Wiener filter improves diagnostic accuracy of CAD SPECT images-comparison to angiography and CT angiography

Optimization of smoothing parameter for block matching and 3D filtering algorithm in low-dose chest and abdominal computed tomography images

Computed tomography (CT), known for its exceptionally high accuracy, is associated with a substantial dose of ionizing radiation. Low-dose protocols have been devised to address this issue; however, a reduction in the radiation dose can lead to a deficiency in the number of photons, resulting in quantum noise. Thus, the aim of this study was to optimize the smoothing parameter (σ-value) of the block matching and 3D filtering (BM3D) algorithm to effectively reduce noise in low-dose chest and abdominal CT images. Acquired images were subsequently analyze using quantitative evaluation metrics, including contrast to noise ratio (CNR), coefficient of variation (CV), and naturalness image quality evaluator (NIQE). Quantitative evaluation results demonstrated that the optimal σ-value for CNR, CV, and NIQE were 0.10, 0.11, and 0.09 in low-dose chest CT images respectively, whereas those in abdominal images were 0.12, 0.11, and 0.09, respectively. The average of the optimal σ-values, which produced the most improved results, was 0.10, considering both visual and quantitative evaluations. In conclusion, we demonstrated that the optimized BM3D algorithm with σ-value is effective for noise reduction in low-dose chest and abdominal CT images indicating its feasibility of in the clinical field.

Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention in Hutchinson-Gilford Progeria

Hutchinson-Gilford progeria syndrome is an extremely rare genetic disease caused by a de novo mutation in the LMNA gene, leading to an accumulation of a form of Lamin A, called Progerin, which results in a typical phenotype and a marked decrease in life expectancy, due to early atherosclerosis and cardiovascular disease. We report the case of a fourteen-year-old Chinese boy with Hutchinson-Gilford progeria syndrome admitted to the emergency room because of precordial pain. Physical examination showed tachycardia 130 beats/min and arterial hypertension: 170/120 mmHg, normal respiratory rate, no neurological impairment; ECG evidenced sinus tachycardia, left ventricular hypertrophy, horizontal ST-segment depression in I, aVL, II, III, aVF leads, and V4-V6 and ST-segment elevation in aVR and V1 leads. Echocardiography highlighted preserved global left ventricular function with concentric hypertrophy, altered diastolic flow pattern, mitral valve insufficiency, and minimal aortic regurgitation. Blood tests evidenced an increase in high-sensitivity troponin T level (335 pg/mL). NSTEMI diagnosis was performed, and the patient was admitted to the intensive care unit. A coronary CT angiography showed a severe obstruction of the common trunk of the left coronary artery, for which an urgent percutaneous coronary intervention (PCI) was proposed. A selective coronary angiography imaged complete chronic occlusion of the left main coronary artery as well as severe stenosis at the origin of a very enlarged right coronary artery that vascularized the left coronary artery through collaterals. Afterwards, the right coronary artery was probed using an Amplatz right (AR1) guiding catheter, through which a large 3.5 mm drug-eluting coronary stent (Xience Sierra, Abbott, Abbott Park, IL, USA) was implanted. At the end of the procedure, no residual stenosis was imaged and improved vascularization of the left coronary artery distribution segments was observed. Dual antiplatelet therapy (DAPT) consisting of aspirin (75 mg daily) and clopidogrel (37.5 mg daily) and anti-hypertensive therapy were started. At the one-year follow-up, the patient had not reported any occurrence of anginal chest pain.

