An analytical approach for compensation of non-uniform attenuation in cardiac SPECT imaging

Photon attenuation can reduce the diagnostic accuracy of cardiac SPECT imaging. Bellini et al have previously derived a mathematically exact method to compensate for attenuation in a uniform attenuator. Since the human thorax contains structures with differing attenuation properties, non-uniform attenuation compensation is required in cardiac SPECT. Given an estimate of the patient attenuation map, we show that the Bellini attenuation compensation method can be used in cardiac SPECT to provide a quantitatively accurate reconstruction of a central region in the image which includes the heart and surrounding soft tissue. Simulations using a mathematical cardiac-torso phantom were conducted to evaluate the Bellini method and to compare its performance to the ML-EM iterative algorithm, and to 180 degrees and 360 degrees filtered backprojection (FBP) with no attenuation compensation. 'Bulls-eye' polar maps and circumferential profiles showed that both the Bellini method and the ML-EM algorithm provided quantitatively accurate reconstructions of the myocardium, with a substantial reduction in attenuation-induced artifacts that were observed in the FBP images. The computational load required to implement the Bellini method is approximately equivalent to that required for one iteration of the ML-EM algorithm, thus it is suitable for routine clinical use.