Patient-specific estimation of spatially variant image noise for a pinhole cardiac SPECT camera

New single photon emission computed tomography (SPECT) cameras using fixed pinhole collimation are increasingly popular. Pinhole collimators are known to have variable sensitivity with distance and angle from the pinhole aperture. It follows that pinhole SPECT systems will also have spatially variant sensitivity and hence spatially variant image noise. The objective of this study was to develop and validate a rapid method for analytically estimating a map of the noise magnitude in a reconstructed image using data from a single clinical acquisition.

The projected voxel (PV) noise estimation method uses a modified forward projector with attenuation effects to estimate the number of photons detected from each voxel in the field-of-view. We approximate the noise for each voxel as the standard deviation of a Poisson distribution with a mean equal to the number of detected photons. An empirical formula is used to address scaling discrepancies caused by image reconstruction. Calibration coefficients are determined for the PV method by comparing it with noise measured from a nonparametrically bootstrapped set of images of a spherical uniformly filled Tc-99m water phantom. Validation studies compare PV noise estimates with bootstrapped measured noise for 31 patient images (5 min, 340 MBq, ^99m Tc-tetrofosmin rest study).

Bland-Altman analysis shows R² correlations ≥70% between the PV-estimated and -measured image noise. For the 31 patient cardiac images, the PV noise estimate has an average bias of 0.1% compared to bootstrapped noise and have a coefficient of variation (CV) ≤ 17%. The bootstrap approach to noise measurement requires 5 h of computation for each image, whereas the PV noise estimate requires only 64 s. In cardiac images, image noise due to attenuation and camera sensitivity varies on average from 4% at the apex to 9% in the basal posterior region of the heart. The standard deviation between 15 healthy patient study images (including physiological variability in the population) ranges from 6% to 16.5% over the length of the heart.

The PV method provides a rapid estimate for spatially variant patient-specific image noise magnitude in a pinhole-collimated dedicated cardiac SPECT camera with a bias of -0.3% and better than 83% precision.