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Der Nuklearmediziner 2004; 27(3): 161-168
DOI: 10.1055/s-2004-822719
Kardiologie aktuell

© Georg Thieme Verlag Stuttgart · New York

Quantitative Analyse von SPECT-Datensätzen des Herzens

Quantitative Analysis of Cardiac SPECTS. G. Nekolla1 , F. M. Bengel1
  • 1Nuklearmedizinische Klinik und Poliklinik der Technischen Universität München
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Publication History

Publication Date:
16 September 2004 (online)

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Zusammenfassung

Die quantitative Analyse myokardialer SPECT-Aufnahmen ist ein leistungsfähiges Verfahren, das physiologisch spezifische Radiotracer-Signale aus dem Datenvolumen extrahieren kann. Im Vergleich zu Normaldatenbanken können diese Werte in einen individuellen Kontext gestellt und die Ergebnisse der Untersuchung objektiv präsentiert werden. Der Beitrag stellt die dabei zugrunde liegende Methodik anhand der geschichtlichen Entwicklung, kommend von der planaren Myokardszintigraphie, dar. Darauf aufbauend werden Erweiterungen, die durch die SPECT-Aufnahmetechnik notwendig wurden, diskutiert. Abschließend werden Limitationen der Methodik sowie Aspekte neuer technischer Entwicklungen in der SPECT, kommerzielle Auswertelösungen und eine modalitätsübergreifende Beschreibung des linken Ventrikels diskutiert.

Abstract

The quantitative analysis of myocardial SPECT images is a powerful tool to extract the highly specific radio tracer uptake in these studies. If compared to normal data bases, the uptake values can be calibrated on an individual basis. Doing so increases the reproducibility of the analysis substantially. Based on the development over the last three decades starting from planar scinitigraphy, this paper discusses the methods used today incorporating the changes due to tomographic image acquisitions. Finally, the limitations of these approaches as well as consequences from most recent hardware developments, commercial analysis packages and a wider view of the description of the left ventricle are discussed.

