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Subtraction SPECT for Parathyroid Scintigraphy Based on Maximization of Mutual Information

¹ Department of Radiological Technology, Sumitomo Hospital, Nakanoshima, Kita-ku, Osaka, Japan; ² Department of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kodatsuno, Kanazawa, Japan; ³ Department of Ultrasonic Examination, Sumitomo Hospital, Nakanoshima, Kita-ku, Osaka, Japan; ⁴ Department of Urology, Sumitomo Hospital, Nakanoshima, Kita-ku, Osaka, Japan; and ⁵ Department of Internal Medicine, Sumitomo Hospital, Nakanoshima, Kita-ku, Osaka, Japan

View larger version (39K): [in this window] [in a new window]   FIGURE 1.  Appearance (A) and illustration (B) of pair of laser pointers aligned at right angles. Point O corresponds to center of rotation of detectors.

View larger version (118K): [in this window] [in a new window]   FIGURE 2.  Planar images used to select reconstructed regions for SPECT images. (A and C) Early planar images. Line marked 63 in A is centerline in 128 matrix. Centerline passes through right and left external auditory canals. Region between lines 13 and 36 is reconstructed region on SPECT images, excluding salivary glands. (B and D) Delayed planar images. Similarly, centerline passes through both external auditory canals. Reconstructed region for delayed SPECT image is similarly selected between lines 13 and 36.

View larger version (65K): [in this window] [in a new window]   FIGURE 3.  SPECT images of a patient: early (A), delayed (B), fusion (C), and subtraction (D).

View larger version (50K): [in this window] [in a new window]   FIGURE 4.  A 61-y-old man with 4 hyperplastic glands (patient 10). Glands weighed 300–700 mg. In this patient, 24 slices (1–24) were reconstructed. Slice numbers more and less than 24 were considered to represent superior and inferior parathyroid glands, respectively. (A–D) Early planar image (A), delayed planar image (B), and subtraction SPECT images showing upper (C) and lower (D) parathyroid hyperplasia. Arrow indicates hyperplastic lesion.

View larger version (57K): [in this window] [in a new window]   FIGURE 5.  A 74-y-old woman with adenoma (patient 12). Lesion weighed 300 mg. (A–C) Early planar image (A), delayed planar image (B), and subtraction SPECT images (C). Lesion (arrow) was seen in left upper region.