The Comparison of Motion Correction Methods in Myocardial Perfusion SPECT

심근관류 SPECT에서 움직임 보정 방법들의 비교

Purpose Patient motion during myocardial perfusion SPECT can produce images that show visual artifacts and perfusion defects. This artifacts and defects remain a significant source of unsatisfactory myocardial perfusion SPECT. Motion correction has been developed as a way to correct and detect the patient motion for reducing artifacts and defects, and each motion correction uses different algorithm. We corrected simulated motion patterns with several motion correction methods and compared those images. Materials and Methods Phantom study was performed. The anthropomorphic torso phantom was made with equal counts from patient's body and simulated defect was added in myocardium phantom for to observe the change in defect. Vertical motion was intentionally generated by moving phantom downward in a returning pattern and in a non-returning pattern throughout the acquisition. In addition, Lateral motion was generated by moving phantom upward in a returning pattern and in a non-returning pattern. The simulated motion patterns were detected and corrected similarly to no-motion pattern image and QPS score, after Motion Detection and Correction Method (MDC), stasis, Hopkins method were applied. Results In phantom study, Changes of perfusion defect were shown in the anterior wall by the simulated phantom motions, and inferior wall's defect was found in some situations. The changes derived from motion were corrected by motion correction methods, but Hopkins and Stasis method showed visual artifact, and this visual artifact did not affect to perfusion score. Conclusion It was confirmed that motion correction method is possible to reduce the motion artifact and artifactual perfusion defect, through the apply on the phantom tests. Motion Detection and Correction Method (MDC) performed better than other method with polar map image and perfusion score result.

심근 관류 SPECT 검사 중 환자의 움직임은 관류 결손과 인공물을 발생시켜 정확한 진단에 영향을 줄 수 있는 인자이다. 움직임으로 왜곡된 데이터를 보정하는 방법으로 움직임 보정방법이 개발되었고 각 방법마다 사용된 알고리즘이 다르기에 상황에 비교하고자 한다. 실험에 사용된 장비는 GE Ventri Gamma Camera와 Anthropomorphic Torso Phantom을 이용하였다. 팬텀을 환자 조건과 동일하게 하기 위하여 심근에 74 kBq/mL, 연부조직 1.1 kBq/mL, 폐 2.6 kBq/mL, 간 9.6 kBq/mL의 Tl-201을 주입하여 제작하고, 움직이는 상황에서 결손의 변화 관찰 목적으로 심근의 Anterior wall에 임의로 결손을 삽입하였다. 움직이지 않는 정상군과 일정간격(2 cm, 3 pixel) 상하 1회 이동, 상하 반복 이동, 좌우 1회 이동, 좌우 반복 이동한 데이터에 나누어 영상 획득하고 MDC, Hopkins, Stasis 방법을 적용하여 Polar map과 정량분석 Score로 비교 하였다. 환자와 동일한 조건으로 회전각 $6^{\circ}$, 50sec/frame으로 영상 획득하고, OSEM (2 iterations, 10 subsets), Butterworth filter (order 10; cutoff frequency; 0.32 cycle per pixel)를 적용, scatter correction, 감쇠보정은 적용하지 않았다. 팬텀 실험에서 세 가지 방법들에서 MDC 방법이 Visual 인공물 없이 잘 보정하였으나, 환자의 데이터에 이를 적용 하였을 때, 환자마다 움직임 보정방법 적용 결과들이 일정하지 않았다. 이는, 환자의 움직임이 일정하지 않고, 장기내의 동위원소의 비율도 다르기에 발생한다고 생각되며 추가적인 연구와 상황에 맞는 움직임 보정방법의 유동적인 사용이 필요하다고 사료된다.