Impact of data-driven cardiac respiratory motion correction on the extent and severity of myocardial perfusion defects with free-breathing CZT SPECT.
We previously reported the clinical feasibility and positive impact on image characteristics of a data-driven cardiac respiratory motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). Here, we evaluate its impact on the extent and severity of myocardial perfusion defects (MPD).



We included 25 patients having a 1-day99mTc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT. Acquisitions were processed with REGAT to generate mean RM gated SPECT. These were summed either after (R-SPECT) or without realignment (NR-SPECT). We noted the maximal cardiac RM shift in the 3 axes of the left ventricle (LV). Both visual and semi-quantitative analyses of myocardial tracer uptake were realized. Studies were classified as having an impact on the extent/severity of MPD with REGAT if ≥1 segment presented a severity score changing by ≥1 level between NR-SPECT and R-SPECT. An impact on the extent of MPD was considered present if at least 1 segment shifted from normal (score = 0) to abnormal (score different from 0) or inversely.



Cardiac RM was >10 mm in 55% of studies. With visual and semi-quantitative analyses, an impact on the extent/severity MPD was observed in 14% of all studies (7/49) and 60% of studies with cardiac RM >15 mm. An impact on the extent of MPD was observed in 5 of the 7 upper listed studies. All studies presenting an impact on MPD had RM in the anterior to inferior LV axis >10 mm.



A substantial number of MPI studies presented significant cardiac RM. Cardiac RM compensation showed a frequent impact on the extent/severity of MPD.
EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France. doumit.daou@cch.aphp.fr.|Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France. doumit.daou@cch.aphp.fr.
Doumit
D
Daou
Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France.
Rémy
R
Sabbah
Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France.
Carlos
C
Coaguila
Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France.
Hatem
H
Boulahdour
D000328:Adult; D000368:Aged; D002104:Cadmium; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D012119:Respiration; D013691:Tellurium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D015032:Zinc
C474490:CdZnTe; D002104:Cadmium; D015032:Zinc; D013691:Tellurium
CZT; Gated SPECT; Myocardial perfusion; Respiratory gating; Respiratory motion