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Reducing CT dose in myocardial perfusion SPECT/CT.

Emma O'Shaughnessy1, Kat L Dixon

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Reducing radiation dose in myocardial perfusion imaging is possible. New computed tomography (CT) settings significantly lower radiation exposure without impacting diagnostic accuracy, benefiting patients undergoing these crucial cardiac scans.

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Cardiology

Background:

  • Computed tomography (CT) attenuation correction is vital for single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).
  • Radiation dose from CT in SPECT MPI is a concern, necessitating strategies for dose reduction.

Purpose of the Study:

  • To decrease radiation dose from CT attenuation correction in SPECT MPI.
  • To ensure dose reduction does not compromise the accuracy of SPECT MPI.

Main Methods:

  • Utilized a Perspex CTDI phantom and Xi detector to measure radiation dose across various CT settings on a Siemens Symbia T system.
  • Compared default CT settings ('AECmean') with dose modulation settings.
  • Evaluated the impact of these settings in 30 patients undergoing SPECT MPI, with one scan using default and the other using dose modulation settings.

Main Results:

  • Dose modulation settings reduced radiation dose from 1.68 mGy to 1.21 mGy (center phantom) and from 0.30 mGy to undetectable levels (<0.01 mGy) (breast scout dose).
  • A mean effective dose reduction of 23.6% was observed in patients, with greater reductions in larger individuals (up to 72%).
  • No discernible difference in CT attenuation correction quality was noted between the two imaging protocols.

Conclusions:

  • Optimized CT settings, specifically dose modulation, effectively reduce radiation exposure during SPECT MPI.
  • The implemented low-dose CT protocols maintain diagnostic accuracy for myocardial perfusion imaging.
  • These findings support the routine clinical application of reduced-dose CT settings in SPECT MPI.