2007;244:639–42.PubMedCrossRef Zaidi H. Is MR-guided attenuation correction a viable option for dual-modality PET/MR imaging? Radiology. 2007;244:639–42.PubMedCrossRef
16.
go back to reference Cherry SRSJ, Phelps ME. Physics in nuclear medicine, 3rd edn. Philadelphia, PA, USA: Saunders; 2003. Cherry SRSJ, Phelps ME. Physics in nuclear medicine, 3rd edn. Philadelphia, PA, USA: Saunders; 2003.
17.
go back to reference Burger C, Goerres G, Schoenes S, et al. PET attenuation coefficients from CT images: Experimental evaluation of the transformation of CT into PET 511-kev attenuation coefficients. Eur J Nucl Med Mol Imaging. 2002;29:922–7.PubMedCrossRef Burger C, Goerres G, Schoenes S, et al. PET attenuation coefficients from CT images: Experimental evaluation of the transformation of CT into PET 511-kev attenuation coefficients. Eur J Nucl Med Mol Imaging. 2002;29:922–7.PubMedCrossRef
18.
go back to reference Kamel E, Hany TF, Burger C, et al. CT vs GE-68 attenuation correction in a combined PET/CT system: Evaluation of the effect of lowering the CT tube current. Eur J Nucl Med Mol Imaging. 2002;29:346–50.PubMedCrossRef Kamel E, Hany TF, Burger C, et al. CT vs GE-68 attenuation correction in a combined PET/CT system: Evaluation of the effect of lowering the CT tube current. Eur J Nucl Med Mol Imaging. 2002;29:346–50.PubMedCrossRef
19.
go back to reference Kalra MK, Maher MM, Toth TL, et al. Strategies for CT radiation dose optimization. Radiology. 2004;230:619–28.PubMedCrossRef Kalra MK, Maher MM, Toth TL, et al. Strategies for CT radiation dose optimization. Radiology. 2004;230:619–28.PubMedCrossRef
20.
go back to reference McCollough CH, Bruesewitz MR, Kofler JM Jr. CT dose reduction and dose management tools: Overview of available options. Radiographics. 2006;26:503–12.PubMedCrossRef McCollough CH, Bruesewitz MR, Kofler JM Jr. CT dose reduction and dose management tools: Overview of available options. Radiographics. 2006;26:503–12.PubMedCrossRef
21.
go back to reference Zaidi H, Hasegawa B. Determination of the attenuation map in emission tomography. J Nucl Med. 2003;44:291–315.PubMed Zaidi H, Hasegawa B. Determination of the attenuation map in emission tomography. J Nucl Med. 2003;44:291–315.PubMed
22.
go back to reference O’Connor M, Kemp B, Anstett F, et al. A multicenter evaluation of commercial attenuation compensation techniques in cardiac SPECT using phantom models. J Nucl Cardiol. 2002;9:361–76.PubMedCrossRef O’Connor M, Kemp B, Anstett F, et al. A multicenter evaluation of commercial attenuation compensation techniques in cardiac SPECT using phantom models. J Nucl Cardiol. 2002;9:361–76.PubMedCrossRef
23.
go back to reference Tonge CM, Manoharan M, Lawson RS, Shields RA, Prescott MC. Attenuation correction of myocardial SPECT studies using low resolution computed tomography images. Nucl Med Commun. 2005;26:231–7.PubMedCrossRef Tonge CM, Manoharan M, Lawson RS, Shields RA, Prescott MC. Attenuation correction of myocardial SPECT studies using low resolution computed tomography images. Nucl Med Commun. 2005;26:231–7.PubMedCrossRef
24.
go back to reference Goetze S, Pannu HK, Wahl RL. Clinically significant abnormal findings on the “nondiagnostic” CT portion of low-amperage-CT attenuation-corrected myocardial perfusion SPECT/CT studies. J Nucl Med. 2006;47:1312–8.PubMed Goetze S, Pannu HK, Wahl RL. Clinically significant abnormal findings on the “nondiagnostic” CT portion of low-amperage-CT attenuation-corrected myocardial perfusion SPECT/CT studies. J Nucl Med. 2006;47:1312–8.PubMed
25.
