Comparison of acquisition protocols for ventilation/perfusion SPECT-a Monte Carlo study

Area of Science:

• Nuclear Medicine
• Radiology
• Medical Imaging

Background:

• Pulmonary embolism (PE) diagnosis commonly utilizes ventilation/perfusion (V/P) scintigraphy.
• Optimization of V/P single photon emission computed tomography (SPECT) protocols is crucial for accurate PE detection.

Purpose of the Study:

• To evaluate the performance of current V/P SPECT imaging protocols for PE diagnosis.
• To investigate the impact of modifying key protocol parameters on diagnostic accuracy and image quality.

Main Methods:

• Simulated 4D digital phantoms with perfusion defects using the Monte Carlo technique.
• Evaluated six V/P SPECT imaging protocols across 72 simulated digital patients.
• Radiologists/nuclear medicine physicians reported perfusion mismatch findings and visually graded image quality.

Main Results:

• No statistically significant differences in diagnostic performance were observed among the studied V/P SPECT protocols.
• Visual grading revealed one protocol as significantly superior to four others.
• Identified specific parameter alterations for protocol harmonization.

Conclusions:

• Harmonization of clinical V/P SPECT protocols for suspected PE is recommended based on study findings.
• Adjustments include altering radiopharmaceutical activities, changing collimator type, and reducing acquisition times.