Schlüsselwörter

SPECT - Quantifizierung - Polarmap - Normaldatenbank

Key words

SPECT - quantification - polarmap - normal database

Literatur

  • 1 Schömig A, Kastrati A, Dirschinger J, Mehilli J, Schricke U, Pache J, Martinoff S, Neumann F J, Schwaiger M. Related Articles. Coronary stenting plus platelet glycoprotein II b/III a blockade compared with tissue plasminogen activator in acute myocardial infarction. Stent versus Thrombolysis for Occluded Coronary Arteries in Patients with Acute Myocardial Infarction.  N Engl J Med. 2000;  343 385-391
    PubMedGoogle Scholar
  • 2 Kastrati A, Mehilli J, Schlotterbeck K, Dotzer F, Dirschinger J, Schmitt C, Nekolla S G, Seyfarth M, Martinoff S, Markwardt C, Clermont G, Gerbig H W, Leiss J, Schwaiger M, Schömig A. Early administration of reteplaseplus abciximab vs abciximab alone in patients with acute myocardial infarction referred for percutaneous coronary intervention: a randomized controlled trial.  JAMA. 2004;  291 947-954
    CrossrefPubMedGoogle Scholar
  • 3 Burow R D, Pond M, Schafer A W, Becker L. Circumferential profiles: a new method for computer analysis of thallium - myocardial perfusion images.  J Nucl Med. 1979;  20 771-777
    PubMedGoogle Scholar
  • 4 Garcia E, Maddahi J, Berman D, Waxman A. Space/time quantitation of thallium-201 myocardial scintigraphy.  J Nucl Med. 1981;  22 309-317
    PubMedGoogle Scholar
  • 5 Cerqueira M D, Weissman, NJ, Dilsizian V, Jacobs A K, Kaul S, Laske W K, Pennel D J, Rumberger J A, Ryan T, Verani M S. A Statement for Healthcare Professionals From the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging . Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart.  Circulation. 2002;  105 539-542
    CrossrefPubMedGoogle Scholar
  • 6 Tamaki N, Yonekura Y, Mukai T, Kodama S, Kadota K, Kambara H, Kawai C, Torizuka K. Stress thallium-201 transaxial emission computed tomography: quantitative versus qualitative analysis for evaluation of coronary artery disease.  J Am Coll Cardiol. 1984;  4 1213-1221
    PubMedGoogle Scholar
  • 7 Garcia E V, Van Train K, Maddahi J, Prigent F, Friedman J, Areeda J, Waxman A, Berman D S. Quantification of rotational thallium-201 myocardial tomography.  J Nucl Med. 1985;  26 17-26
    PubMedGoogle Scholar
  • 8 Stirner H, Bull U, Kleinhans E. Three-dimensional ROI-based quantification of stress/rest 201Tl myocardial SPECT: presentation of a method.  Nuklearmedizin. 1986;  25 128-133
    PubMedGoogle Scholar
  • 9 Buell U, Stirner H, vom Dahl J, Uebis R, Kleinhans E, Biedermann M, Grosse W, Simon H J. Quantitative evaluation of myocardial stress/rest 201TL SPECT: results of a ROI-based method in 108 patients with CHD.  Nuklearmedizin. 1987;  26 234-240
    PubMedGoogle Scholar
  • 10 Nuyts J, Mortelmans L, Suetens P, Oosterlinck A, de Rou M. Model based quantification of myocardial perfusion images from SPECT.  J Nucl Med. 1989;  30 1992-2001
    PubMedGoogle Scholar
  • 11 Cooke C D, Garcia E V, Folks R D. et al .IEEE proceedings of the first conference on visualisation in biomedical engineering. IEEE Computer Society Press, Los Alamitos, Ca. 1990; 185-189
    Google Scholar
  • 12 Garcia E V, Cooke C D, Van Train K F, Folks R, Peifer J, DePuey E G, Maddahi J, Alazraki N, Galt J, Ezquerra N. et al . Technical aspects of myocardial SPECT imaging with technetium-99m sestamibi.  Am J Cardiol. 1990;  66 23E-31E
    CrossrefPubMedGoogle Scholar
  • 13 Germano G, Kavanagh P B, Su H T, Mazzanti M, Kiat H, Hachamovitch R, Van Train K F, Areeda J S, Berman D S. Automatic reorientation of three-dimensional, transaxial myocardial perfusion SPECT images.  J Nucl Med. 1995;  36 1107-1114
    PubMedGoogle Scholar
  • 14 Slomka P J, Hurwitz G A, Stephenson J, Cradduck T. Automated alignment and sizing of myocardial stress and rest scans to three-dimensional normal templates using an image registration algorithm.  J Nucl Med. 1995;  36 1115-1122
    PubMedGoogle Scholar
  • 15 Mahmarian J J, Moyé L A, Verani M S, Bloom M F, Pratt C M. High reproducibility of myocardial perfusion defects in patients undergoing serial exercise Thallium-201 tomography.  Am J Cardiol. 1995;  75 116-119
    PubMedGoogle Scholar
