MYOCARDIAL PERFUSION IMAGING (MPI)

SUPERIOR CLINICAL PERFORMANCE, A COMPARISON BETWEEN FILTERED BACKPROJECTION (FBP) AND ASTONISH ITERATIVE RECONSTRUCTION METHOD WITH CARDIAC CATHETERIZATION

Abstract

Objective: Myocardial perfusion imaging (MPI) with superior quality of images
in least acquisition time is imperative for diagnostic purpose. The objective of this study was
to compare the Filter Back Projection (FBP) and half time Astonish reconstruction techniques
in diagnosis of coronary artery disease using cardiac catheterization as gold standard. Place
and period of study: Study was conducted in nuclear cardiology department, at Faisalabad
institute of cardiology, Faisalabad from November 2014 to July2015. Material & Methods:
A total of 60patients (56 + 19years) underwent gated MPI with Tc-99m Sestamibi and 30
patients of these underwent cardiac catheterization as well. Images were reconstructed with
half time Astonish and FBP algorithms. CAD detection, LVEF, perfusion defect comparison
using polar maps and diagnostic performance were calculated. Results: Perfusion defects
calculated through Astonish and FBP techniques were compared and correlated with coronary
angiogram. The sensitivity, specificity and accuracy for detection of CAD in vascular territories
(LAD, LCX & RCA) of the patients were 72%, 41% and 57% with FBP and 86%, 54% and 71%
with Astonish. The calculated LVEF showed good correlation (r = 0.8773) between Astonish
and cardiac catheterization. Conclusion: There were no significant changes in image quality of
Half-time Astonish compared to full-time FBP. Astonish reconstruction showed equal resolution,
reduced background noise and radiation dose. Reduced scanning time will improve patient
scan quality due to less chance of attenuation.