Myocardial Perfusion Single-Photon Emission Computed Tomography (SPECT) Image Denoising: A Comparative Study

The present study aimed to evaluate the effectiveness of different filters in improving the quality of myocardial perfusion single-photon emission computed tomography (SPECT) images. Data were collected using the Siemens Symbia T2 dual-head SPECT/Computed tomography (CT) scanner. Our dataset included more than 900 images from 30 patients. The quality of the SPECT was evaluated after applying filters such as the Butterworth, Hamming, Gaussian, Wiener, and median-modified Wiener filters with different kernel sizes, by calculating indicators such as the signal-to-noise ratio (SNR), peak signal-to-noise ratio (PSNR), and contrast-to-noise ratio (CNR). SNR and CNR were highest with the Wiener filter with a kernel size of 5 × 5. Additionally, the Gaussian filter achieved the highest PSNR. The results revealed that the Wiener filter, with a kernel size of 5 × 5, outperformed the other filters for denoising images of our dataset. The novelty of this study includes comparison of different filters to improve the quality of myocardial perfusion SPECT. As far as we know, this is the first study to compare the mentioned filters on myocardial perfusion SPECT images, using our datasets with specific noise structures and mentioning all the elements necessary for its presentation within one document.

Comparing Different Algorithms for the Pseudo-Coloring of Myocardial Perfusion Single-Photon Emission Computed Tomography Images

Single-photon emission computed tomography (SPECT) images can significantly help physicians in diagnosing patients with coronary artery or suspected coronary artery diseases. However, these images are grayscale with qualities that are not readily visible. The objective of this study was to evaluate the effectiveness of different pseudo-coloring algorithms of myocardial perfusion SPECT images. Data were collected using a Siemens Symbia T2 dual-head SPECT/computed tomography (CT) scanner. After pseudo-coloring, the images were assessed both qualitatively and quantitatively. The qualities of different pseudo-color images were examined by three experts, while the images were evaluated quantitatively by obtaining indices such as mean squared error (MSE), peak signal-to-noise ratio (PSNR), normalized color difference (NCD), and structure similarity index metric (SSIM). The qualitative evaluation demonstrated that the warm color map (WCM), followed by the jet color map, outperformed the remaining algorithms in terms of revealing the non-visible qualities of the images. Furthermore, the quantitative evaluation results demonstrated that the WCM had the highest PSNR and SSIM but the lowest MSE. Overall, the WCM could outperform the other color maps both qualitatively and quantitatively. The novelty of this study includes comparing different pseudo-coloring methods to improve the quality of myocardial perfusion SPECT images and utilizing our collected datasets.

Evaluation of qualitative and quantitative data of Y-90 imaging in SPECT/CT and PET/CT phantom studies

Introduction

We aimed to assess the feasibility of SPECT and PET Y-90 imaging, and to compare these modalities by visualizing hot and cold foci in phantoms for varying isotope concentrations.

Materials and methods

The data was acquired from the Jaszczak and NEMA phantoms. In the Jaszczak phantom Y-90 concentrations of 0.1 MBq/ml and 0.2 MBq/ml were used, while higher concentrations, up to 1.0 MBq/ml, were simulated by acquisition time extension with respect to the standard clinical protocol of 30 sec/projection for SPECT and 30 min/bed position for PET imaging. For NEMA phantom, the hot foci had concentrations of about 4 MB/ml and the background 0.1 or 0.0 MBq/ml. All of the acquired data was analysed both qualitatively and quantitatively. Qualitative assessment was conducted by six observers asked to identify the number of visible cold or hot foci. Inter-observer agreement was assessed. Quantitative analysis included calculations of contrast and contrast-to-noise ratio (CNR), and comparisons with the qualitative results.

Results

For SPECT data up to two cold foci were discernible, while for PET four foci were visible. We have shown that CNR (with Rose criterion) is a good measure of foci visibility for both modalities. We also found good concordance of qualitative results for the Jaszczak phantom studies between the observers (corresponding Krippendorf’s alpha coefficients of 0.76 to 0.84).

In the NEMA phantom without background activity all foci were visible in SPECT/CT images. With isotope in the background, 5 of 6 spheres were discernible (CNR of 3.0 for the smallest foci). For PET studies all hot spheres were visible, regardless of the background activity.

Conclusions

PET Y-90 imaging provided better results than Bremsstrahlung based SPECT imaging. This indicates that PET/CT might become the method of choice in Y-90 post radioembolization imaging for visualisation of both necrotic and hot lesions in the liver.