A phantom study for the evaluation of the effect of the high uptake in the liver on technetium-99m myocardial perfusion SPECT images

The purpose of this study was to evaluate influences of the high hepatic uptake on parameters such as filtering, attenuation coefficient, and scatter correction at reconstructing of the myocardial SPECT images. Hepatic and cardiac spaces of a myocardial phantom (RH-2, Kyoto Kagaku), were filled with technetium-99m and a three-detector SPECT system (GCA 9300-DI, TOSHIBA) was used. The hepatic activity's influence was estimated from a qualitative percent regional scattering and the effects of attenuation and scatter correction were evaluated by a circumferential profile curve. Percent regional scattering increased in reverse to hepato-cardiac distance (HCD) and in proportion to hepatic to cardiac activity ratio (HCR). This tendency was observed the most significantly in the inferior region, followed by in the lateral, anterior and septal regions, declining in this order. An artifactual defect adjacent to the liver was observed when HCR is three and HCD is zero. However, when the Butterworth filter was used with small filtering-sizes and lower orders in combination with attenuation and scatter correction, the defects were decreased up to 15% at counts in the inferior region. This study showed that the hepatic to cardiac activity ratio, and the hepato-cardiac distance should be considered for reconstruction of the SPECT images. (author)