Because the prevalence of coronary artery disease (CAD) and SPECT 's cost-effectiveness for evaluation of coronary artery disease, cardiac SPECT procedures account for nearly 60% of the 18 millions nuclear imaging performed yearly in the US. However, most SPECT systems used for cardiac studies are not yet optimized for cardiac imaging. As a result, the scope of applications and diagnostic accuracy of the technique have not changed significantly for decades. There is an urgent need to develop improved cardiac SPECT systems and techniques to meet the existing and future demands for clinical and research applications. To address this need, we have developed a new platform - C-SPECT- for cardiac SPECT imaging. It is based on using a large-area contoured detector for efficient detection and a versatile collimator system for effective sampling from a small volume, in which the heart is placed. Our design has many unique provisions to optimize imaging for the majority of patients, and will make adaptive SPECT clinically practical for the first time. It also includes an integrated cost-effective TCT to provide quality attenuation maps for quantitative SPECT imaging. Our long-term goal is to help clinical cardiac SPECT to realize its quantitative imaging potential. Our approach is to improve the performance and expand the clinical functionality of SPECT through optimized instrumentation. In this project, our objective is to develop the first lab-prototype, C-SPECT-I, to realize its superior performance and versatility. We propose this Bioengineering Research Partnership, formed by the two ECT groups of Rush and Penn, to finalize the design and construct the prototype to pave the way for its future conversion to a clinical prototype. The group at Penn will bring their expertise in PET detectors, SPECT collimators, and image reconstruction to complement Rush's system design. This is an academic research collaboration formed to combine hardware and software expertise in PET, SPECT and CT technologies. Our partnership is in an excellent position to take on this project based on both groups'track records in developing ECT systems. We anticipate that the C-SPECT-I will have far more versatility and higher (2-2.5X) geometric efficiency than that of conventional systems at the same system resolution. Recently, the new resolution recovery reconstruction (RRR) techniques have been credited with many folds (3-9X) of increase in effective efficiency without compromising diagnostic quality in several new cardiac SPECT systems. We will implement and optimize the use of these software processing techniques in C-SPECT-I. With optimized hardware and advanced software, the C-SPECT-I could have an unprecedented effective efficiency for cardiac SPECT imaging for the same imaging quality. In addition, with reduced image quality required for fast and dynamic imaging, a gain of an order of magnitude higher sensitivity or speed could be achieved in C-SPECT-I relative to existing systems. We believe that with the potential improvements in performance, versatility and functionality, C-SPECT platform will help break new grounds and lead to improved quality and reduced cost of patient care.

Public Health Relevance

The proposed research is relevant to public health because the proposed C-SPECT-I imaging system, if developed, will improve quality of patient care in the highly demanded area of diagnostic cardiac imaging. Thus, this project is directly relevant to NIH's core mission of improving quality and reducing cost of healthcare, because the potential imaging system will offer unprecedented level of versatility and performance, and with reduced radiation burden to patients.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Biomedical Imaging Technology Study Section (BMIT)
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Buxton, Denis B
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Rush University Medical Center
Schools of Medicine
United States
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Van Audenhaege, Karen; Van Holen, Roel; Vandenberghe, Stefaan et al. (2015) Review of SPECT collimator selection, optimization, and fabrication for clinical and preclinical imaging. Med Phys 42:4796-813