open access

Vol 20, No 1 (2017)
Research paper
Published online: 2016-11-18
Submitted: 2016-08-25
Accepted: 2016-11-02
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Comparison of shortened gated myocardial perfusion imaging processed with „Myovation Evolution” with full time study

Krzysztof Filipczak, Jacek Kuśmierek, Jarosław Drożdż, Krzysztof Chiżyński, Jarosław D. Kasprzak, Jan Z. Peruga, Anna Płachcińska
DOI: 10.5603/NMR.a2016.0041
·
Pubmed: 28198518
·
Nucl. Med. Rev 2017;20(1):25-31.

open access

Vol 20, No 1 (2017)
Original articles
Published online: 2016-11-18
Submitted: 2016-08-25
Accepted: 2016-11-02

Abstract

BACKGROUND: The work compares the results of shortened gated myocardial perfusion imaging (MPI), processed with „Myovation Evolution” software, with a study performed in a standard way.

MATERIAL AND METHODS: A retrospective study was conducted in a group of 95 patients (56 males and 39 females, age 62 ± 9 years, BMI 28 ± 4) with known or suspected CAD, without clinical history or any signs of a previous myocardial infarction. All patients underwent coronary angiography (CA) within 3 months of MPI. CA was used as a reference for diagnostic performance of MPI. Patients underwent a stress/rest 2-day MPI. Both studies were performed twice, with normal (25s) and shortened (13s) time per projection. Studies were processed using Myovation protocol (OSEM with 2 iterations and 10 subsets) for full time (FT) studies and a Myovation Evolution protocol dedicated to half time (HT) studies (OSEM with 12 iterations, 10 subsets). Reconstructed images, with and without attenuation correction (AC), were evaluated by 2 experienced nuclear medicine specialists (a consensus), with regard to image quality and perfusion, evaluated using a visual semi-quantitative method, applying a standard division of myocardium into 17 segments. Perfusion was assessed in every segment using a standard 5 grade scale. Summed stress scores were calculated for every patient and threshold values for detection of CAD were selected based on ROC analysis with CA treated as a reference method. After 2 months FT images were interpreted again by the same specialists.

RESULTS: The quality of images obtained from shortened and normal studies was equally good. All correlation coefficients between segmental scorings of FT and HT studies were high and statistically significant. Correlation coefficients between corresponding segments in FTAC and HTAC (i.e. with AC) studies were systematically higher than without AC. The agreement between FT and HT study results was equal to 81% for FT and HT studies and to 86% for FTAC and HTAC studies (p = 0.40). The repeatability of FTAC study assessments was equal to 94%. 95-percent confidence intervals calculated for agreement between FTAC and HTAC studies and the repeatability of FTAC study overlapped considerably. Correlation coefficients for EDV, ESV and EF values between FT and HT were high: 0.93, 0.96 and 0.88, respectively.

CONCLUSION: Myovation Evolution protocol used for reconstruction of myocardial perfusion studies with reduced number of counts requires AC. The agreement between the results of visual assessment of normal and reduced count studies is high and not worse than the agreement between repeat assessment of a full time study.

Abstract

BACKGROUND: The work compares the results of shortened gated myocardial perfusion imaging (MPI), processed with „Myovation Evolution” software, with a study performed in a standard way.

MATERIAL AND METHODS: A retrospective study was conducted in a group of 95 patients (56 males and 39 females, age 62 ± 9 years, BMI 28 ± 4) with known or suspected CAD, without clinical history or any signs of a previous myocardial infarction. All patients underwent coronary angiography (CA) within 3 months of MPI. CA was used as a reference for diagnostic performance of MPI. Patients underwent a stress/rest 2-day MPI. Both studies were performed twice, with normal (25s) and shortened (13s) time per projection. Studies were processed using Myovation protocol (OSEM with 2 iterations and 10 subsets) for full time (FT) studies and a Myovation Evolution protocol dedicated to half time (HT) studies (OSEM with 12 iterations, 10 subsets). Reconstructed images, with and without attenuation correction (AC), were evaluated by 2 experienced nuclear medicine specialists (a consensus), with regard to image quality and perfusion, evaluated using a visual semi-quantitative method, applying a standard division of myocardium into 17 segments. Perfusion was assessed in every segment using a standard 5 grade scale. Summed stress scores were calculated for every patient and threshold values for detection of CAD were selected based on ROC analysis with CA treated as a reference method. After 2 months FT images were interpreted again by the same specialists.

