J Med Assoc Thai 2005; 88 (9):235

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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
Tepmongkol S Mail, Pasawang P , Krisanachinda A , Srimahachota S

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.
Material and Method: 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