A new automated delineation method for SPECT lung scans using adaptive dual‐exponential thresholding

An accurate method for delineating lung contours in single photon emission computed tomography (SPECT) is critical to respiratory studies such as pulmonary embolism (PE) and respiratory aerosol deposition. Current delineation methods are not adaptive in nature and may require a priori information on lung volumes. We have developed a dual‐exponential thresholding method that solely requires SPECT scans, and is fast, accurate, and adaptive in nature. A dataset consisted of 90 patients was studied retrospectively. While most were suspected of PE, other pulmonary disorders were also present. SPECT ventilation scans were obtained after inhalation of ∼40 MBq of 99mTc‐Technegas. Examination of the corresponding natural logarithmically transformed histograms revealed dual exponential functions like pattern. Adaptive thresholds were found as the intercept between the two exponential functions. 350 Monte Carlo simulations representative of normally‐ventilated scans with varying counts were used to quantitatively measure and evaluate the method. Our method correctly delineated lung volumes to above 97% agreement for 310 of the 350 Monte Carlo simulations with maximum count values greater than or equal to 31. The 40 low‐count simulations were included purely as extreme cases. For real patient scenario, an experienced physician was called upon to visually delineate a sample of 50 actual patient scans, and these delineated lung volumes were used as gold standard and compared with those delineated using our method. Our results had an average of 96% agreement. © 2007 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 17, 22–27, 2007

[1]  Sasa Mutic,et al.  Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. , 2004, International journal of radiation oncology, biology, physics.

[2]  Michael Ljungberg,et al.  A new automated method for analysis of gated‐SPECT images based on a three‐dimensional heart shaped model , 2005, Clinical physiology and functional imaging.

[3]  J S Fleming,et al.  A new method of quantification of the pulmonary regional distribution of aerosols using combined CT and SPECT and its application to nedocromil sodium administered by metered dose inhaler. , 1994, The British journal of radiology.

[4]  A K Dixon,et al.  A randomized trial of spiral CT and ventilation perfusion scintigraphy for the diagnosis of pulmonary embolism. , 1998, Clinical radiology.

[5]  Joy Conway,et al.  Description of Pulmonary Deposition of Radiolabeled Aerosol by Airway Generation Using a Conceptual Three Dimensional Model of Lung Morphology , 1995 .

[6]  John Palmer,et al.  Lung ventilation/perfusion SPECT in the artificially embolized pig. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[7]  P. Roach,et al.  Combining anatomy and function: the future of medical imaging , 2005, Internal medicine journal.

[8]  G Bautovich,et al.  Comparisons of planar and tomographic gamma scintigraphy to measure the penetration index of inhaled aerosols. , 1989, The American review of respiratory disease.

[9]  J. Hoefs,et al.  A novel, simple method of functional spleen volume calculation by liver-spleen scan. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[10]  J S Fleming,et al.  Three-Dimensional imaging of aerosol deposition. , 2001, Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine.

[11]  Curtis B Caldwell,et al.  The impact of (18)FDG-PET on target and critical organs in CT-based treatment planning of patients with poorly defined non-small-cell lung carcinoma: a prospective study. , 2002, International journal of radiation oncology, biology, physics.

[12]  T B Martonen,et al.  Assessment of deposition of inhaled aerosol in the respiratory tract of man using three-dimensional multimodality imaging and mathematical modeling. , 1996, Journal of aerosol medicine : the official journal of the International Society for Aerosols in Medicine.

[13]  P. Grigsby,et al.  Measurement of tumor volume by PET to evaluate prognosis in patients with advanced cervical cancer treated by radiation therapy. , 2002, International journal of radiation oncology, biology, physics.

[14]  L. W. Allen,et al.  99mTc technegas ventilation and perfusion lung scintigraphy for the diagnosis of pulmonary embolus. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[16]  Di Yan,et al.  Defining a radiotherapy target with positron emission tomography. , 2002, International journal of radiation oncology, biology, physics.

[17]  Orazio Schillaci,et al.  Hybrid SPECT/CT: a new era for SPECT imaging? , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  Jean Ponsonnaille,et al.  Preliminary evaluation of a fuzzy logic-based automatic quantitative analysis in myocardial SPECT. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  Dale L Bailey,et al.  SPECT/CT imaging using a spiral CT scanner for anatomical localization: Impact on diagnostic accuracy and reporter confidence in clinical practice , 2006, Nuclear medicine communications.

[20]  John Palmer,et al.  Diagnostic evaluation of planar and tomographic ventilation/perfusion lung images in patients with suspected pulmonary emboli , 2004, Clinical physiology and functional imaging.

[21]  Andreas Bockisch,et al.  Segmentation of PET volumes by iterative image thresholding. , 2007, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[22]  A. D. Nelson,et al.  A robust edge detection method for gated radionuclide ventriculograms. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[23]  Sasa Mutic,et al.  18F-FDG PET definition of gross tumor volume for radiotherapy of non-small cell lung cancer: is a single standardized uptake value threshold approach appropriate? , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[24]  S. Daeschner Pulmonary embolism. , 1988, Nursing.

[25]  B Jonson,et al.  Comprehensive ventilation/perfusion SPECT. , 2001, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[26]  Lars Edenbrandt,et al.  Validation of a new automated method for analysis of gated‐SPECT images , 2006, Clinical physiology and functional imaging.

[27]  J Thrall,et al.  Ventilation-perfusion scintigraphy in the PIOPED study. Part I. Data collection and tabulation. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[28]  J Thrall,et al.  Ventilation-perfusion scintigraphy in the PIOPED study. Part II. Evaluation of the scintigraphic criteria and interpretations. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  P H Pretorius,et al.  Verification of a varying threshold edge detection SPECT technique for spleen volume: a comparison with computed tomography volumes. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[30]  B C Lentle,et al.  Single photon emission tomography of lungs imaged with 99mTc-labeled aerosol. , 1984, Journal of the Canadian Association of Radiologists.

[31]  Emanuele Trucco,et al.  Introductory techniques for 3-D computer vision , 1998 .

[32]  C. Rübe,et al.  Comparison of different methods for delineation of 18F-FDG PET-positive tissue for target volume definition in radiotherapy of patients with non-Small cell lung cancer. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.