Evaluation of the accuracy and precision of lung aerosol deposition measurements from single-photon emission computed tomography using simulation.
ABSTRACT Single-photon emission computed tomography (SPECT) imaging is being increasingly used to assess inhaled aerosol deposition. This study uses simulation to evaluate the errors involved in such measurements and to compare them with those from conventional planar imaging. SPECT images of known theoretical distributions of radioaerosol in the lung have been simulated using lung models derived from magnetic resonance studies in human subjects. Total lung activity was evaluated from the simulated images. A spherical transform of the lung distributions was performed, and the absolute penetration index (PI) and a relative value expressed as a fraction of that in a simulated ventilation image were calculated. All parameters were compared with the true value used in the simulation, and the errors were assessed. An iterative method was used to correct for the partial volume effect, and its effectiveness in improving errors was evaluated. The errors were compared with those of planar imaging. The precision of measurements was significantly better for SPECT than planar imaging (2.8 vs 6.3% for total lung activity, 6 vs 20% for PI, and 3 vs 6% for relative PI). The method of correcting for the influence of the partial volume effect significantly improved the accuracy of PI evaluation without affecting precision. SPECT is capable of accurate and precise measurements of aerosol distribution in the lung, which are improved compared with those measured by conventional planar imaging. A technique for correcting the SPECT data for the influence of the partial volume effect has been described. Simulation is demonstrated as a valuable method of technique evaluation and comparison.
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ABSTRACT: Aerosols of nedocromil sodium labelled with 99Tcm were delivered on 20 separate occasions to healthy male volunteers. Planar and single photon emission computerized tomography (SPECT) gamma scintigraphy were immediately performed to assess the pulmonary regional distribution of delivered aerosol. On a separate occasion volunteers were imaged using X-ray computed tomography (CT). Alignment of SPECT and CT images was performed using marked anatomical features and the anterior and lateral skin outlines. CT images provided data for attenuation correction and were used to define the anatomical lung volume. Central to peripheral (CP) ratios of deposited activity were calculated from volumes of interest in coronal and transverse sections of the right lung. These were compared with CP ratios obtained from planar images obtained immediately following aerosol inhalation. Volumetric CP ratio correlated significantly with immediate planar CP ratio (p < 0.001). Analysis of deposition in the whole right lung was performed by separating the SPECT lung data into a series of thin concentric shells centred on the entry of the right main bronchus. Measures were defined for describing the variation of deposition density and cumulative total deposition with distance from the lung centre. These showed significant correlation with planar CP ratio (p < 0.001). SPECT analysis using CT is consistent with planar measures of aerosol deposition but offers a more complete quantification of aerosol penetration and absolute deposited activity within the whole lung. It is a valuable new tool for aerosol analysis.British Journal of Radiology 01/1994; 67(793):46-53. · 1.22 Impact Factor
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ABSTRACT: The quantitative measurement of regional aerosol deposition in human lungs using two-dimensional (2D) gamma scintigraphy has proven to be useful in therapeutic and diagnostic aerosol studies. The penetration index (PI) has been defined as the ratio of activity in a peripheral lung zone to a central lung zone, but the ability to discriminate between aerosol deposition in the large airways and lung parenchyma is reduced by the fact that the latter overlies the former in the central zone. To overcome this, we used a three-dimensional (3D) technique. Seven healthy subjects inhaled isotonic saline aerosols containing 99mTc-DTPA on two occasions. The droplets had a mass median aerodynamic diameter (MMAD) of either 2.6 or 5.5 microns (with geometric standard deviations [sigma g] of 1.4 and 1.7, respectively). Transmission tomography was performed on each subject to delineate lung boundaries in 2D and 3D. After inhalation, anterior (A) and posterior (P) images were collected and a tomographic study performed. Mid-lung slices were taken from coronal (CC) and transverse (TC) sections. PI was calculated on the 2D images (AP and P) and the 3D slices (CC and TC) using exactly defined regions. The PI values were smaller for the large droplet aerosol (5.5 microns) in all subjects and methods. The relative differences in PI between large and small (2.6 microns) droplet studies (d values) were greater and less variable for the 3D methods (TC, 56.5 +/- 11.4% and CC, 52.4 +/- 12.3%) compared to the 2D methods (P, 25.4 +/- 17.1% and AP, 38.3 +/- 15%; p less than 0.005). We found the 3D methods to be more sensitive for discriminating between aerosol deposition in large and small airways than were the conventional 2D methods.The American review of respiratory disease 07/1989; 139(6):1516-23. · 10.19 Impact Factor
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ABSTRACT: Three-dimensional assessment of pulmonary deposition of inhaled aerosol may be performed using SPECT. The use of aligned anatomical images enables improved accuracy of quantification and anatomical localization of deposition. METHODS: Techniques of analyzing these data and their application to deposition studies of two nebulizer-generated aerosols (mass median diameter 1.5 and 6.5 microM respectively) in 12 normal subjects are described. The deposition data were transformed to a standard hemispherical shape and the mean distribution pattern for each aerosol evaluated. Deposition by airway generation was then calculated using a spatial model of airway morphology. The results were compared to those from planar image analysis. RESULTS: The hemispherical transform yielded considerably more qualitative information on deposition pattern. The central-to-peripheral concentration ratio between conducting and alveolated airways was 5.27 for the coarser aerosol and 2.43 for the fine. The two-dimensional spatial estimates of the ratio were 2.61 and 2.03 respectively. Conclusion: Analysis of multimodality imaging data considerably enhanced information on deposition compared to planar imaging. It provides new data on aerosol deposition which will be of value to physicians involved in drug inhalation therapy.Journal of Nuclear Medicine 06/1996; 37(5):873-7. · 5.77 Impact Factor