The Difference Among Stress and Rest Normal Reference Databases Using Non-Corrected, Scatter Corrected, and Scatter with Attenuation Corrected Bull’s Eye Myocardial Perfusion Scintigraphy in Both Genders
Supatporn Tepmongkol MD*, Panya Pasawang MSc*, Anchali Krisanachinda PhD*, Suphot Srimahachota MD**
Affiliation : * Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chulalongkorn University ** Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University
Objectives : To compare 3 types of Bull’s eye normal reference maps; non-corrected, scatter corrected, and
scatter with attenuation corrected Bull’s eye in both genders.
Materials and Methods : Sixty-seven normal healthy males and females volunteered for the present study. After
screening tests to identify low post-test (exercise EKG) likelihood of coronary artery disease, 41 subjects (20
males and 21 females) had stress and rest myocardial perfusion scintigraphy (99mTc-sestamibi). The data were
reconstructed by filtered back projection reconstruction in three ways as follows; 1) non-correction (NoC), 2)
scatter elimination only (SC), 3) scatter elimination and attenuation correction (SC+AC). Three sets of
reconstructed data of both stress and resting studies were added into 6 sets of Bull’s eye. The data of each Bull’s
eye were normalized to 100% of the maximum count. Percentage of uptake in each area was compared by t-test
statistics.
Results : Stress and rest count distribution of NoC and SC sets were lowest at the inferior wall, followed by the
septal wall, anterior wall, and lateral wall in both genders. In the SC+AC sets, septum and lateral walls
showed more uptake than anterior and inferior walls. A significant difference of percentage uptake between
stress and rest images at septum in NoC and SC images in male and in SC image in female was observed. No
difference was seen in the SC+AC groups.
Conclusion : There was similarity of count distribution between NoC and SC images. SC+AC caused more
uniform image. However, some non-uniformity was observed. The use of sex-independent SC+AC bull’s eye is
possible. Stress study can be omitted for bull’s eye collection of normal files.
Keywords : Myocardial perfusion imaging, Normal database, Bull’s eye, Scatter elimination, Attenutation correction
