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A template-based method for semi-quantitative single photon emission computed tomography myocardial perfusion imaging

University of British Columbia

This thesis presents the template-based quantitative perfusion SPECT (TQPS) method, which is designed for the semi-quantitative analysis in SPECT myocardial perfusion imaging (MPI). Unlike traditional methods employing normal patient databases as the healthy standard when quantifying myocardial perfusion defects, the proposed method utilizes a patient-specific template for its healthy standard. In doing so, TQPS aims to overcome a number of the limitations associated with the non-patient-specific nature of normal patient databases. The TQPS method begins with the construction of a template, which is a 3D digital model of the patient’s healthy heart, using the SPECT reconstructed image. The template is then projected, reconstructed and sampled into the bulls-eye map domain. A ratio of the patient and template bulls-eye images produces a final corrected image in which a patient-specific threshold is applied to identify perfusion defects. Traditional semi-quantitative cardiac measurements, such as the summed stress score and perfusion defect extent were employed for the analysis. This thesis presents the investigation of TQPS in three phases: method evaluation, optimization, and validation. The first two phases focused on controlled simulation studies in which the assessment was based on how well TQPS was able to quantify myocardial perfusion defects relative to the truth. In these studies, the method was able to spatially define perfusion defects with a sensitivity and specificity of 79% and 76%, respectively, while estimating the global perfusion defect size to within 3% of the truth. In the third phase, the aim was to clinically evaluate TQPS relative to an established commercial method (QPS). TQPS exhibited improved specificity relative to the commercial method for the detection of significant coronary artery disease in the left anterior descending artery. The sensitivities for detecting 70% stenosis or greater in the LAD, LCX and RCA territories for QPS and TQPS were 60%, 82%, 75%, and 88%, 94%, 75%, respectively. In summary, the TQPS method was able to accurately quantify myocardial perfusion defects in SPECT MPI, while exhibiting considerable advantages over a traditional normal database method, particularly in the LAD coronary territory.

Text

2012-07-31

Attribution-NoDerivs 3.0 Unported

http://hdl.handle.net/2429/42844

Physics

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nd/3.0/