Receiver operating characteristic evaluation of iterative reconstruction with attenuation correction in 99mTc-sestamibi myocardial SPECT images

Karen J. LaCroix, Benjamin Tsui, Eric Frey, Ronald J. Jaszczak

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to evaluate differences in myocardial defect detection between 99mTc-sestamibi myocardial SPECT images reconstructed using conventional filtered backprojection (FBP) without attenuation correction (AC) and those reconstructed using maximum-likelihood expectation maximization with nonuniform attenuation correction (MLAC). Methods: An observer study and receiver operating characteristic (ROC) curve analysis were performed using simulated 99mTc-sestamibi SPECT data from a population of 24 mathematic anthropomorphic torso phantoms, which realistically modeled a wide range of anatomic variations. The phantoms modeled male patients with a flat diaphragm, male patients with a diaphragm raised to the level of the heart, and female patients with large breasts. Transmural, cold defects with a contrast of 0.25 were simulated in the left ventricular wall for 6 locations. Noisy projection data were generated from the phantoms and included the effects of nonuniform attenuation, collimator- detector response, and scatter. The data were then reconstructed using FBP and MLAC. Images were displayed in the short- and long-axis formats, as in clinical practice. Eight observers viewed blocks of FBP and MLAC images and, for each image, indicated on a continuous rating scale the probability that a defect was present. From the rating data, FBP and MLAC ROC curves were generated, and their areas (A(z)) were estimated and compared. Results: In general, the FBP and MLAC ROC curves did not cross and the MLAC curve showed a higher A(z) than did the corresponding FBP curve. For male phantoms with a flat diaphragm, the average difference in A(z) was 0.04 and was not statistically significant (at the P = 0.05 level) for 6 of 8 observers. For male phantoms with a raised diaphragm, the average difference in A(z) was 0.22 and was statistically significant for 6 of 8 observers. For female phantoms with large breasts, the average difference in A(z) was 0.19 and was statistically significant for all 8 observers. Conclusion: This study showed an improvement in defect detection in myocardial SPECT images using MLAC in comparison with images using FBP without AC, particularly for patients with large breasts or with a diaphragm raised to the level of the heart.

Original languageEnglish (US)
Pages (from-to)502-513
Number of pages12
JournalJournal of Nuclear Medicine
Volume41
Issue number3
StatePublished - Mar 2000
Externally publishedYes

Fingerprint

Technetium Tc 99m Sestamibi
Diaphragm
Single-Photon Emission-Computed Tomography
ROC Curve
Breast
Anatomic Variation
Torso
Mathematics
Population

Keywords

  • Tc-sestamibi radionuclide
  • Attenuation correction
  • Cardiac SPECT
  • Phantom study
  • ROC study

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Receiver operating characteristic evaluation of iterative reconstruction with attenuation correction in 99mTc-sestamibi myocardial SPECT images. / LaCroix, Karen J.; Tsui, Benjamin; Frey, Eric; Jaszczak, Ronald J.

In: Journal of Nuclear Medicine, Vol. 41, No. 3, 03.2000, p. 502-513.

Research output: Contribution to journalArticle

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AU - Frey, Eric

AU - Jaszczak, Ronald J.

PY - 2000/3

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N2 - The purpose of this study was to evaluate differences in myocardial defect detection between 99mTc-sestamibi myocardial SPECT images reconstructed using conventional filtered backprojection (FBP) without attenuation correction (AC) and those reconstructed using maximum-likelihood expectation maximization with nonuniform attenuation correction (MLAC). Methods: An observer study and receiver operating characteristic (ROC) curve analysis were performed using simulated 99mTc-sestamibi SPECT data from a population of 24 mathematic anthropomorphic torso phantoms, which realistically modeled a wide range of anatomic variations. The phantoms modeled male patients with a flat diaphragm, male patients with a diaphragm raised to the level of the heart, and female patients with large breasts. Transmural, cold defects with a contrast of 0.25 were simulated in the left ventricular wall for 6 locations. Noisy projection data were generated from the phantoms and included the effects of nonuniform attenuation, collimator- detector response, and scatter. The data were then reconstructed using FBP and MLAC. Images were displayed in the short- and long-axis formats, as in clinical practice. Eight observers viewed blocks of FBP and MLAC images and, for each image, indicated on a continuous rating scale the probability that a defect was present. From the rating data, FBP and MLAC ROC curves were generated, and their areas (A(z)) were estimated and compared. Results: In general, the FBP and MLAC ROC curves did not cross and the MLAC curve showed a higher A(z) than did the corresponding FBP curve. For male phantoms with a flat diaphragm, the average difference in A(z) was 0.04 and was not statistically significant (at the P = 0.05 level) for 6 of 8 observers. For male phantoms with a raised diaphragm, the average difference in A(z) was 0.22 and was statistically significant for 6 of 8 observers. For female phantoms with large breasts, the average difference in A(z) was 0.19 and was statistically significant for all 8 observers. Conclusion: This study showed an improvement in defect detection in myocardial SPECT images using MLAC in comparison with images using FBP without AC, particularly for patients with large breasts or with a diaphragm raised to the level of the heart.

AB - The purpose of this study was to evaluate differences in myocardial defect detection between 99mTc-sestamibi myocardial SPECT images reconstructed using conventional filtered backprojection (FBP) without attenuation correction (AC) and those reconstructed using maximum-likelihood expectation maximization with nonuniform attenuation correction (MLAC). Methods: An observer study and receiver operating characteristic (ROC) curve analysis were performed using simulated 99mTc-sestamibi SPECT data from a population of 24 mathematic anthropomorphic torso phantoms, which realistically modeled a wide range of anatomic variations. The phantoms modeled male patients with a flat diaphragm, male patients with a diaphragm raised to the level of the heart, and female patients with large breasts. Transmural, cold defects with a contrast of 0.25 were simulated in the left ventricular wall for 6 locations. Noisy projection data were generated from the phantoms and included the effects of nonuniform attenuation, collimator- detector response, and scatter. The data were then reconstructed using FBP and MLAC. Images were displayed in the short- and long-axis formats, as in clinical practice. Eight observers viewed blocks of FBP and MLAC images and, for each image, indicated on a continuous rating scale the probability that a defect was present. From the rating data, FBP and MLAC ROC curves were generated, and their areas (A(z)) were estimated and compared. Results: In general, the FBP and MLAC ROC curves did not cross and the MLAC curve showed a higher A(z) than did the corresponding FBP curve. For male phantoms with a flat diaphragm, the average difference in A(z) was 0.04 and was not statistically significant (at the P = 0.05 level) for 6 of 8 observers. For male phantoms with a raised diaphragm, the average difference in A(z) was 0.22 and was statistically significant for 6 of 8 observers. For female phantoms with large breasts, the average difference in A(z) was 0.19 and was statistically significant for all 8 observers. Conclusion: This study showed an improvement in defect detection in myocardial SPECT images using MLAC in comparison with images using FBP without AC, particularly for patients with large breasts or with a diaphragm raised to the level of the heart.

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KW - Phantom study

KW - ROC study

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