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01.04.2015 | Original Article | Ausgabe 3/2015

Annals of Nuclear Medicine 3/2015

Characteristics of images of angiographically proven normal coronary arteries acquired by adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ⋅SPECT with CT attenuation correction changed stepwise

Zeitschrift:
Annals of Nuclear Medicine > Ausgabe 3/2015
Autoren:
Teruyuki Takahashi, Haruki Tanaka, Nami Kozono, Yoshiki Tanakamaru, Naomi Idei, Norihiko Ohashi, Hideki Ohtsubo, Takenori Okada, Yuji Yasunobu, Shunichi Kaseda

Abstract

Objective

Although several studies have shown the diagnostic and prognostic value of CT-based attenuation correction (AC) of single photon emission computed tomography (SPECT) images for diagnosing coronary artery disease (CAD), this issue remains a matter of debate. To clarify the characteristics of CT-AC SPECT images that might potentially improve diagnostic performance, we analyzed images acquired using adenosine-stress thallium-201 myocardial perfusion SPECT/CT equipped with IQ⋅SPECT (SPECT/CT-IQ⋅SPECT) from patients with angiographically proven normal coronary arteries after changing the CT attenuation correction (CT-AC) in a stepwise manner.

Methods

We enrolled 72 patients (Male 36, Female 36) with normal coronary arteries according to findings of invasive coronary angiography or CT-angiography within three months after a SPECT/CT study. Projection images were reconstructed at CT-AC values of (−), 40, 60, 80 and 100 % using a CT number conversion program according to our definition and analyzed using polar maps according to sex.

Results

CT attenuation corrected segments were located from the mid- and apical-inferior spread through the mid- and apical-septal regions and finally to the basal-anterior and basal- and mid-lateral regions in males, and from the mid-inferior region through the mid-septal and mid-anterior, and mid-lateral regions in females as the CT-AC values increased. Segments with maximal mean counts shifted from the apical-anterior to mid-anterolateral region under both stress and rest conditions in males, whereas such segments shifted from the apical-septal to the mid-anteroseptal region under both stress and rest conditions in females.

Conclusions

We clarified which part of the myocardium and to which degree CT-AC affects it in adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ⋅SPECT images by changing the CT-AC value stepwise. We also identified sex-specific shifts of segments with maximal mean counts that changed as CT-AC values increased.

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