One unique feature of SPECT is the ability to acquire projection data simultaneously from two or more pharmaceuticals each labeled with a radioisotope emitting photons with different energies, allowing simultaneous measurement of multiple physiological processes such as rest/stress perfusion or perfusion/innervation. This may provide additional diagnostic information and, in addition, there are practical advantages such as increased patient throughput, elimination of problems with registration and results in common patient motion in the two studies. However, due to scatter in the patient and ? camera and the poor energy resolution of conventional gamma cameras, dual isotope acquisition will result in crosstalk contamination of the two sets of projection data. The overall goal of this work has been to develop, optimize and evaluate methods for simultaneously acquiring and reconstructing dual isotope images that can reduce the effects of this crosstalk to the point where the images have diagnostic image quality close to that which they would have if acquired separately. In this application, we focus on two specific applications: dual isotope 99mTc stress/201Tl rest myocardial perfusion SPECT and dual isotope 99mTc perfusion/123I innervation myocardial SPECT. In the previous funding cycles, we have characterized the crosstalk and developed compensation methods. Since these methods allow classifying patients into more than two diagnostic classes, e.g., having normal, ischemic or infracted myocardium, we have developed methods for assessing 3-class image. We have also developed simulation tools, including realistic populations of phantoms and fast methods for simulating realistic SPECT data, for use in optimizing and evaluating the simultaneous acquisition and crosstalk compensation methods. Using these simulation tools, we have performed preliminary optimizations and evaluations of the compensation methods. In these, we have demonstrated that the compensation methods significantly reduce the degradation in image quality due to crosstalk and image quality approaching that from separate acquisition. In this application, we propose to perform rigorous optimization and validation of these methods in order to demonstrate their clinical potential and efficacy. Toward this end, we propose to: (1) further develop 3-class methods for rigorous optimization of the simultaneous acquisition methods;(2) further develop and optimize the crosstalk compensation and simultaneous acquisition methods;(3) rigorously validate rigorously the compensation methods using animal and human studies;and (4) explore the feasibility of simultaneous acquisition from three isotopes. Given the frequency of rest/stress myocardial perfusion SPECT, and the prevalence of heart disease, simultaneous acquisition protocols for myocardial SPECT have a high potential for clinical impact. However, rigorous validation is essential before this clinical potential can be realized. The proposed studies have the potential to provide definitive evidence about the utility of simultaneous acquisition methods, and thus to have a significant impact on patient care.

Public Health Relevance

The goal of this project is to develop, optimize, and evaluate methods for imaging two properties of the heart at the same time. In one subproject we will develop methods to image the blood flow in the heart at rest and when the patient has been stressed;in the other we develop methods to image blood flow and areas where the nerves causing the heart to beat are damaged. These methods have the potential to provide better and cheaper diagnosis of heart problems.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
5R01EB000288-13
Application #
7799083
Study Section
Special Emphasis Panel (ZRG1-SBIB-P (02))
Program Officer
Sastre, Antonio
Project Start
1999-02-01
Project End
2012-02-29
Budget Start
2010-03-01
Budget End
2011-02-28
Support Year
13
Fiscal Year
2010
Total Cost
$617,615
Indirect Cost
Name
Johns Hopkins University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
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Ghaly, Michael; Links, Jonathan M; Frey, Eric C (2015) Optimization and comparison of simultaneous and separate acquisition protocols for dual isotope myocardial perfusion SPECT. Phys Med Biol 60:5083-101
Ghaly, Michael; Links, Jonathan M; Frey, Eric (2015) Optimization of energy window and evaluation of scatter compensation methods in myocardial perfusion SPECT using the ideal observer with and without model mismatch and an anthropomorphic model observer. J Med Imaging (Bellingham) 2:
Ghaly, Michael; Du, Yong; Fung, George S K et al. (2014) Design of a digital phantom population for myocardial perfusion SPECT imaging research. Phys Med Biol 59:2935-53
Du, Y; Links, J M; Becker, L et al. (2014) Evaluation of simultaneous 201Tl/99mTc dual-isotope cardiac SPECT imaging with model-based crosstalk compensation using canine studies. J Nucl Cardiol 21:329-40
Du, Yong; Bhattacharya, Manojeet; Frey, Eric C (2014) Simultaneous Tc-99m/I-123 dual-radionuclide myocardial perfusion/innervation imaging using Siemens IQ-SPECT with SMARTZOOM collimator. Phys Med Biol 59:2813-28
He, Xin; Cheng, Lishui; Fessler, Jeffrey A et al. (2011) Regularized image reconstruction algorithms for dual-isotope myocardial perfusion SPECT (MPS) imaging using a cross-tracer prior. IEEE Trans Med Imaging 30:1169-83
Descourt, P; Carlier, T; Du, Y et al. (2010) Implementation of angular response function modeling in SPECT simulations with GATE. Phys Med Biol 55:N253-66
He, Xin; Gallas, Brandon D; Frey, Eric C (2010) Three-class ROC analysis--toward a general decision theoretic solution. IEEE Trans Med Imaging 29:206-15
He, Bin; Frey, Eric C (2010) The impact of 3D volume of interest definition on accuracy and precision of activity estimation in quantitative SPECT and planar processing methods. Phys Med Biol 55:3535-44

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