go back to reference Grossman G, Garcia E, Bateman T, et al. Quantitative Tc-99m sestamibi attenuation-corrected SPECT: Development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population. J Nucl Cardiol. 2004;11:263–72.PubMedCrossRef Grossman G, Garcia E, Bateman T, et al. Quantitative Tc-99m sestamibi attenuation-corrected SPECT: Development and multicenter trial validation of myocardial perfusion stress gender-independent normal database in an obese population. J Nucl Cardiol. 2004;11:263–72.PubMedCrossRef
26.
go back to reference Heller G, Bateman T, Johnson L, et al. Clinical value of attenuation correction in stress-only Tc-99m sestamibi SPECT imaging. J Nucl Cardiol. 2004;11:273–81.PubMedCrossRef Heller G, Bateman T, Johnson L, et al. Clinical value of attenuation correction in stress-only Tc-99m sestamibi SPECT imaging. J Nucl Cardiol. 2004;11:273–81.PubMedCrossRef
27.
go back to reference Slomka PJ, Fish MB, Lorenzo S, et al. Simplified normal limits and automated quantitative assessment for attenuation-corrected myocardial perfusion SPECT. J Nucl Cardiol. 2006;13:642–51.PubMedCrossRef Slomka PJ, Fish MB, Lorenzo S, et al. Simplified normal limits and automated quantitative assessment for attenuation-corrected myocardial perfusion SPECT. J Nucl Cardiol. 2006;13:642–51.PubMedCrossRef
28.
go back to reference Almeida P, Bendriem B, de Dreuille O, et al. Dosimetry of transmission measurements in nuclear medicine: A study using anthropomorphic phantoms and thermoluminescent dosimeters. Eur J Nucl Med. 1998;25:1435–41.PubMedCrossRef Almeida P, Bendriem B, de Dreuille O, et al. Dosimetry of transmission measurements in nuclear medicine: A study using anthropomorphic phantoms and thermoluminescent dosimeters. Eur J Nucl Med. 1998;25:1435–41.PubMedCrossRef
29.
go back to reference Perisinakis K, Theocharopoulos N, Karkavitsas N, Damilakis J. Patient effective radiation dose and associated risk from transmission scans using GD-153 line sources in cardiac SPECT studies. Health Phys. 2002;83:66–74.PubMedCrossRef Perisinakis K, Theocharopoulos N, Karkavitsas N, Damilakis J. Patient effective radiation dose and associated risk from transmission scans using GD-153 line sources in cardiac SPECT studies. Health Phys. 2002;83:66–74.PubMedCrossRef
30.
go back to reference Bellemann ME, Riemann S, Kapplinger S, Brix G, Gottschild D. Assessment of radiation exposure caused by transmission scans in SPECT: An anthropomorphic dosimetry study]. Biomed Tech (Berl). 2002;47(Suppl 1 Pt 1):474–5.CrossRef Bellemann ME, Riemann S, Kapplinger S, Brix G, Gottschild D. Assessment of radiation exposure caused by transmission scans in SPECT: An anthropomorphic dosimetry study]. Biomed Tech (Berl). 2002;47(Suppl 1 Pt 1):474–5.CrossRef
32.
go back to reference Preuss R, Lindner O, Weise R, Fricke E, Burchert W. Reduction of radiation exposure in x-ray computed tomography-derived attenuation correction for myocardial SPECT perfusion imaging. J Nucl Med Meeting Abstracts. 2006;47:257P. Preuss R, Lindner O, Weise R, Fricke E, Burchert W. Reduction of radiation exposure in x-ray computed tomography-derived attenuation correction for myocardial SPECT perfusion imaging. J Nucl Med Meeting Abstracts. 2006;47:257P.
Metadata
Title
Optimisation of protocol for low dose CT-derived attenuation correction in myocardial perfusion SPECT imaging
Authors
Rainer Preuss
Reiner Weise
Oliver Lindner
Eva Fricke
Harald Fricke
Wolfgang Burchert
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 6/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0680-2

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