Attenuation correction strategies for multi-energy photon emitters using SPECT

The aim of this study was to investigate whether the photopeak window projections from different energy photons can be combined into a single window for reconstruction or if it is better to not combine the projections due to differences in the attenuation maps required for each photon energy. The mathematical cardiac torso (MCAT) phantom was modified to simulate the uptake of Ga-67 in the human body. Four spherical hot tumors were placed in locations which challenged attenuation correction. An analytical 3D projector with attenuation and detector response included was used to generate projection sets. Data were reconstructed using filtered backprojection (FBP) reconstruction with Butterworth filtering in conjunction with one iteration of Chang attenuation correction, and with 5 and 10 iterations of ordered-subset maximum-likelihood expectation-maximization (ML-OS) reconstruction. To serve as a standard for comparison, the projection sets obtained from the two energies were first reconstructed separately using their own attenuation maps. The emission data obtained from both energies were added and reconstructed using the following attenuation strategies: (1) the 93 keV attenuation map for attenuation correction, (2) the 185 keV attenuation map for attenuation correction, (3) using a weighted mean obtained from combining the 93 keV and 185 keV maps, and (4) an ordered subset approach which combines both energies. The central count ratio (CCR) and total count ratio (TCR) were used to compare the performance of the different strategies. Compared to the standard method, results indicate an overestimation with strategy 1, an under-estimation with strategy 2 and comparable results with strategies 3 and 4. In all strategies, the CCR's of sphere 4 (in proximity to the liver, spleen and backbone) were under-estimated, although TCR's were comparable to that of the other locations. The weighted mean and ordered subset strategies for attenuation correction were of comparable accuracy to reconstruction of the windows separately. They are recommended for multi-energy photon SPECT imaging quantitation when there is a need to combine the acquisitions of multiple windows.