Vera Froeling MD, Abstract Co-Author: Nothing to Disclose

Alexander Poellinger MD, Abstract Co-Author: Nothing to Disclose

Felix Doellinger, Abstract Co-Author: Nothing to Disclose

Bernd K. Hamm MD, Abstract Co-Author: Research Consultant, Bayer AG Research Consultant, Toshiba Corporation Stockholder, Siemens AG Stockholder, General Electric Company Research Grant, Toshiba Corporation Research Grant, Koninklijke Philips NV Research Grant, Siemens AG Research Grant, General Electric Company Research Grant, Elbit Medical Imaging Ltd Research Grant, Bayer AG Research Grant, Guerbet AG Research Grant, Bracco Group Research Grant, B. Braun Melsungen AG Research Grant, KRAUTH medical KG Research Grant, Boston Scientific Corporation Equipment support, Elbit Medical Imaging Ltd Investigator, CMC Contrast AB

Winfried Brenner, Abstract Co-Author: Research Consultant, Bayer AG

Nils Friedemann Schreiter, Presenter: Nothing to Disclose

The established analysis and quantification of lung function in 2 dimensions (D) is increasingly replaced by a 3D approach. Purpose of this study was to evaluate the influence of attenuation correction (AC) on the 3D analysis and quantification of ventilation/perfusion (V/P) SPECT

21 patients with inhomogeneous pulmonary ventilation and perfusion pattern due to pulmonary emphysema (PE) were scanned with V/P SPECT/CT (Tracer: Tc-99m Technegas and Tc-99m-MAA). The data was analyzed with a software based analysis system (RunPMOD 3.4). Counts per lung lobe (CpLo) were assessed for AC SPECT and non-AC SPECT. Percentages of counts (PC=(CpLo/CpLu)*100) were calculated. Two phycisians for nuclear medicine performed a visual consensus comparison of AC and non-AC SPECT with a 5 point scale (1=low conformity; 5= high conformity). The association between AC and non-AC SPECT was analyzed using Spearman’s Rho correlation coefficient. Differences between AC and non-AC SPECT were tested with the t-test for significance.

The correlation coefficients for P SPECT were: 0.511 (p<0.001) for CpLo; and 0.982 (p<0.001 for PC). The mean difference between PC was 1.31%±1.11% with the highest difference (1.56%±1.99%) in the right lower lobe. Resulting p-values in the t-test were: p= 0.889 for PC; and p<0.001 for count CpLo. The correlation coefficients for V SPECT were: 0.515 (p<0.001) for CpLo; and 0.979 (p<0.001 for PC). The mean difference between PC was 1.48%±1.19% with the highest difference (1.62%±1.77%) in the right middle lobe. Resulting p-values in the t-test were: p= 0.809 for PC; and p<0.001 for CpLo. All AC and non-AC SPECT were rated as highly conform in the visual analysis.    

AC and non-AC SPECT have a high correlation regarding the proportions of lobe based ventilation and perfusion. Analysis and exact quantification of lung function can be performed with non-AC SPECT.

If separate high-resolution chest CT images are available SPECT suffices and SPECT/CT is not necessary when analyzing and quantifying lung function in 3D.

Froeling, V, Poellinger, A, Doellinger, F, Hamm, B, Brenner, W, Schreiter, N, Evaluating the Role of Attenuation Correction in Ventilation/Perfusion SPECT for Analysis and 3D Quantification of Lung Function.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014524.html