Contribution of scatter and attenuation compensation to SPECT images of nonuniformly distributed brain activities (282 views)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 2003 Apr; 44(4): 512-519.
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Paper type: Journal Article,
Impact factor: 4.899, 5-year impact factor: 6.119
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0038315472&partnerID=40&md5=4fd1f70a57dcd75a1e806e0d20ec048a
Keywords: 123i-2β-Carbomethoxy-3β-(4-Iodophenyl)-Tropane, Attenuation Correction, Binding Potential, Scatter Correction, Spect, 3beta (4 Iodophenyl) 2beta Tropanecarboxylic Acid Methyl Ester, Iodine 123, Cocaine, Diagnostic Agent, Drug Derivative, Radioactive Iodine, Radiopharmaceutical Agent, Accuracy, Article, Brain, Brain Region, Calculation, Camera, Collimator, Controlled Study, Corpus Striatum, Evaluation, Experiment, Human, Image Analysis, Image Reconstruction, Injection, Measurement, Occipital Lobe, Phantom, Priority Journal, Quantitative Analysis, Simulation, Single Photon Emission Computer Tomography, Adult, Clinical Trial, Comparative Study, Female, Image Enhancement, Image Quality, Image Subtraction, Methodology, Quality Control, Radiation Scattering, Reproducibility, Scintiscanning, Sensitivity And Specificity, Iodine Radioisotopes, Imaging, Reproducibility Of Results, Subtraction Technique, Emission-Computed, Single-Photon, 123i-2ß-Carbomethoxy-3ß-(4-Iodophenyl)-Tropane, 123i-2-Carbomethoxy-3-(4-Iodophenyl)-Tropane,
Affiliations:
*** IBB - CNR ***
Dept. of Investigative Radiology, Natl. Cardiovasc. Ctr. Res. Inst., Osaka, Japan
National Research Council, Biostructure and Bioimaging Inst., Naples, Italy
Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
References:
Varrone, A., Marek, K.L., Jennings, D., [123I]Beta-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson's disease and multiple system atrophy (2001) Mov Disord, 16, pp. 1023-103
Innis, R.B., Seibyl, J.P., Scanley, B.E., Single photon emission computed tomographic imaging demonstrates loss of striatal dopamine transporters in Parkinson disease (1993) Proc Natl Acad Sci USA, 90, pp. 11965-11969
Laruelle, M., Baldwin, R., Amlison, R., SPECT imaging of dopamine and serotonin transporters with [ 123I]β-CIT: Pharmacological characterization of brain uptake in nonhuman primate (1993) Synapse, 13, pp. 295-309
Pirker, W., Asenbaum, S., Hauk, M., Imaging serotonin and dopamine transporters with 123I-β- CIT SPECT: Binding kinetics and effects of normal aging (2000) J Nucl Med, 41, pp. 36-44
Laruelle, M., Wallace, E., Seibyl, J.P., Graphical, kinetic, and equilibrium analyses of in vivo [ 123I]β-CIT binding to dopamine transporters in healthy human subjects (1994) J Cereb Blood Flow Metab, 14, pp. 982-994
Laruelle, M., Abi-Dargham, A., Van Dyck, C., Dopamine and serotonin transporters in patients with schizophrenia: An imaging study with [123I]beta-CIT (2000) Biol Psychiatry, 47, pp. 371-379
Seibyl, J.P., Marek, K., Sheff, K., Test/retest reproducibility of iodine-123-β-CIT SPECT brain measurement of dopamine transporters in Parkinson's patients (1997) J Nucl Med, 38, pp. 1453-1459
Van Dyck, C.H., Seibyl, J.P., Malison, R.T., Age-related decline in striatal dopamine transporter binding with iodine-123-β-CIT SPECT (1995) J Nucl Med, 36, pp. 1175-1181
Asenbaum, S., Brucke, T., Pirker, W., