title: Attenuation correction maps for SPECT myocardial perfusion imaging from contrast-enhanced coronary CT angiography: gemstone spectral imaging with single-source dual energy and material decomposition.
abstract: The aim of this study was to explore the feasibility of attenuation correction (AC) of myocardial perfusion imaging (MPI) with a virtual unenhanced cardiac CT scan synthesized from contrast-enhanced single-source dual-energy coronary CT angiography.
  
  
  METHODS
  Segmental myocardial percentage uptake values obtained with AC were analyzed by use of correlation analysis and Bland-Altman limits of agreement (20-segment model), and clinical agreement was evaluated in 30 patients.
  
  
  RESULTS
  The 2 methods showed an excellent correlation for segmental myocardial percentage uptake at stress (r = 0.93; P < 0.001; low dose) and at rest (r = 0.90; P < 0.001; high dose) with narrow Bland-Altman limits of agreement (-6.8% to 7.8% and -7.8% to 7.4%, respectively). The levels of clinical agreement of SPECT MPI corrected with standard versus virtual unenhanced CT AC were 99% per coronary territory and 97% per patient.
  
  
  CONCLUSIONS
  Our results suggest that AC of SPECT MPI with a virtual unenhanced CT scan synthesized from contrast-enhanced coronary CT angiography is feasible and reliable.
authors.affiliation: Cardiac Imaging, Department of Radiology, University Hospital Zurich, Zurich, Switzerland; and.
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Fuchs
authors.forename: Bert-Ram
authors.initials: BR
authors.lastname: Sah
authors.forename: Julia
authors.initials: J
authors.lastname: Stehli
authors.forename: Sacha
authors.initials: S
authors.lastname: Bull
authors.forename: Svetlana
authors.initials: S
authors.lastname: Dougoud
authors.forename: Martin W
authors.initials: MW
authors.lastname: Huellner
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: SPECT; attenuation correction; gemstone spectral imaging; virtual unenhanced CT