Can Deep Learning Provide a CT-Less Alternative for Attenuation Compensation with SPECT MPI?

While single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is well validated for the detection of coronary artery disease (CAD) and other cardiovascular abnormalities, there is a degrading effect with attenuation that requires an additional computed tomography (CT) scan to address attenuation compensation.

However, in a recent interview, Abhinav Kumar Jha, Ph.D, noted there are a large number of SPECT scanners that do not have the CT component and this issue is particularly prevalent in community hospitals and rural facilities. Dr. Jha says this problem is compounded as studies have demonstrated a higher prevalence of heart disease in rural health-care settings.

Dr. Jha pointed out that 75 percent of SPECT MPI exams are performed without attenuation compensation and cites a recent survey of nuclear cardiology providers that found only 5.6 percent provided CT-based attenuation correction.

“Therefore, you can imagine there's a very important need for a large segment of the patient population to have access to this technology of attenuation correction without being able to take a CT scan,” noted Dr. Jha, an associate professor of biomedical engineering and radiology at the Washington University School of Medicine in St. Louis.

However, in recently published research, Dr. Jha and other researchers developed a deep learning technique that provides CT-less (dubbed CTLESS) attenuation compensation. With this research and other studies, Dr. Jha said the CTLESS approach has provided consistent performance across scanner models and patients with different degrees of heart disease.

While acknowledging that more studies are needed to validate the technology, Dr. Jha noted the CTLESS approach has potential to bolster access to SPECT MPI.

“I'm excited about the CTLESS technology (and) making the process of attenuation compensation more accessible, affordable as well as safe,” emphasized Dr. Jha.

(Editor’s note: For related content, see “Assessing MACE Risk in Women: Can an Emerging Model with SPECT MPI Imaging Have an Impact?,” “Radiology ‘Game-Changer’: FDA Approves PET Agent for Enhanced Detection of Coronary Artery Disease” and “Study Shows Merits of CTA-Derived Quantitative Flow Ratio in Predicting MACE.”)

For more insights from Dr. Jha, watch the video below.