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研究生:楊佑文
研究生(外文):YU-WEN YANG
論文名稱:呼吸運動對心臟灌注單光子斷層掃描的影響
論文名稱(外文):Effect of Respiratory Motion on Myocardial Perfusion Single Photon Emission Computed Tomography
指導教授:陳志成陳志成引用關係
指導教授(外文):Jyh-Cheng Chen
學位類別:博士
校院名稱:國立陽明大學
系所名稱:生物醫學影像暨放射科學系暨研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:148
中文關鍵詞:呼吸運動心臟灌注單光子斷層掃描OSEM疊代式演算法NCAT假體
外文關鍵詞:respiratory motionmyocardial perfusion SPECTchannelized Hotelling observerOS-EMNCAT phantom
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  • 被引用被引用:0
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  • 收藏至我的研究室書目清單書目收藏:1
本研究的目的是利用一個包含病患變異性的假體群組,來評估呼吸運動對Tc-99m Sestamibi心臟灌注單光子斷層掃描影像的缺損區域的偵測能力的影響。評估的對象包含了三種呼吸模式:閉氣,輕微加強的正常呼吸,以及深呼吸。對於每一種呼吸模式,分別產生了6個4維的NCAT假體,每一個假體的解剖構造都不相同;模擬中並在前壁、左側壁以及下壁產生不同對比與大小的心臟缺損。利用一個解析投影器產生無雜訊的單光子斷層掃描投影資料後,再將poisson雜訊加入,以產生包含雜訊的投影資料。投影資料利用OSEM疊代式演算法加以重建,重建的疊代次數包含1、2、3、5、7及10次的疊代,每次疊代的子集數目則包含1 及4個。包含心臟缺損質心的短軸影像在被截取出來後,利用CHO (channelized Hotelling observe) 數位觀察者來計算其缺損偵測能力。
CHO的結果顯示,ROC (Receiver Operating Characteristic)曲線的AUC (Area Under the Curve)值受到呼吸幅度的影響。不論缺損的大小與對比,隨著呼吸幅度的增加,代表最大偵測能力的最大AUC值都會隨之減少。在比較靜止呼吸時的最大AUC值時,不同部位之間的偵測能力的排序則為前壁最佳、左側壁其次、下壁則為最差。當呼吸幅度增加時,呼吸運動對於左側壁的影響大於另外兩個部位。相較於大的缺損的偵測,當呼吸幅度增加時,小的缺損的AUC值下降的比較快,顯示呼吸對其有比較顯著的負面影響。
利用這個研究,我們顯示了呼吸運動會影響到心臟灌注單光子斷層掃描的缺損偵測能力,而為了改善其偵測能力,影像擷取方法的最佳化與呼吸運動校正方法的發展是必要的。
The objective of this study was to investigate the effects of respiratory motion (RM) on defect detection in Tc-99m sestamibi myocardial perfusion SPECT (MPS) using a phantom population that includes patient variability. Three RM patterns were included, namely breath-hold, slightly enhanced normal breathing, and deep breathing. For each RM pattern, six 4-D NCAT phantoms were generated, each with anatomical variations. Anterior, lateral and inferior myocardial defects with different sizes and contrasts were inserted. Noise-free SPECT projections were simulated using an analytical projector. Poisson noise was then added to generate noisy realizations. The projection data were reconstructed using the OS-EM algorithm with 1 and 4 subsets/iteration and with 1, 2, 3, 5, 7, and 10 iterations. Short-axis images centered at the centroid of the myocardial defect were extracted, and the channelized Hotelling observer (CHO) was applied for the detection of the defect. The CHO results show that the value of the area under the receiver operating characteristics (ROC) curve (AUC) is affected by the RM amplitude. For all the defect sizes and contrasts studied, the highest or optimal AUC values indicate maximum detectability decrease with the increase of the RM amplitude. With no respiration, the ranking of the optimal AUC value in decreasing order is anterior then lateral, and finally inferior defects. The AUC value of the lateral defect drops more severely as the RM amplitude increases compared to other defect locations. Furthermore, as the RM amplitude increases, the AUC values of the smaller defects drop more quickly than the larger ones. We demonstrated that RM affects defect detectability of MPS imaging. The results indicate that developments of optimal data acquisition methods and RM correction methods are needed to improve the defect detectability in MPS.