RESULTS: The quality of images obtained from shortened and normal studies was equally good. All correlation coefficients between segmental scorings of FT and HT studies were high and statistically significant. Correlation coefficients between corresponding segments in FTAC and HTAC (i.e. with AC) studies were systematically higher than without AC. The agreement between FT and HT study results was equal to 81% for FT and HT studies and to 86% for FTAC and HTAC studies (p = 0.40). The repeatability of FTAC study assessments was equal to 94%. 95-percent confidence intervals calculated for agreement between FTAC and HTAC studies and the repeatability of FTAC study overlapped considerably. Correlation coefficients for EDV, ESV and EF values between FT and HT were high: 0.93, 0.96 and 0.88, respectively.

CONCLUSION: Myovation Evolution protocol used for reconstruction of myocardial perfusion studies with reduced number of counts requires AC. The agreement between the results of visual assessment of normal and reduced count studies is high and not worse than the agreement between repeat assessment of a full time study.

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Keywords

myocardial perfusion imaging, Myovation Evolution, attenuation correction, dose reduction, resolution recovery

About this article
Title

Comparison of shortened gated myocardial perfusion imaging processed with „Myovation Evolution” with full time study

Journal

Nuclear Medicine Review

Issue

Vol 20, No 1 (2017)

Article type

Research paper

Pages

25-31

Published online

2016-11-18

DOI

10.5603/NMR.a2016.0041

Pubmed

28198518

Bibliographic record

Nucl. Med. Rev 2017;20(1):25-31.

Keywords

myocardial perfusion imaging
Myovation Evolution
attenuation correction
dose reduction
resolution recovery

Authors

Krzysztof Filipczak
Jacek Kuśmierek
Jarosław Drożdż
Krzysztof Chiżyński
Jarosław D. Kasprzak
Jan Z. Peruga
Anna Płachcińska

References (12)
  1. Loong CY, Anagnostopoulos C. Diagnosis of coronary artery disease by radionuclide myocardial perfusion imaging. Heart. 2004; 90 Suppl 5: v2–v9.
  2. Hachamovitch R, Berman DS, Shaw LJ, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation. 1998; 97(6): 535–543.
  3. Einstein AJ, Moser KW, Thompson RC, et al. Radiation dose to patients from cardiac diagnostic imaging. Circulation. 2007; 116(11): 1290–1305.
  4. Kuśmierek J, Płachcińska A. Patient exposure to ionising radiation due to nuclear medicine cardiac procedures. Nucl Med Rev Cent East Eur. 2012; 15(1): 71–74.
  5. Cerqueira MD, Weissman NJ, Dilsizian V, et al. American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002; 105(4): 539–542.
  6. Ali I, Ruddy TD, Almgrahi A, et al. Half-time SPECT myocardial perfusion imaging with attenuation correction. J Nucl Med. 2009; 50(4): 554–562.
  7. Valenta I, Treyer V, Husmann L, et al. New reconstruction algorithm allows shortened acquisition time for myocardial perfusion SPECT. Eur J Nucl Med Mol Imaging. 2010; 37(4): 750–757.
  8. Druz RS, Phillips LM, Chugkowski M, et al. Wide-beam reconstruction half-time SPECT improves diagnostic certainty and preserves normalcy and accuracy: a quantitative perfusion analysis. J Nucl Cardiol. 2011; 18(1): 52–61.
  9. Modi BN, Brown JLE, Kumar G, et al. A qualitative and quantitative assessment of the impact of three processing algorithms with halving of study count statistics in myocardial perfusion imaging: filtered backprojection, maximal likelihood expectation maximisation and ordered subset expectation maximisation with resolution recovery. J Nucl Cardiol. 2012; 19(5): 945–957.
  10. Zafrir N, Solodky A, Ben-Shlomo A, et al. Feasibility of myocardial perfusion imaging with half the radiation dose using ordered-subset expectation maximization with resolution recovery software. J Nucl Cardiol. 2012; 19(4): 704–712.
  11. Armstrong IS, Arumugam P, James JM, et al. Reduced-count myocardial perfusion SPECT with resolution recovery. Nucl Med Commun. 2012; 33(2): 121–129.
  12. Lawson RS, White D, Nijran K, et al. Institute of Physics and Engineering in Medicine, Nuclear Medicine Software Quality Group. An audit of half-count myocardial perfusion imaging using resolution recovery software. Nucl Med Commun. 2014; 35(5): 511–521.

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