Evaluation of how attenuation correction influences image quality in myocardial perfusion SPECT/CT applying Flash3D iterative reconstruction techniques

This study evaluated Computed tomography (CT) based attenuation correction (AC) in myocardial perfusion imaging (MPI) SPECT/CT using 45 patients (28 males: (mean age: 54.7±12.6 years, mean weight: 79.75±28.2 kg/m²); 17 females: (mean age: 54.8±11.3 years, mean weight: 80.76±28.23 kg/m²)). Participants were categorized by body mass index (BMI), with image quality assessed through the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) metrics using Flash3D reconstruction. Results demonstrated that AC significantly enhanced image quality compared to non-attenuation-corrected (NAC) images. The correction notably reduced false-positive findings caused by diaphragmatic attenuation in male patients and breast tissue attenuation in female patients. Additionally, AC effectively minimized artifactual defects in the inferior and anterior myocardial walls. These improvements highlight the clinical value of CT-based AC in hybrid SPECT/CT systems, as it enhances diagnostic accuracy by addressing gender-specific attenuation challenges. The findings support routine application of AC in MPI protocols to optimize perfusion assessment and reduce interpretation errors related to soft tissue attenuation.