Automated quality control of emission-transmission misalignment for attenuation correction in myocardial perfusion imaging with SPECT-CT systems.

摘要

BACKGROUND: Emission-transmission misalignment with single-photon emission computed tomography (SPECT)-computed tomography (CT) systems can impair attenuation correction (AC) in myocardial perfusion imaging. This study was performed to develop automated quality control (Auto-QC) to detect critical misalignment that can significantly impact AC. METHODS AND RESULTS: Auto-QC was developed to segment myocardium and mediastinum from emission and transmission reconstructions, respectively. Myocardium-mediastinum mismatch was used as the quality-control index (QCI). The QCI threshold for acceptable AC was determined with NCAT (NURBS nonuniform rational B-spline-based cardiac torso phantom) simulation and verified with 2 patients with minimal misalignment. Compromised data sets, generated by shifting the attenuation maps by 0.5, 1.0, 1.5, and 2.0 pixels along left-right, up-down, and head-foot directions, respectively, were qualitatively and quantitatively compared with the unshifted data sets. Auto-QC was tested with the 2 verification patients and 41 additional patients. Shifts by more than 1 pixel along any direction compromised AC. Auto-QC with the QCI threshold (3) had highly concordant results with manual quality control in the detection of critical misalignment (sensitivity of 88 and 90 and specificity of 93 and 95 for the tests by use of the 2 verification patients and 41 additional patients, respectively). CONCLUSION: QCI quantitatively represented the severity of misalignment. Auto-QC can help clinicians be aware of critical misalignment and can assist in realignment of SPECT and CT images.