Clinical utility of co-registered respiratory-gated 99mTc-Technegas/MAA SPECT-CT images in the assessment of regional lung functional impairment in patients with lung cancer

Suga, Kazuyoshi; Kawakami, Yoshiyuki; Zaki, Mohammed; Yamashita, Tomio; Shimizu, Kensaku; Matsunaga, Naofumi

doi:10.1007/s00259-004-1558-1

Cited by 77 publications

(38 citation statements)

References 33 publications

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“…In a recent study a significantly better alignment was yielded using respiratory gated images compared to non-gated (4.9 AE 3.1 vs. 19 AE 9.1 mm) images. Respiratory gated SPECT/CT systems are evolving in order to improve diagnostics and therapy (15). However, the present investigation focuses on today's clinical routine with ungated SPECT and CT.…”

Section: Discussionmentioning

confidence: 99%

“…Use of single photon emission computed tomography (SPECT) lung perfusion scans may enable better accuracy of nuclear medicine methods compared to the planar imaging and usefully enhance the comparability of both functional and morphological tomographic images (SPECT and CTPA) (14). To accomplish this either multimodality registration of SPECT and CT or combined imaging is suggested (15).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of operability by means of CTPA and perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension

et al. 2015

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Background: Chronic thromboembolic pulmonary hypertension (CTEPH) can potentially be cured by pulmonary thrombendarterectomy (PEA), the criteria for differentiation between operable and non-operable patients are not standardized. Purpose: To retrospectively evaluate the value of rigidly registered computed tomography pulmonary angiography (CTPA) and single photon emission CT (SPECT) in differentiating for PEA. Material and Methods: Forty-nine patients with CTEPH (21 men; age, 58 AE 13 years) were evaluated by an interdisciplinary expert board using all available diagnostic information and their consensus statement as gold standard. For SPECT a lobe based perfusion score was visually assessed using the score of 0 (lack of perfusion) to 1 (normal perfusion) calculating percentage of vascular obstruction (PVO). By CTPA, vascular obstruction index (OI) of central, peripheral, and global PA-bed were determined. The accuracy of the alignment between CTPA and SPECT was determined by fusion score (FS) ranging from 1 (no alignment) to 5 (exact alignment). Angiography provided PA pressure (PAP), pulmonary vascular resistance (PVR), and PA wedge pressure (PAWP). Receiver operating characteristics (ROC) analysis was performed. Results: Twenty-nine patients were considered surgically amenable, and 20 patients were inoperable. Mean PAP, PVR, and PAWP were 48 AE 11 mmHg, 868 AE 461 dynes*sec*cm À5 , and 11 AE 5 mmHg, without differences between surgical and non-surgical patients (P > 0.5). In all patients accurate registration was reached (FS ¼ 4.1 AE 0.7; range, 2-5). PVO and central OI separated PEA-amenable patients (P 0.001) resulting in the area under the curve of 0.828 (cutoff for PVO: 37.8% with a sensitivity of 82% and specificity of 79%) and 0.755 (cutoff for central OI: 29% with a sensitivity and specificity of 86.2% and 79%) for operability. Conclusion: An accurate interpretation of rigidly registered CTPA and perfusion SPECT may contribute to stratification of operability in patients with CTEPH.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of operability by means of CTPA and perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension

et al. 2015

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“…These characteristics are especially suitable for oncology [14,[104][105][106][107][108] where detailed anatomical localization is needed. Other investigators have reported using the higher-performance SPECT/CT systems for applications in orthopedics [129][130][131][132], infection and inflammation [133][134][135][136][137][138], pulmonary function [139,140], and endocrinology [141], where the improved anatomical localization helps identify areas of disease that can be difficult to discriminate with SPECT alone. As previously mentioned, high-resolution CT performance also can be used to define target anatomy to improve the quantitation of absolute radionuclide uptake in small lesions such as tumors or in the myocardium.…”

Section: Current Spect/ct Technologiesmentioning

confidence: 99%

“…Clinical Applications of SPECT/CT Cited Anatomical/Disease Site Radiopharmaceutical SPECT/CT Application Adrenal masses 123 I-metaiodobenzylguanidine, 75 Se-cholesterol Anatomical localization [161] Biliary leak 99m Tc-diisopropyl iminodiacetic acid Anatomical localization [141] Bone scintigraphy 99m Tc-methylene diphosphonate, 99m Tc-dicarboxypropane diphosphonate Anatomical localization, attenuation correction [162][163][164][165][166][167][168][169] Brain cancer 99m Tc-tetrofosmin Anatomical localization [170] Breast cancer 99m Tc-sestamibi Anatomical localization [171] Colorectal cancer 99m Tc-labelled macroaggregated albumin Hepatic artery infusion of chemotherapy [172] Coronary artery calcification 99m Tc-tetrofosmin Head/neck cancer L-3-123 I-iodine-alpha-methyl-tyrosine, 123 I-labeled L19(scFv)2 antibody Anatomical localization [175][176][177] Hepatic haemangioma 99m Tc-labelled red blood cells Anatomical localization [178,179] Hepatic carcinoma 99m Tc-macroaggregated albumin Anatomical localization [180] Human immunodeficiency virus (HIV) 99m Tc-sulfur colloid Anatomical localization of microbicide surrogate [138] Infection Gallium-67, 111 In-labeled leukocytes Anatomical localization [133][134][135][136] Left ventricular function 99m Tc-tetrofosmin Regional wall motion evaluation, myocardial muscle mass, ejection fraction, cardiac volumes [118] Lung (ventilation/perfusion) 99m Tc-Technegas, 99m Tc-macroaggregated albumin Anatomical localization and registration of ventilation-perfusion patterns [139,140] Lung cancer 99m Tc-sestamibi, 99m Tc-depreotide Anatomical localization [181][182]…”

mentioning

confidence: 99%

Technological Development and Advances in Single-Photon Emission Computed Tomography/Computed Tomography

