Reliability and advantages of using non-uniform Chang’s attenuation correction method using a CT-based attenuation coefficient map in (99m)Tc-GSA SPECT/CT hepatic imaging

BACKGROUND: Generally, attenuation correction is made by incorporating a linear attenuation coefficient, which is based on the attenuation coefficient map (mu-map) created from a computed tomography scan, into the ordered subsets-expectation maximization reconstruction method in non-uniform domains. A non-uniform Chang’s attenuation correction method that uses the mu-map created from a computed tomography image that was made after reconstruction has been performed is currently available. The purpose of this study was to determine the usefulness of the non-uniform Chang’s attenuation correction method in (99m)Tc-galactosyl human serum albumin diethylenetriamine pentaacetic acid single photon emission computed tomography/computed tomography imaging. METHODS: Single photon emission computed tomography/computed tomography imaging was performed in phantoms with (99m)Tc water solutions and in a clinical study of 20 donors in living liver tissue transplantation. Attenuation correction was then performed in the reconstructed single photon emission computed tomography images with the non-uniform Chang’s method and ordered subsets-expectation maximization attenuation correction methods with triple energy window scatter correction. Root mean square error values were used for assessment of the image uniformity, and we evaluated the absolute radioactivity in liver parts in the phantoms and those in the donors who had a normal liver function. RESULTS: The values of root mean square error on the non-uniform Chang’s attenuation correction images were lower than those on ordered subsets-expectation maximization attenuation correction images for both the phantoms and the 20 donors. The difference between the true and estimated radioactivity in the non-uniform Chang’s attenuation correction method was smaller than that in the ordered subsets-expectation maximization attenuation correction methods in the phantom study. CONCLUSIONS: The non-uniform Chang’s attenuation correction is considered to be superior to the ordered subsets-expectation maximization attenuation correction in the assessment of absolute liver radioactivity and liver image uniformity on (99m)Tc-galactosyl human serum albumin diethylenetriamine pentaacetic acid single photon emission computed tomography/computed tomography imaging.