Reducing radiation dose in rest-stress cardiac PET/CT by single poststress cine CT for attenuation correction: Quantitative validation

被引:26
作者
Gould, K. Lance [1 ]
Pan, Tinsu [2 ]
Loghin, Catalin
Johnson, Nils P. [5 ]
Sdringola, Stefano [3 ,4 ]
机构
[1] Univ Texas Houston, Sch Med, Weatherhead PET Ctr Prevent & Reversing Atheroscl, Houston, TX 77030 USA
[2] Univ Texas Houston, MD Anderson Canc Ctr, Imaging Phys Dept, Houston, TX 77030 USA
[3] Univ Texas Houston, Sch Med, Weatherhead PET Ctr, Houston, TX 77030 USA
[4] Univ Texas Houston, Sch Med, Dept Med, Div Cardiol, Houston, TX 77030 USA
[5] Northwestern Univ, Dept Med, Div Cardiol, Chicago, IL USA
关键词
positron emission tomography; cardiac PET-CT; radiation dose; attenuation correction;
D O I
10.2967/jnumed.107.049163
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Cardiac PET/CT is optimized by cine CT with dedicated shift software for manual correction of attenuation-emission misregistration. Separate rest and stress CT scans incur greater radiation dose to patients than does standard helical PET/CT or "pure" PET using rotating rod attenuation sources. To reduce radiation dose, we tested quantitative accuracy of using a single poststress cine CT attenuation scan for reconstructing rest perfusion images to eliminate resting CT attenuation scans. Methods: A total of 250 consecutive patients underwent diagnostic rest-dipyridamole myocardial perfusion PET/CT with Rb-82 and a 16-slice PET/CT scanner using averaged cine CT attenuation data during breathing at rest and stress. After correcting for any attenuation-emission misregistration, we quantitatively compared resting perfusion images reconstructed using rest cine CT attenuation data with the same resting emission data reconstructed with poststress cine CT attenuation data. Automated software quantifying average regional quadrant activity, severity, size, and combined size and severity of perfusion defects was used for this comparison. Results: Resting perfusion images reconstructed using rest cine CT attenuation data were quantitatively comparable to resting images reconstructed with poststress cine CT attenuation data with no clinically significant differences. Twenty-five (10%) of 250 cases required shifting of stress cine CT attenuation data to achieve optimal attenuation-emission coregistration with resting perfusion data. Eliminating rest CT attenuation scans reduced CT radiation dose by 50% below rest-plus-stress cine CT protocols. Conclusion: Resting perfusion images reconstructed using poststress cine CT attenuation data are quantitatively comparable to resting images reconstructed with resting cine CT attenuation data. Eliminating the rest CT scan reduces CT radiation dose by 50%.
引用
收藏
页码:738 / 745
页数:8
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