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Chapter 11 / Display and Analysis of Planar MPI 131The basic principles of planar quantification are similar for each ofthese software packages. Raw planar projection images are corrected fordifferences in background activity on rest and stress images by theapplication of interpolative background subtraction.Normalized relative radiotracer uptake in the background subtractedleft ventricular images is subsequently quantitatively compared withnormal data files. Relative radiotracer uptake on planar images can bedisplayed in different ways (2–4). In our laboratory we preferred circumferentialcount distribution profiles (4). The size of myocardial perfusiondefects can be expressed as percentage of the total potentially visualizednormal left ventricle.EXAMPLE OF QUANTIFICATION OF PLANAR IMAGESFigures 11-6–11-8 show representative screen captures of quantificationof exercise-delayed Tl-201 images of a patient with a reversibleanteroseptal defect (shown in Figs. 11-1 and 11-2) using softwaredeveloped in our laboratory (4).(Fig. 11-6. continued) subtraction and small square ROIs for lung/heart (HRT)ratio calculation. Lung/HRT ratio is abnormal at 0.54. Below in the same left toppanel are the resulting background-corrected LAO images. On the top right arecircumferential count profiles (exercise, white dots; rest, black dots) forquantification of defect size, displayed against the lower limit of normalTl-201 uptake (white curve). Defect reversibility is quantified in the septal area(exercise defect is 12 and rest defect is 5). The lower right panel shows agraphic display of regional Tl-201 washout. Tl-201 washout is low in theseptal region. The lower left panel shows functional images. In the top leftimage (ABN.POS.REDIST.), the background-corrected exercise image issubtracted pixel-by-pixel from the background-corrected rest image. The differencebetween the two images (=defect reversibility) is displayed as positivevalues in the septal area. To the right of this image (ABN.REV.REDIST), therest image is subtracted from the exercise image. If reverse redistribution waspresent, this would show as positive values. The bottom image displays Tl-201washout on a pixel-by-pixel basis. The darker area in the inferoseptal regionindicates low washout.
132 <strong>Nuclear</strong> <strong>Cardiology</strong>, The BasicsFig. 11-7. Quantification of left lateral (LAT) images of the planar Tl-201images shown in Figs. 11-1 and 11-2. The same quantification methoddescribed in Fig. 11-6 is used. A large fixed anterior wall defect is present.
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NuclearCardiology:The BasicsHow to
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iiCONTEMPORARY CARDIOLOGYCHRISTOPHE
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iv© 2004 Humana Press Inc.999 Rive
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viPrefacetechnologists, laboratory
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xiAUTHORS’ AFFILIATIONSFrans J. T
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USING THIS BOOK AND THE COMPANION C
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Index 293INDEXAccreditation, see La
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Index 295linearity, 259, 261prevent
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Index 297Planar equilibrium radionu
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