TABLE OF CONTENTS Page
中文摘要 ii
ABSTRACT iii
ACKNOWLEDGEMENTS iv
LIST OF TABLES viii
LIST OF FIGURES ix
LIST OF ABBREVIATIONS xi
CHAPTER 1 INTRODUCTION 14
1.1 Background 14
1.2 Motivation 16
1.3 Objectives 19
1.4 Significance 20
1.5 Organization 21
CHAPTER 2 COMPUTED TOMOGRAPHY AND SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY 22
2.1 Tomography Technique 22
2.2 Single Photon Emission Computed Tomography (SPECT) 26
2.2.1 Nuclear Medicine Imaging 26
2.2.2 Data Collection of SPECT 28
2.2.3 Image Degrading Factors of SPECT 30
2.2.4 Image Reconstruction in SPECT 33
2.2.4.1 Filtered Backprojection (FBP) Method 34
2.2.4.2 ML-EM (Maximum Likelihood-Expectation Maximization (ML-EM) and Ordered-Subsets-Expectation Maximization (OS-EM) Algorithms 36
2.3 Computed Tomography (CT) 38
2.3.1 Principles of X-ray CT Imaging 38
2.3.2 Image Reconstruction in Transmission Computed Tomography (TCT) 39
2.4 Tc-99m Sestamibi Myocardial Perfusion SPECT 40
2.4.1 Myocardial Kinetics of Tc-99m Sestamibi 41
2.4.2 Acquisition Protocol of Tc-99m Sestamibi Perfusion SPECT 42
CHAPTER 3 RESPIRATORY MOTION 44
3.1 Respiratory Mechanism 44
3.2 Bull’s Eyes Quantitative Method 47
3.3 Effects of Patient Motion on Myocardial Perfusion SPECT 48
3.4 Effects of Respiratory Motion on Myocardial Perfusion SPECT 51
3.5 Effects of Respiratory Motion on Myocardial Perfusion SPECT/CT 54
3.6 Respiratory Motion Correction Methods in Cardiac Emission Study 57
3.6.1 Respiratory Gating 57
3.6.2 Respiratory Motion-Correction Algorithm 60
3.6.3 Stereo-Infrared Tracking System 63
3.6.4 Non-Gated Motion Estimation and Reconstruction 65
CHAPTER 4 NURBS-BASED CARDIAC-TORSO (NCAT) PHANTOM 66
4.1 Computational Anthropomorphic Phantoms 66
4.2 Mathematical Cardiac-Torso (MCAT) Phantom 71
4.3 Mathematical Basis of Non-Uniform Rational B-Spline (NURBS) 77
4.4 Development of the NCAT Phantom 82
4.4.1 Modeling of the Torso 83
4.4.2 Modeling of the Cardiac Motion 85
4.4.3 Modeling of the Respiratory Motion 87
CHAPTER 5 OBSERVER EVALUATION OF IMAGE QUALITY 89
5.1 Methods to Evaluate Image Quality 89
5.2 Receiver Operating Characteristic (ROC) Methodology 92
5.2.1 Basic Principles of Binary Decision Making 92
5.2.2 Receiver Operating Characteristic (ROC) Curve 94
5.2.3 Rating Method 95
5.2.4 Binormal Model for ROC Curves 96
5.3 Observers 100
5.3.1 Human Observer 101
5.3.2 Mathematical Observer 101
5.3.2.1 Ideal Observer 103
5.3.2.2 Linear Observer 104
5.3.2.3 Non-prewhitening (NPW) Observer 104
5.3.2.4 Prewhitening (PW) Observer 105
5.3.2.4 Hotelling Observer 105
5.3.2.5 Channelized Hotelling Observer (CHO) 107
5.3.2.6 Signal-to-Noise Ratio Associated with Test Statistic 110
CHAPTER 6 EVALUATION OF RESPIRATORY MOTION EFFECT ON MYOCARDIAL PERFUSION SPECT 112
6.1 Introduction 112
6.2 Methods 113
6.2.1 Phantoms 114
6.2.2 Projection Data Simulation 116
6.2.3 Image Reconstruction and Processing 117
6.2.4 Implementation of the Channelized Hotelling Observer 117
6.3 Results 119
6.3.1 Effects of Respiratory Amplitude 119
6.3.2 Effects of Defect Location 123
6.3.3 Effects of Defect Size 124
6.3.4 Effects of Defect Contrast 126
6.4 Discussion 127
6.5 Conclusion 129
CHAPTER 7 CONCLUSION AND FUTURE WORKS 130
7.1 Conclusion 130
7.2 Future Works 131
REFERENCES 133
PUBLICATION LIST 147
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