title: Registration of myocardial PET and SPECT for viability assessment using mutual information.
abstract: OBJECTIVE
  The combination of sequentially acquired cardiac PET and SPECT data integrating metabolic and perfusion information allows the assessment of myocardial viability, a relevant clinical parameter for the management of patients who have suffered myocardial infarction and are now candidates for complex and cost intensive therapies such as bypass surgery. However, registration of cardiac functional datasets acquired on different imaging systems is limited by the difficulty to define anatomical landmarks and by the relatively poor inherent spatial resolution. In this article, the authors sought to evaluate whether it is possible to automatically register FDG-PET and sestamibi-SPECT cardiac data.
  
  
  METHODS
  Automatic rigid registration was implemented with the ITK framework using Mattes mutual information as the similarity measure and a quaternion to represent the rotational component. The goodness of the alignment was evaluated by computing the mean target registration error (mTRE) at the myocardial wall. The registration parameters were optimized for robustness and speed using the data from 11 cardiac patients undergoing both PET and SPECT examinations (training datasets). The optimized algorithm was applied on the PET and SPECT data from 11 further patients (evaluation datasets). Quantitative (mTRE calculation) and visual (scoring method) comparisons were performed between automatic and manual registrations. Moreover, the automatic registration was also compared to the registration implicitly defined in the standard clinical analysis.
  
  
  RESULTS
  The registration parameters were successfully optimized and resulted in a mean mTRE of 1.13 mm and 1.2 s average runtime on standard computer hardware for the training datasets. Automatic registration in the 11 validation datasets resulted in an average mTRE of 2.3 mm, with 7.5 mm mTRE in the worst case and an average runtime of 1.6 s. Automatic registration outperformed manual registrations both for the mTRE and for the visual assessment. Automatic registration also resulted in higher accuracy and better visual assessment as compared to the registration implicitly performed in the standard clinical analysis.
  
  
  CONCLUSIONS
  The results demonstrate the possibility to successfully perform mutual information based registration of PET and SPECT cardiac data, allowing an improved workflow for the sequentially acquired cardiac datasets, in general, and specifically for the assessment of myocardial viability.
authors.affiliation: Nuklearmedinische Klinik der TU München, Ismaningerstrasse 22, 81675 München, Germany. m.marinelli@sssup.it
authors.forename: Martina
authors.initials: M
authors.lastname: Marinelli
authors.forename: Axel
authors.initials: A
authors.lastname: Martinez-Möller
authors.forename: Brian
authors.initials: B
authors.lastname: Jensen
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Positano
authors.forename: Susanne
authors.initials: S
authors.lastname: Weismüller
authors.forename: Nassir
authors.initials: N
authors.lastname: Navab
authors.forename: Luigi
authors.initials: L
authors.lastname: Landini
authors.forename: Markus
authors.initials: M
authors.lastname: Schwaiger
authors.forename: Stephan G
authors.initials: SG
authors.lastname: Nekolla
mesh_terms: D000465:Algorithms; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008954:Models, Biological; D015233:Models, Statistical; D055414:Myocardial Perfusion Imaging / Q000295:instrumentation / Q000379:methods*; D017682:Myocardial Stunning / Q000175:diagnosis*; D010363:Pattern Recognition, Automated / Q000379:methods; D019047:Phantoms, Imaging; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*