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Background: The aim of this study was to assess the robustness of cardiacSPECT radiomics features against changes in imaging settings includingacquisition and reconstruction settings.  Methods: Four scanners were used to acquire SPECT scans of a cardiac phantomwith 5mCi of 99mTc. The effects of different image acquisition andreconstruction settings including the Number of View, View Matrix Size,attenuation correction, image reconstruction algorithm, number of iterations,number of subsets, type of filter, full width at half maximum (FWHM) ofGaussian filter, Butterworth filter order, and Butterworth filter cut-off werestudied. In total 5263 different images were reconstructed. Eighty-sevenradiomic features including first, second, and high order textures wereextracted from images. To assess reproducibility and repeatability thecoefficient of variation (COV) was used for each image feature over thedifferent imaging settings.  Result: IDMN and IDN features from GLCM, RP from GLRLM, ZE from GLSZM, and DEfrom GLDM feature sets were the only features that were the most reproducible(COV < 5) against changes in all imaging settings. In addition, the IDMNfeature from GLCM, LALGLE, SALGLE and LGLZE from GLSZM, and SDLGLE from GLDMfeature sets were the features that were less reproducible (COV>20 ) againstchanges in all imaging settings. Matrix size has the greatest impact on featurevariability as most of features are not repeatable and 82.76 of them had(COV>20 ).  Conclusion: Repeatability and reproducibility of SPECT radiomics texturefeatures in different imaging settings is feature-dependent, and differentimage acquisitions and reconstructions have different effects on radiomicstexture features. Low COV radiomics features could be consider for furtherclinical studies.  Keywords: SPECT, Radiomics, Cardiac, Repeatability, Reproducibility

Cardiac SPECT Radiomics Features Repeatability and Reproducibility: A Multi Scanner Phantom Study