Seo

Marì

Hasegawa

2008

Seminars in Nuclear Medicine

172

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SPECT/CT has emerged over the past decade as a means of correlating anatomical information from CT with functional information from SPECT. The integration of SPECT and CT in a single imaging device facilitates anatomical localization of the radiopharmaceutical to differentiate physiological uptake from that associated with disease and patient-specific attenuation correction to improve the visual quality and quantitative accuracy of the SPECT image. The first clinically available SPECT/CT systems performed emission-transmission imaging using a dual-headed SPECT camera and a low-power x-ray CT sub-system. Newer SPECT/CT systems are available with high-power CT sub-systems suitable for detailed anatomical diagnosis, including CT coronary angiography and coronary calcification that can be correlated with myocardial perfusion measurements. The high-performance CT capabilities also offer the potential to improve compensation of partial volume errors for more accurate quantitation of radionuclide measurement of myocardial blood flow and other physiological processes and for radiation dosimetry for radionuclide therapy. In addition, new SPECT technologies are being developed that significantly improve the detection efficiency and spatial resolution for radionuclide imaging of small organs including the heart, brain, and breast, and therefore may provide new capabilities for SPECT/CT imaging in these important clinical applications.

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“…4 Nuclear medicine imaging methods, such as PET and SPECT, are established and still expanding methods for functional and molecular imaging. For instance, Tc-99m Technegas/macro aggregated albumin (MAA) has been used for lung cancer imaging, 5 and Tc-99m MIBI has been used for detecting breast tumor. 6 Current on-board imaging systems are limited in their functional and molecular imaging capability.…”

Section: Introductionmentioning

confidence: 99%

A line‐source method for aligning on‐board and other pinhole SPECT systems

2013

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Purpose: In order to achieve functional and molecular imaging as patients are in position for radiation therapy, a robotic multipinhole SPECT system is being developed. Alignment of the SPECT system-to the linear accelerator (LINAC) coordinate frame and to the coordinate frames of other on-board imaging systems such as cone-beam CT (CBCT)-is essential for target localization and image reconstruction. An alignment method that utilizes line sources and one pinhole projection is proposed and investigated to achieve this goal. Potentially, this method could also be applied to the calibration of the other pinhole SPECT systems. Methods: An alignment model consisting of multiple alignment parameters was developed which maps line sources in three-dimensional (3D) space to their two-dimensional (2D) projections on the SPECT detector. In a computer-simulation study, 3D coordinates of line-sources were defined in a reference room coordinate frame, such as the LINAC coordinate frame. Corresponding 2D line-source projections were generated by computer simulation that included SPECT blurring and noise effects. The Radon transform was utilized to detect angles (α) and offsets (ρ) of the line-source projections. Alignment parameters were then estimated by a nonlinear least squares method, based on the α and ρ values and the alignment model. Alignment performance was evaluated as a function of number of line sources, Radon transform accuracy, finite line-source width, intrinsic camera resolution, Poisson noise, and acquisition geometry. Experimental evaluations were performed using a physical linesource phantom and a pinhole-collimated gamma camera attached to a robot. Results: In computer-simulation studies, when there was no error in determining angles (α) and offsets (ρ) of the measured projections, six alignment parameters (three translational and three rotational) were estimated perfectly using three line sources. When angles (α) and offsets (ρ) were provided by the Radon transform, estimation accuracy was reduced. The estimation error was associated with rounding errors of Radon transform, finite line-source width, Poisson noise, number of line sources, intrinsic camera resolution, and detector acquisition geometry. Statistically, the estimation accuracy was significantly improved by using four line sources rather than three and by thinner linesource projections (obtained by better intrinsic detector resolution). With five line sources, median errors were 0.2 mm for the detector translations, 0.7 mm for the detector radius of rotation, and less than 0.5• for detector rotation, tilt, and twist. In experimental evaluations, average errors relative to a different, independent registration technique were about 1.8 mm for detector translations, 1.1 mm for the detector radius of rotation (ROR), 0.5• and 0.4• for detector rotation and tilt, respectively, and 1.2• for detector twist. Conclusions: Alignment parameters can be estimated using one pinhole projection of line sources. Alignment errors are largely associated with limite...

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Clinical utility of co-registered respiratory-gated 99mTc-Technegas/MAA SPECT-CT images in the assessment of regional lung functional impairment in patients with lung cancer

Cited by 77 publications

References 33 publications

Assessment of operability by means of CTPA and perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension

Assessment of operability by means of CTPA and perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension

Technological Development and Advances in Single-Photon Emission Computed Tomography/Computed Tomography

A line‐source method for aligning on‐board and other pinhole SPECT systems

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