  • 16 Lewin H C, Sharir T, Germano G, Kavanagh P B, Lai S, Friedman J, Kang X, Berman D. Reproducibility of dual isotope myocardial perfusion SPECT using a new quantitative perfusion SPECT (QPS) approach.  J Am Coll Cardiol. 1999;  33 (Suppl A) 438
    PubMedGoogle Scholar
  • 17 Laubenbacher C, Rothley J, Sitomer J, Beanlands R, Sawada S, Sutor R, Muller D, Schwaiger M. An automated analysis program for the evaluation of cardiac PET studies: initial results in the detection and localization of coronary artery disease using nitrogen-13-ammonia.  J Nucl Med. 1993;  34 968-978
    PubMedGoogle Scholar
  • 18 Nekolla S, Miethaner C, Nguyen N, Ziegler S I, Schwaiger M. Reproducibility of Polar Map Generation, Defect Severity and Extent Assessment in Tomographic Myocardial PET Perfusion Imaging.  Eur J Nucl Med. 1998;  25 1313-1321
    CrossrefPubMedGoogle Scholar
  • 19 DePuey E G, Garcia E V. Updated Imaging Guidelines for Nuclear Cardiology Procedures.  J Nucl Cardiol. 2001;  8 G1-G58
    CrossrefPubMedGoogle Scholar
  • 20 Faber T L, Akers M S, Peshock R M, Corbett J R. Three-dimensional motion and perfusion quantification in gated single-photon emission computed tomograms.  J Nucl Med. 1991;  32 2311-2317
    PubMedGoogle Scholar
  • 21 Liu Y H, Sinusas A J, DeMan P, Zaret B L, Wackers F J. Quantification of SPECT myocardial perfusion images: methodology and validation of the Yale-CQ method.  J Nucl Cardiol. 1999;  6 190-204
    CrossrefPubMedGoogle Scholar
  • 22 Matsunari I, Böning G, Ziegler S I, Kosa I, Nekolla S G, Ficaro E P, Schwaiger M. Attenuation-corrected rest thallium-201/stress technetium- 99m sestamibi myocardial SPECT in Normals.  J Nuc Card. 1998;  5 48-55
    PubMedGoogle Scholar
  • 23 Hendel R C, Corbett J R, Cullom S J. et al . The value and practice of attentuation correction for myocardial perfusion SPECT imaging: a joint position statement from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine.  J Nucl Cardiol. 2002;  9 135-143
    CrossrefPubMedGoogle Scholar
  • 24 Simoes M V, Neverve J, Schwaiger M, Nekolla S G. Nuclear Cardiology Core Laboratory: State of the Art.  HeartDrug. 2003;  3 34-47
    PubMedGoogle Scholar
  • 25 O'Connor M K, Gibbons R J, Juni J E, O'Keefe J, Ali A. Quantitative myocardial SPECT for infarct sizing: feasibility of a multicenter trial evaluated using a cardiac phantom.  J Nucl Med. 1995;  36 1130-1136
    PubMedGoogle Scholar
  • 26 O'Connor M K, Leong L K, Gibbons R J. Assessment of infarct size and severity by quantitative myocardial SPECT: Results from a multicenter study using a cardiac phantom.  J Nucl Med. 2000;  41 1383-1390
    PubMedGoogle Scholar
  • 27 Ohlsson M. WeAidU - a decision support system for myocardial perfusion images using artificial neural networks.  Artif Intell Med. 2004;  30 49-60
    PubMedGoogle Scholar
  • 28 www.WeAidYou.com
  • 29 Buller V G, van der Geest R J, Kool M D, van der Wall E E, de Roos A, Reiber J H. Assessment of regional left ventricular wall parameters from short axis magnetic resonance imaging using a three-dimensional extension to the improved centerline method.  Invest Radiol. 1997;  32 529-533
    CrossrefPubMedGoogle Scholar
  • 30 Keck A, Hertting K, Schwartz Y, Kitzing R, Weber M, Leisner B, Franke C, Bahlmann E, Schneider C, Twisselmann T, Weisbach M, Kuchler R, Kuck K H. Electromechanical mapping for determination of myocardial contractility and viability. A comparison with echocardiography, myocardial single-photon emission computed tomography, and positron emission tomography.  J Am Coll Cardiol. 2002;  40 1067-1074
    CrossrefPubMedGoogle Scholar
  • 31 Khorsand A, Haddad M, Graf S, Deddo Moertl D, Sochor H, Porenta G. Automated Assessment of Dipyridamole 201Tl Myocardial SPECT Perfusion Scintigraphy by Case-Based Reasoning.  J Nuclear Med. 2001;  42 189-193
    PubMedGoogle Scholar
  • 32 Taki J, Fujino S, Nakajima K, Matsunari I, Okazaki H, Saga T, Bunko H, Tonami N. 99mTc-Sestamibi Retention Characteristics During Pharmacologic Hyperemia in Human Myocardium: Comparison with Coronary Flow Reserve Measured by Doppler Flowire.  J Nucl Med. 2001;  42 1457-1463
    PubMedGoogle Scholar

Dr. rer. nat. Stephan G. Nekolla

Nuklearmedizinische Klinik der Technischen Universität München

Ismaningerstr. 22

81675 München

Phone: +49-89-41 40 29 71

Email: s.nekolla@lrz.tu-muenchen.de

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