Influence of Reconstruction Methods on Regional Wall Motion Abnormalities During Gated SPECT Myocardial Perfusion...

Area of Science:

• Cardiovascular Imaging
• Nuclear Cardiology
• Medical Image Processing

Background:

• Accurate assessment of regional wall motion abnormalities (RWMA) is crucial for diagnosing coronary artery disease (CAD).
• The image reconstruction method in gated SPECT myocardial perfusion imaging (MPI) critically impacts diagnostic accuracy for RWMA.
• Filtered backprojection (FBP) is a traditional method, while iterative reconstruction (IR) offers potential improvements.

Purpose of the Study:

• To compare the diagnostic performance of iterative reconstruction (IR) versus filtered backprojection (FBP) for assessing RWMA in gated SPECT MPI.
• To determine optimal IR parameters for improving RWMA detection in patients with varying degrees of coronary artery disease.

Main Methods:

• Retrospective analysis of 100 patients undergoing gated SPECT MPI (25 normal, 75 abnormal).
• Images reconstructed using FBP and IR with varying iteration-subset settings (e.g., 4i x 6s, 4i x 8s).
• RWMA assessed visually using a 20-segment model; statistical agreement analyzed.

Main Results:

• No significant differences between FBP and IR in normal or mild defect groups.
• IR (4i x 6s, 4i x 8s) reclassified more patients into severe RWMA categories in moderate and severe defect groups.
• IR demonstrated significantly higher diagnostic sensitivity compared to FBP (P < 0.0001) for moderate to severe disease.

Conclusions:

• Optimized IR parameters (4i x 6s, 4i x 8s) enhance RWMA detection in moderate to severe coronary artery disease.
• IR improves diagnostic accuracy in gated SPECT MPI compared to FBP.
• Integrating IR into routine MPI protocols may improve clinical decision-making and patient outcomes.