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The impact of transmission-emission misregistration on the interpretation of SPET/CT myocardial perfusion studies and the value of misregistration correction.

TitleThe impact of transmission-emission misregistration on the interpretation of SPET/CT myocardial perfusion studies and the value of misregistration correction.
Publication TypeJournal Article
Year of Publication2015
AuthorsApostolopoulos, D. J., Gąsowska M., Savvopoulos C. A., Skouras T., Spyridonidis T., Andrejczuk A., & Vassilakos P. J.
JournalHell J Nucl Med
Volume18
Issue2
Pagination114-21
Date Published2015 May-Aug
ISSN1790-5427
KeywordsArtifacts, Coronary Artery Disease, Female, Humans, Image Enhancement, Image Interpretation, Computer-Assisted, Male, Middle Aged, Multimodal Imaging, Myocardial Perfusion Imaging, Reproducibility of Results, Sensitivity and Specificity, Subtraction Technique, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed
Abstract

OBJECTIVE: Previous studies indicate that the quality of single photon emission tomography/computed tomography (SPET/CT) myocardial perfusion imaging (MPI) is degraded by even mild transmission-emission misregistrations. The purpose of the current study was to investigate the impact of SPET/CT misalignment on the interpretation of MPI and examine the value of a commercial software application for registration correction.SUBJECTS AND METHODS: A total of 255 technetium-99m ((99m)Tc)-tetrofosmin stress/rest MPI examinations in 150 patients were reviewed for SPET/CT misalignment. After registration correction by the software, images were reassessed for interpretation differences from the misregistered study. The diagnostic benefit of reregistration was determined by taking into account the non-attenuation compensated image pattern, combined stress-rest evaluation, gated-SPET data and patient's history. In a phantom experiment and in 3 representative clinical cases, SPET/CT misalignment was purposely created by the software by sequential slice shifts and its effect was evaluated quantitatively.RESULTS: Misregistration ≥1 pixel in at least one direction was observed in 24% of studies. Interpretation of MPI changed after registration correction in 11% of cases with misalignment <1 pixel, in 18% with 1-2 and in 73% with ≥2 pixels. The diagnostic information seemed to improve after registration correction in 58% of studies irrespective of the degree of misregistration. Software-simulated misregistration had dissimilar effects in the phantom and the 3 selected clinical cases.CONCLUSIONS: The impact of SPET/CT misregistration on MPI interpretation although influenced by the degree and direction of slice misplacement, it is also case-specific and hardly predictable. Registration restoration by the software seems worthwhile regardless of misregistration magnitude.

DOI10.1967/s002449910205
Alternate JournalHell J Nucl Med
PubMed ID26187210

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