Evaluation of scatter compensation strategies and their impact on human detection performance in Tc-99m myocardial perfusion imaging

Human-observer receiver-operating characteristic (ROC) results with clinical patient studies indicate that ordered-subset expectation-maximization (OSEM) reconstructions with a combination of corrections for attenuation, scatter and distance-dependent resolution (DDR) significantly improves perfusion defect detection accuracy over FBP images. A recent Monte-Carlo study has also shown that for scatter correction (SC) in particular, selection of an appropriate strategy can impact cardiac uniformity. The spatial domain based effective source scatter estimation (ESSE) technique was shown to provide more robust performance in improving cardiac uniformity than the triple-energy window (TEW) method which is our current clinical standard for SC.