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Phantom experiments to improve parathyroid lesion detection
Author(s) -
Nichols Kenneth J.,
Tronco Gene G.,
Tomas Maria B.,
Kunjummen Biju D.,
Siripun Lisa,
Rini Josephine N.,
Palestro Christopher J.
Publication year - 2007
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.2804553
Subject(s) - imaging phantom , nuclear medicine , medicine , lesion , iterative reconstruction , radiology , pathology
This investigation tested the hypothesis that visual analysis of iteratively reconstructed tomograms by ordered subset expectation maximization (OSEM) provides the highest accuracy for localizing parathyroid lesions usingT99 m c ‐sestamibi SPECT data. From an Institutional Review Board approved retrospective review of 531 patients evaluated for parathyroid localization, image characteristics were determined for 85T99 m c ‐sestamibi SPECT studies originally read as equivocal (EQ). Seventy‐two plexiglas phantoms using cylindrical simulated lesions were acquired for a clinically realistic range of counts (mean simulated lesion counts of 75 ± 50 counts ∕ pixel ) and target‐to‐background( T : B )ratios ( range = 2.0 to 8.0 ) to determine an optimal filter for OSEM. Two experienced nuclear physicians graded simulated lesions, blinded to whether chambers contained radioactivity or plain water, and two observers used the same scale to read all phantom and clinical SPECT studies, blinded to pathology findings and clinical information. For phantom data and all clinical data, T : B analyses were not statistically different for OSEM versus FB, but visual readings were significantly more accurate than T : B ( 88 ± 6 % versus 68 ± 6 % , p = 0.001 ) for OSEM processing, and OSEM was significantly more accurate than FB for visual readings ( 88 ± 6 % versus 58 ± 6 % , p < 0.0001 ). These data suggest that visual analysis of iteratively reconstructed MIBI tomograms should be incorporated into imaging protocols performed to localize parathyroid lesions.