Myocardial perfusion SPECT using a rotating multi-segment slant-hole collimator.

PURPOSE: A rotating multi-segment slant-hole (RMSSH) collimator is able to provide much higher (approximately 3 times for four-segment collimator with 30 degrees slant angle) sensitivity than a parallel-hole (PH) collimator with the similar spatial resolution for imaging small organs such as the heart and the breast. In this article, the authors evaluated the performance of myocardial perfusion SPECT (MPS) using a RMSSH collimator compared to MPS using the low-energy high-resolution parallel-hole collimators. METHODS: The authors conducted computer simulation studies using the NURBS-based cardiac-torso phantom, receiver operative characteristic (ROC) analysis using the channelized Hotelling observer, physical phantom experiments, and pilot patient studies to evaluate the performance of MPS using a rotating four-segment slant-hole (R4SSH) collimator with respect to MPS using a PH collimator. RESULTS: In the simulation study, the R4SSH MPS provides images with superior contrast-noise trade-off than those of PH MPS with the same acquisition time. The defect detectability in terms of the largest area under the ROC curve for R4SSH MPS is significantly higher than those of PH MPS with p-values < 0.01. In the phantom experiments, the R4SSH MPS images with 7.5 min acquisition had similar noise level and overall image quality as those of PH MPS with 21 min acquisition. Pilot patient studies showed that with the same acquisition time, the R4SSH SPECT using a single-head camera gave images with similar quality as those of PH SPECT using a dual-head camera. CONCLUSIONS: The RMSSH SPECT has a potential to improve the coronary artery disease detection and workflow of SPECT imaging acquisition due to the high sensitivity property of the RMSSH collimator.