A multivendor phantom study comparing the image quality produced from three state-of-the-art SPECT-CT systems

Ongoing advancements in single photon emission computed tomography with on-board X-ray computed tomography (SPECT-CT) hardware and software raise important questions regarding the relative performances of various cameras and their respective image-processing software. This phantom-based study compares images produced from three state-of-the-art cameras using four image quality measurements.

A thorax phantom modeling the spine, lungs, a healthy heart, and three tumors (cylindrical bottles) was scanned using the following SPECT-CT systems: Philips' Precedence (PP), GE's Infinia-Hawkeye (GH), and Siemens' Symbia-T6 (SS). For each scan, Tc-99m solutions were injected into the heart, three bottles, and thorax to yield activity concentration ratios of roughly 6:1 for both heart:thorax and tumor:thorax. The data were reconstructed using the most advanced software available on the cameras, namely, Evolution for Bone and Evolution for Cardiac (EVB and EVC, respectively), Astonish (AST), and Flash3D (FLA) for GH, PP, and SS, respectively. In addition, all sets of data were reconstructed using our in-house software. The mean values of activity error, uniformity, signal-to-noise ratio, and contrast error were used as figures of merit (FOM).

No significant differences were observed for all FOM between all in-house reconstructions using PP, GH, and SS acquisition data. The mean activity error for the AST reconstruction (-24.0±1.6%) was significantly closer to the truth relative to EVB (-38.0±1.6%), EVC (-34.5±2.3%), and FLA (-33.8±1.6%). No significant differences were found between EVC and FLA for all FOM.

In this phantom-based study, Philips' AST provided the most quantitatively accurate and highest contrast images, whereas Siemens' FLA and GE's EVC provided relatively higher signal-to-noise ratios and more uniform images.