Investigation of dose reduction in cardiac perfusion SPECT via optimization and choice of the image reconstruction strategy

UMMS Affiliation

Department of Radiology

Publication Date


Document Type



Cardiology | Radiology


BACKGROUND: We investigated the extent to which the administered dose (activity) level can be reduced without sacrificing diagnostic accuracy for three reconstruction strategies for SPECT-myocardial perfusion imaging (MPI).

METHODS: We optimized the parameters of the three reconstruction strategies for perfusion-defect detection over a range of simulated administered dose levels using a set of hybrid studies (derived from 190 subjects) consisting of clinical SPECT-MPI data modified to contain realistic simulated lesions. The optimized strategies we considered are filtered backprojection (FBP) with no correction for degradations, ordered-subsets expectation-maximization (OS-EM) with attenuation correction (AC), scatter correction (SC), and resolution correction (RC), and OS-EM with scatter and resolution correction only. Each study was evaluated using a total perfusion deficit (TPD) score computed by the Quantitative Perfusion SPECT (QPS) software package. We conducted a receiver operating characteristics (ROC) study based on the TPD scores for each dose level and reconstruction strategy.

RESULTS: For FBP, the achieved optimum values of the area under the ROC curve (AUC) at 100%, 50%, 25%, and 12.5% of standard dose were 0.75, 0.74, 0.72, and 0.70, respectively, compared to 0.81, 0.79, 0.76, and 0.74 for OS-EM with AC-SC-RC and 0.78, 0.77, 0.74, 0.72 for OS-EM with SC-RC.

CONCLUSIONS: Our results suggest that studies reconstructed by OS-EM with AC-SC-RC could possibly be reduced, on average, to 25% of the originally administered dose without causing diagnostic accuracy (AUC) to decrease below that of FBP.


Myocardial perfusion imaging, SPECT, dose reduction, optimization

DOI of Published Version



J Nucl Cardiol. 2017 May 23. doi: 10.1007/s12350-017-0920-1. Link to article on publisher's site

Journal/Book/Conference Title

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

Related Resources

Link to Article in PubMed

PubMed ID