Document Detail

The value of attenuation correction by hybrid SPECT/CT imaging on infarct size quantification in male patients with previous inferior myocardial infarct.
MedLine Citation:
PMID:  21897308     Owner:  NLM     Status:  Publisher    
BACKGROUND: Attenuation correction (AC) has been shown to improve the accuracy of myocardial perfusion single photon emission computed tomography (SPECT) for the detection and evaluation of patients with coronary artery disease. Attenuation artifacts, because of diaphragmatic attenuation, frequently affect the evaluation of the inferior wall, especially in male patients. PURPOSE: The aim of this study was to evaluate the value of AC for the assessment of infarct size in coronary artery disease patients after inferior myocardial infarction. MATERIALS AND METHODS: Gated-SPECT with Tc-labeled compounds with AC by hybrid SPECT/computed tomography (CT) was performed in 56 male patients with documented previous inferior myocardial infarction. Both corrected and uncorrected SPECT images were processed after motion and scatter correction by ordered-subset expectation maximization iterative reconstruction. When needed, a manual realignment between SPECT and computed tomography (CT) sections was performed. Uncorrected and corrected SPECT images were analyzed for perfusion using a 5-point segmental scoring scale from 0 (normal) to 4 (absent). Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) of the inferior left ventricle wall (inferoseptal, inferior, infero-apical and infero-lateral segments) were determined and compared with the regional wall motion score as determined by uncorrected gated-SPECT. RESULTS: The SSS, SRS, SDS for attenuation-uncorrected and attenuation-corrected studies were 14.02±7.9, 9.51±7, 4.5±3.2 and 9.39±7.1, 5.6±6.1, 3.8±2.8, respectively. Differences were statistically significant (P<0.0001) for SSS and SRS but not for SDS. The regional summed rest score of the inferior wall (SRS of inferior segments) showed a better correlation with the regional summed wall motion score of the same segments: R=0.50 in comparison to uncorrected SRS, R=0.46. CONCLUSION: The combination of diaphragmatic attenuation and inferior myocardial infarction determines an artifactual overestimation of infarct size of inferior infarcts. The AC regional perfusion score (SRS) correlates with the regional wall motion score of the inferior wall. AC does not affect the detection and size of residual ischemia (SDS).
Raffaele Mario Tarquinio Giubbini; Sara Gabanelli; Silvia Lucchini; Giuseppe Merli; Erinda Puta; Carlo Rodella; Federica Motta; Barbara Paghera; Pierluigi Rossini; Arturo Terzi; Francesco Bertagna
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-3
Journal Detail:
Title:  Nuclear medicine communications     Volume:  -     ISSN:  1473-5628     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
aChair of Nuclear Medicine, University of Brescia bNuclear Medicine Unit cHealth Physics Unit, Spedali Civili di Brescia, Italy.
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