ROC evaluation of SPECT myocardial lesion detectability with and without non-uniform attenuation compensation using an anthropomorphic female phantom

The purpose of this work was to evaluate lesion detectability with and without nonuniform attenuation compensation (AC) in myocardial perfusion SPECT imaging in women using an anthropomorphic phantom and receiver operating characteristics (ROC) methodology. Breast attenuation causes artifacts in reconstructed images and may increase the difficulty of diagnosis of myocardial perfusion imaging in women. The null hypothesis tested using the ROC study was that nonuniform AC does not change the lesion detectability in myocardial perfusion SPECT imaging in women. We used a filtered backprojection (FBP) reconstruction algorithm and Chang's single iteration method for AC. In conclusion, with our proposed myocardial defect model nuclear medicine physicians demonstrated no significant difference for the detection of the anterior wall defect; however, a greater accuracy for the detection of the inferior wall defect was observed without nonuniform AC than with it (P-value = 0.0034). Medical physicists did not demonstrate any statistically significant difference in defect detection accuracy with or without nonuniform AC in the female phantom.