title: Avoiding full corrections in dynamic SPECT images impacts the performance of SPECT myocardial blood flow quantitation.
abstract: This study investigated the performance of SPECT myocardial blood flow (MBF) quantitation lacking full physical corrections (All Corr) in dynamic SPECT (DySPECT) images.
  
  
  
  Eleven healthy normal volunteers (HVT) and twenty-four patients with angiography-documented CAD were assessed. All Corr in99mTc-sestamibi DySPECT encompassed noise reduction (NR), resolution recovery (RR), and corrections for scatter (SC) and attenuation (AC), otherwise no correction (NC) or only partial corrections. The performance was evaluated by quality index (R2) and blood-pool spillover index (FBV) in kinetic modeling, and by rest flow (RMBF) and stress flow (SMBF) compared with those of All Corr.
  
  
  
  In HVT group, NC diminished 2-fold flow uniformity with the most degraded quality (15%-18% reduced R2) and elevated spillover effect (45%-50% increased FBV). Consistently higher RMBF and SMBF were discovered in both groups (HVT 1.54/2.31 higher; CAD 1.60/1.72; all P < .0001). Bland-Altman analysis revealed positive flow bias (HVT 0.9-2.6 mL/min/g; CAD 0.7-1.3) with wide ranges of 95% CI of agreement (HVT NC -1.9-7.1; NR -0.4-4.4; NR + SC -1.1-4.3; NR + SC + RR -0.7-2.5) (CAD NC -1.2-3.8; NR -1.0-2.8; NR + SC -1.0-2.5; NR + SC + RR -1.1-2.6).
  
  
  
  Uncorrected physical interference in DySPECT images can extensively impact the performance of MBF quantitation. Full physical corrections should be considered to warrant this tool for clinical utilization.
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Dayong
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Medical Physics Research, Bailing Cloud Biomedical Technologies Innovation, Taipei, Taiwan.
authors.forename: Ing-Jou
authors.initials: IJ
authors.lastname: Chen
authors.affiliation: Department of Medical Physics Research, Bailing Cloud Biomedical Technologies Innovation, Taipei, Taiwan.|Department of Electro-optical Engineering, National Taipei University of Technology, Taipei, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Nuclear Science and Engineering Institute, University of Missouri-Columbia, E2433 Lafferre Hall, Columbia, MO, 65211, USA. bailinghsu@gmail.com.
authors.forename: Bailing
authors.initials: B
authors.lastname: Hsu
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. nuclearfw@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.affiliation: Coronary Heart Disease Center, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China. tangyida@fuwaihospital.org.
authors.forename: Yi-Da
authors.initials: YD
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D003326:Coronary Circulation; D006801:Humans; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
keywords: SPECT myocardial blood flow quantitation; dynamic SPECT; physical corrections; physical interference