# Attenuation correction strategies for myocardial perfusion imaging using dual-gated SPECT

> **NIH NIH R15** · UNIVERSITY OF TEXAS ARLINGTON · 2020 · $472,225

## Abstract

Summary
Myocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) is a
prevalent clinical tool in diagnosis and prognosis of coronal artery disease (CAD). Dual cardiac-respiratory
gated SPECT (D-SPECT) has been proposed long ago to eliminate artifacts from patient's cardiac and
respiratory motion, but elevated noise and lack of evidence for diagnostic benefit over processing complexity
hamper its clinical adoption. Cardiac ECG-gated SPECT (C-SPECT) remains the mainstream enabling the
assessment of left-ventricular (LV) functions. Advanced 4D reconstruction with superior denoising ability
resurrects interests in D-SPECT recently. Meanwhile, attenuation correction (AC) is essential for quantitative
MPI and minimizing false positives. However, AC artifacts can arise when SPECT images are mismatched with
attenuation maps derived from the hybrid SPECT/CT scanner. This becomes another major hurdle for D-
SPECT because the accompanied cone-beam CT (CBCT) yields only one non-respiratory-gated 3D CT image.
To address these issues, we propose a novel SPECT MPI protocol: D-SPECT with motion matched AC (D-
SPECT-MAC), which will minimize SPECT MPI artifacts. The motion-matched attenuation maps can be
obtained by a general simultaneous motion estimation and image reconstruction (G-SMEIR) method and D-
SPECT images without changing low-dose CBCT imaging. Founded on our success on 4D spatiotemporal
reconstruction and artifact-correction methods for both SPECT and CBCT and experience collecting D-SPECT
data for more than 1,500 patients, with advances in development of realistic computational human phantoms
and computer power, it is time to systematically evaluate D-SPECT-MAC using a mass simulation study
backed by a patient study to provide the urgently needed evidence for use of D-SPECT. We hypothesize that
D-SPECT-MAC can significantly improve perfusion defect detection and LV functional assessment, compared
to two other protocols: popular C-SPECT with averaged AC over respiratory cycles (C-SPECT-AAC) and
emerging D-SPECT with averaged AC (D-SPECT-AAC). Our hypothesis will be tested through the following
specific aims: 1) To evaluate performance of three SPECT MPI protocols using a mass simulation study of
5,000 virtual patients from the XCAT phantom program; 2) To develop D-SPECT-MAC for clinical data and to
verify simulation findings using 150 patient data sets retrospectively selected.
The success of this project will lead to artifact-free SPECT MPI, which enables use of only one set of faithfully
corrected MPI images instead of visual reading both non-corrected and AC images in the current clinical
practice, thus significantly improving diagnostic accuracy, reproducibility, and clinical workflow. Furthermore,
this project will provide opportunities for under-represented students at the PI's institute to be professionally
trained and to gain precious experience on medical imaging research with clinical collaborators at medi...

## Key facts

- **NIH application ID:** 10046939
- **Project number:** 1R15HL150708-01A1
- **Recipient organization:** UNIVERSITY OF TEXAS ARLINGTON
- **Principal Investigator:** Mingwu Jin
- **Activity code:** R15 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $472,225
- **Award type:** 1
- **Project period:** 2020-08-05 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10046939

## Citation

> US National Institutes of Health, RePORTER application 10046939, Attenuation correction strategies for myocardial perfusion imaging using dual-gated SPECT (1R15HL150708-01A1). Retrieved via AI Analytics 2026-07-28 from https://api.ai-analytics.org/grant/nih/10046939. Licensed CC0.

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