Patient-specific SPECT imaging protocols to standardize image noise

Cuddy-Walsh, Sarah G.; Clackdoyle, Duncan; Renaud, Jennifer; Wells, R. Glenn

doi:10.1007/s12350-019-01664-5

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…In contrast to our findings of improved standardization using exponential dosing with rubidium PET, a previous study with technetium SPECT perfusion imaging found that image noise in the LV myocardium could be standardized using the product of injected activity and scan-time adjusted as a proportional function of patient weight. 30 While image quality using both these modalities is affected by the Poisson distribution of counting statistics, the noise effects and correction methods for the physical effects of scatter and attenuation (as well as random and prompt-gamma coincidences in PET) are quite different, which may explain the different results in SPECT vs PET.…”

Section: Discussionmentioning

confidence: 99%

Exponential dosing to standardize myocardial perfusion image quality with rubidium-82 PET

Tavoosi

Khetarpal

Wells

et al. 2023

Journal of Nuclear Cardiology

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Background 82Rb PET is commonly performed using the same injected activity in all patients, resulting in lower image quality in larger patients. This study compared 82Rb dosing with exponential vs proportional functions of body weight on the standardization of myocardial perfusion image (MPI) quality. Methods Two sequential cohorts of N = 60 patients were matched by patient weight. Rest and dipyridamole stress 82Rb PET was performed using 0.1 MBq·kg−2 exponential and 9 MBq·kg−1 proportional dosing. MPI scans were compared qualitatively with visual image quality scoring (IQS) and quantitatively using the myocardium-to-blood contrast-to-noise ratio (CNR) and blood background signal-to-noise ratio (SNR) as a function of body weight. Results Average (min–max) patient body weight was 81 ± 18 kg (46–137 kg). Proportional dosing resulted in decreasing CNR, SNR, and visual IQS with increasing body weight (P < 0.05). Exponential dosing eliminated the weight-dependent decreases in these image quality metrics that were observed in the proportional dosing group. Conclusion 82Rb PET dosing as an exponential (squared) function of body weight produced consistent stress perfusion image quality over a wide range of patient weights. Dramatically lower doses can be used in lighter patients, with the equivalent population dose shifted toward the heavier patients to standardize diagnostic image quality.

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Section: Discussionmentioning

confidence: 99%

Exponential dosing to standardize myocardial perfusion image quality with rubidium-82 PET

Tavoosi

Khetarpal

Wells

et al. 2023

Journal of Nuclear Cardiology

Self Cite

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show abstract

“…In the current issue of the Journal of Nuclear Cardiology, Cuddy-Walsh et al developed a patientspecific activity protocol to standardize the average noise in a reconstructed image, irrespective of the SPECT camera, reconstruction algorithm, body weight, or gender. 11 They retrospectively included 43 patients and simulated and calculated the image noise in the SPECT MPI scans acquired on both a conventional and multi-pinhole cadmium-zinc-telluride (CZT)-based SPECT camera. They found that there was a 3.6-fold difference in activity required to obtain the same number of photon counts and a 16-fold difference to obtain the same image noise between the CZT and conventional SPECT camera when using the same scan time.…”

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confidence: 99%

“…The derived correlation between image noise and body weight (R 2 = 0.85 to 0.89) is better than the previously reported correlation between photon counts and body weight (R 2 = 0.61). 10,11 One remark which should be made is that the 16-fold difference in the product of activity and scan time required to obtain the same image noise on a conventional instead of a pinhole camera does not necessarily imply that one has to increase the activity or scan time a 16-fold to obtain the same image quality. The level of noise and defect detectability in a reconstructed image heavily depends in a nonlinear fashion on the reconstruction method.…”

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confidence: 99%