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Evaluation of a Rigid Registration Method of Lung Perfusion SPECT and Thoracic CT

¹ Department of Nuclear Medicine, Rouen University Hospital Charles-Nicolle and Henri Becquerel Center, Laboratoire Universitaire QUANT.I.F., Rouen, France.
² Department of Radiation Therapy and Radiophysics, Henri Becquerel Center, Laboratoire Universitaire QUANT.I.F., Rouen, France.
³ GE Healthcare, Israel.
⁴ Service of Radiology, Henri Becquerel Center, Laboratoire Universitaire QUANT.I.F., Rouen, France.

View larger version (11K): [in a new window]   Fig. 1 —Drawing shows design of external markers used for both CT and SPECT acquisitions. 99m-Tc = technetium-99m.

View larger version (51K): [in a new window]   Fig. 2A —Placement of markers on phantom and patients. For selection order A, registration with four markers used markers 1, 2, 3, 8; five markers, 1, 2, 3, 8, 4; six markers, 1, 2, 3, 8, 4, 7; seven markers: 1, 2, 3, 8, 4, 7, 6; eight markers, 1, 2, 3, 8, 4, 7, 6, 5; nine markers, 1, 2, 3, 8, 4, 7, 6, 5, 9. For selection order B, registration with four markers used markers 1, 4, 5, 9; five markers, 1, 4, 5, 9, 8; six markers, 1, 4, 5, 9, 8, 3; seven markers, 1, 4, 5, 9, 8, 3, 10; eight markers, 1, 4, 5, 9, 8, 3, 10, 6; nine markers, 1, 4, 5, 9, 8, 3, 10, 6, 7. Graphic (A) and photograph (B) show placement of external markers on phantom.

View larger version (124K): [in a new window]   Fig. 2B —Placement of markers on phantom and patients. For selection order A, registration with four markers used markers 1, 2, 3, 8; five markers, 1, 2, 3, 8, 4; six markers, 1, 2, 3, 8, 4, 7; seven markers: 1, 2, 3, 8, 4, 7, 6; eight markers, 1, 2, 3, 8, 4, 7, 6, 5; nine markers, 1, 2, 3, 8, 4, 7, 6, 5, 9. For selection order B, registration with four markers used markers 1, 4, 5, 9; five markers, 1, 4, 5, 9, 8; six markers, 1, 4, 5, 9, 8, 3; seven markers, 1, 4, 5, 9, 8, 3, 10; eight markers, 1, 4, 5, 9, 8, 3, 10, 6; nine markers, 1, 4, 5, 9, 8, 3, 10, 6, 7. Graphic (A) and photograph (B) show placement of external markers on phantom.

View larger version (90K): [in a new window]   Fig. 2C —Placement of markers on phantom and patients. For selection order A, registration with four markers used markers 1, 2, 3, 8; five markers, 1, 2, 3, 8, 4; six markers, 1, 2, 3, 8, 4, 7; seven markers: 1, 2, 3, 8, 4, 7, 6; eight markers, 1, 2, 3, 8, 4, 7, 6, 5; nine markers, 1, 2, 3, 8, 4, 7, 6, 5, 9. For selection order B, registration with four markers used markers 1, 4, 5, 9; five markers, 1, 4, 5, 9, 8; six markers, 1, 4, 5, 9, 8, 3; seven markers, 1, 4, 5, 9, 8, 3, 10; eight markers, 1, 4, 5, 9, 8, 3, 10, 6; nine markers, 1, 4, 5, 9, 8, 3, 10, 6, 7. Graphic (C) and photograph (D) show placement of external markers on patient.

View larger version (89K): [in a new window]   Fig. 2D —Placement of markers on phantom and patients. For selection order A, registration with four markers used markers 1, 2, 3, 8; five markers, 1, 2, 3, 8, 4; six markers, 1, 2, 3, 8, 4, 7; seven markers: 1, 2, 3, 8, 4, 7, 6; eight markers, 1, 2, 3, 8, 4, 7, 6, 5; nine markers, 1, 2, 3, 8, 4, 7, 6, 5, 9. For selection order B, registration with four markers used markers 1, 4, 5, 9; five markers, 1, 4, 5, 9, 8; six markers, 1, 4, 5, 9, 8, 3; seven markers, 1, 4, 5, 9, 8, 3, 10; eight markers, 1, 4, 5, 9, 8, 3, 10, 6; nine markers, 1, 4, 5, 9, 8, 3, 10, 6, 7. Graphic (C) and photograph (D) show placement of external markers on patient.

View larger version (9K): [in a new window]   Fig. 3 —Bar graph shows reproducibility of marker selection in pixels for observers 1 and 2 and shows interobservator reproducibility. Values are means and error bars indicate SEM.

View larger version (11K): [in a new window]   Fig. 4 —Bar graph shows robustness of registration method plotted versus the rotation applied to target. FOM10 is figure of merit, which is mean square errors, expressed in square millimeters, between 10 homologous external markers after each registration study. Values are means and error bars indicate SEM.

View larger version (12K): [in a new window]   Fig. 5 —Bar graph shows FOM10 plotted versus selection orders A (black bars) and B (white bars) for phantom data. FOM10 is figure of merit, which is mean square errors, expressed in square millimeters, between 10 homologous external markers after each registration study. Values are means and error bars indicate SEM.

View larger version (82K): [in a new window]   Fig. 6A —Visualization of perfusion defects. CT scan (top image) and SPECT image (bottom image) of 48-year-old woman (patient 3 in Table 1) with lung tumor in right upper lobe show no perfusion defects around tumor. Arrow in top image = right superior lobe tumor, arrow in bottom image = left superior lobe tumor.

View larger version (80K): [in a new window]   Fig. 6B —Visualization of perfusion defects. CT scan (top image) and SPECT image (bottom image) of 69-year-old man (patient 4 in Table 1) with lung tumor in right upper lobe show perfusion defects around tumor. Arrow in top image = left superior lobe tumor, arrows in bottom image = external markers.

View larger version (17K): [in a new window]   Fig. 7 —Bar graph shows FOM10 (mm2) plotted versus number of markers for selection orders A (black bars) and B (white bars) for patient data (free breathing during CT). FOM10 is figure of merit, which is mean square errors, expressed in square millimeters, between 10 homologous external markers after each registration study.

View larger version (9K): [in a new window]   Fig. 8 —Bar graph shows FOM6 (mm2) plotted versus four internal and external markers for patients data (free breathing during CT). FOM6 is registration accuracy with internal landmarks using mean error of six external markers (markers 1, 3, 6, 7, 8, 9). Values are means and error bars indicate SEM.

View larger version (13K): [in a new window]   Fig. 9 —Bar graph shows effect of breathing state—deep inspiration (black bars) or normal breathing (white bars)—during CT acquisition on quality of registration (FOM10) for external markers. FOM10 is figure of merit, which is mean square errors, expressed in millimeters squared, between 10 homologous external markers after each registration study. Values are means and error bars indicate SEM.

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