Validation of attenuation correction using transmission truncation compensation with a small field of view dedicated cardiac SPECT camera system.

Background: Although attenuation correction (AC) has been successfully applied to large field of view (LFOV) cameras, applicability to small field of view (SFOV) cameras is a concern due to truncation. This study compared perfusion images between a LFOV and SFOV camera with truncation compensation, using the same AC solution.
Methods and Results: Seventy-eight clinically referred patients underwent rest-stress single-photon emission computed tomography (SPECT) using both a SFOV and LFOV camera in a randomized sequence. Blinded images were interpreted by a consensus of three experienced readers. The percentage of normal images for SFOV and LFOV was significantly higher with than without AC (72% vs 44% and 72% vs 49%, both P < .001). Interpretive agreement between cameras was better with than without AC (kappa = 0.736 to 0.847 vs 0.545 to 0.774). Correlation for the summed stress score was higher with than without AC (r (2) = 0.892 vs 0.851, both P < 0.001) while Bland Altman analysis demonstrated narrower limits with than without AC (4.0 to -4.3 vs 5.9 to -5.6).
Conclusion: Attenuation correction using truncation compensation with a SFOV camera yields similar results to a LFOV camera. The higher interpretive agreement between cameras after attenuation correction suggests that such images are preferable to non-attenuation-corrected images.