V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps

Background: V/Q SPECT/CT is attractive for regional lung function assessment, but accurate delineation and quantification of functional lung volumes remains a challenge. Physiological intra and inter patient non-uniformity of V/Q SPECT images make conventional delineation methods of functional lung...

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Main Authors: David Bourhis, Philippe Robin, Marine Essayan, Ronan Abgral, Solène Querellou, Cécile Tromeur, Pierre-Yves Salaun, Pierre-Yves Le Roux
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-04-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fmed.2020.00143/full
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author David Bourhis
David Bourhis
Philippe Robin
Philippe Robin
Marine Essayan
Ronan Abgral
Ronan Abgral
Solène Querellou
Cécile Tromeur
Cécile Tromeur
Pierre-Yves Salaun
Pierre-Yves Salaun
Pierre-Yves Le Roux
Pierre-Yves Le Roux
author_facet David Bourhis
David Bourhis
Philippe Robin
Philippe Robin
Marine Essayan
Ronan Abgral
Ronan Abgral
Solène Querellou
Cécile Tromeur
Cécile Tromeur
Pierre-Yves Salaun
Pierre-Yves Salaun
Pierre-Yves Le Roux
Pierre-Yves Le Roux
author_sort David Bourhis
collection DOAJ
description Background: V/Q SPECT/CT is attractive for regional lung function assessment, but accurate delineation and quantification of functional lung volumes remains a challenge. Physiological intra and inter patient non-uniformity of V/Q SPECT images make conventional delineation methods of functional lung volumes inaccurate. In that context it would be of interest to build statistical maps of normal V/Q SPECT to assess the physiological variability of radiotracers. The aim of this study was to generate normal mean and standard deviation maps of regional lung function as assessed with V/Q SPECT/CT, with (AC) and without (NoAC) attenuation correction.Methods: During a 13 month period, 73 consecutive patients referred for suspected acute pulmonary embolism, that had normal V/Q SPECT/CT based on the interpretation of 2 independent nuclear medicine physicians, were selected. Four set of images were reconstructed: perfusion and ventilation images, AC, and NoAC, respectively. Statistical maps were created as follows: all cases were registered to a reference scan using the CT data, first with a rigid then with a non-rigid method. SPECTs reconstructions were then co-registered and normalized, and mean and standard deviation voxel-wise maps were calculated. To assess the consistency of generated maps to lung physiology and the potential impact of non-rigid registration, visual analysis and quantitative comparison with non-registered data were performed in the whole series. Quantitative comparison was also conducted in two randomly sampled independent subsets.Results: Perfusion mean maps showed a continuous negative posterior to anterior gradient, majored on the AC mean map. Perfusion standard deviation maps showed higher variability in the periphery of the lungs, but especially in the posterior areas. The ventilation mean map showed a slightly positive posterior to anterior gradient on NoAC mean ventilation map, while the AC mean map showed no gradient. The NoAC ventilation SD map showed a higher variability in the periphery of the lungs as compared with AC SD map. No statistical difference in the posterior to anterior gradient measurements was found between the generated mean statistical maps and the non-registered data, either in the whole series or across the two independent datasets.Conclusion: We proposed a methodology to create statistical normal maps for V/Q SPECTs. Maps were consistent with the known physiological non-uniformity and showed the impact of attenuation correction on the posterior to anterior gradient. These maps could be used for a Z-score analysis, and a better segmentation of healthy uptake areas.
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spelling doaj.art-adbdd2a3f01d4af0968c7c335331f20a2022-12-22T00:19:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-04-01710.3389/fmed.2020.00143510949V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D MapsDavid Bourhis0David Bourhis1Philippe Robin2Philippe Robin3Marine Essayan4Ronan Abgral5Ronan Abgral6Solène Querellou7Cécile Tromeur8Cécile Tromeur9Pierre-Yves Salaun10Pierre-Yves Salaun11Pierre-Yves Le Roux12Pierre-Yves Le Roux13Service de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceService de Pneumologie, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceService de Médecine Nucléaire, Centre Hospitalier Régional Universitaire de Brest, Brest, FranceEA3878 GETBO, Université de Bretagne Occidentale, Brest, FranceBackground: V/Q SPECT/CT is attractive for regional lung function assessment, but accurate delineation and quantification of functional lung volumes remains a challenge. Physiological intra and inter patient non-uniformity of V/Q SPECT images make conventional delineation methods of functional lung volumes inaccurate. In that context it would be of interest to build statistical maps of normal V/Q SPECT to assess the physiological variability of radiotracers. The aim of this study was to generate normal mean and standard deviation maps of regional lung function as assessed with V/Q SPECT/CT, with (AC) and without (NoAC) attenuation correction.Methods: During a 13 month period, 73 consecutive patients referred for suspected acute pulmonary embolism, that had normal V/Q SPECT/CT based on the interpretation of 2 independent nuclear medicine physicians, were selected. Four set of images were reconstructed: perfusion and ventilation images, AC, and NoAC, respectively. Statistical maps were created as follows: all cases were registered to a reference scan using the CT data, first with a rigid then with a non-rigid method. SPECTs reconstructions were then co-registered and normalized, and mean and standard deviation voxel-wise maps were calculated. To assess the consistency of generated maps to lung physiology and the potential impact of non-rigid registration, visual analysis and quantitative comparison with non-registered data were performed in the whole series. Quantitative comparison was also conducted in two randomly sampled independent subsets.Results: Perfusion mean maps showed a continuous negative posterior to anterior gradient, majored on the AC mean map. Perfusion standard deviation maps showed higher variability in the periphery of the lungs, but especially in the posterior areas. The ventilation mean map showed a slightly positive posterior to anterior gradient on NoAC mean ventilation map, while the AC mean map showed no gradient. The NoAC ventilation SD map showed a higher variability in the periphery of the lungs as compared with AC SD map. No statistical difference in the posterior to anterior gradient measurements was found between the generated mean statistical maps and the non-registered data, either in the whole series or across the two independent datasets.Conclusion: We proposed a methodology to create statistical normal maps for V/Q SPECTs. Maps were consistent with the known physiological non-uniformity and showed the impact of attenuation correction on the posterior to anterior gradient. These maps could be used for a Z-score analysis, and a better segmentation of healthy uptake areas.https://www.frontiersin.org/article/10.3389/fmed.2020.00143/fullV/Q SPECTlung functionregistrationZ-scorequantification
spellingShingle David Bourhis
David Bourhis
Philippe Robin
Philippe Robin
Marine Essayan
Ronan Abgral
Ronan Abgral
Solène Querellou
Cécile Tromeur
Cécile Tromeur
Pierre-Yves Salaun
Pierre-Yves Salaun
Pierre-Yves Le Roux
Pierre-Yves Le Roux
V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
Frontiers in Medicine
V/Q SPECT
lung function
registration
Z-score
quantification
title V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
title_full V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
title_fullStr V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
title_full_unstemmed V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
title_short V/Q SPECT for the Assessment of Regional Lung Function: Generation of Normal Mean and Standard Deviation 3-D Maps
title_sort v q spect for the assessment of regional lung function generation of normal mean and standard deviation 3 d maps
topic V/Q SPECT
lung function
registration
Z-score
quantification
url https://www.frontiersin.org/article/10.3389/fmed.2020.00143/full
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