감쇠보정, 산란보정 및 해상도복원이 정량적 심근 SPECT의 관상동맥질환 진단성능에 미치는 효과 (Effect of Attenuation Correction, Scatter Correction and Resolution Recovery on Diagnostic Performance of Quantitative Myocardial SPECT for Coronary Artery Disease) |
Author |
황경훈, 이동수, 팽진철, 이명묵1, 정준기, 이명철, |
Kyung Hoon Hwang, M.D., Dong Soo Lee, M.D., Jin Chul Paeng, M.D.,Myoung Mook Lee, M.D.1, June-Key Chung, M.D. and Myung Chul Lee, M.D. |
Affiliation |
서울대학교 의과대학 핵의학교실, 내과학교실1 Departments of Nuclear Medicine and Internal Medicine,1 Seoul National University College of Medicine |
Abstract |
Purpose: Soft tissue attenuation and scattering are major methodological limitations of myocardial perfusion
SPECT. To overcome these limitations, algorithms for attenuation, scatter correction and resolution recovery
(ASCRR) is being developed, while quantitative myocardial SPECT has also become available. In this study, we
investigated the efficacy of an ASCRR-corrected quantitative myocardial SPECT method for the diagnosis of
coronary artery disease (CAD). Materials and Methods: Seventy-five patients (M:F=51:24, 61.0¡¾8.9 years old)
suspected of CAD who underwent coronary angiography (CAG) within 7¡¾12 days of SPECT(Group-I) and 20
subjects (M:F=10:10, age 40.6¡¾9.4) with a low likelihood of coronary artery disease (Group-II) were enrolled.
Tl-201 rest/ dipyridamole-stress Tc-99m-MIBI gated myocardial SPECT was performed. ASCRR correction was
performed using a Gd-153 line source and automatic software (Vantage-Pro; ADAC Labs, USA). Using a 20-
segment model, segmental perfusion was automatically quantified on both the ASCRR-corrected and uncorrected
images using an automatic quantifying software (AutoQUANT; ADAC Labs.). Using these quantified values,
CAD was diagnosed in each of the 3 coronary arterial territories. The diagnostic performance of ASCRR-corrected
SPECT was compared with that of non-corrected SPECT. Results: Among the 75 patients of Group-I, 9
patients had normal CAG while the remaining 66 patients had 155 arterial lesions; 61 left anterior descending
(LAD), 48 left circumflex (LCX) and 46 right coronary (RCA) arterial lesions. For the LAD and LCX lesions, there
was no significant difference in diagnostic performance. In Group-II patients, the overall normalcy rate improved
but this improvement was not statistically significant (p=0.07). However, for RCA lesions, specificity improved
significantly but sensitivity worsened significantly with ASCRR correction (both p<0.05). Overall accuracy was the
same. Conclusion: The ASCRR correction did not improve diagnostic performance significantly although the
diagnostic specificity for RCA lesions improved on quantitative myocardial SPECT. The clinical application of the
ASC-RR correction requires more discretion regarding cost and efficacy. (Korean J Nucl Med 2002;36;288-97) |
Keyword |
Attenuation correction, Myocardial SPECT, Coronary artery disease |
Full text Article |
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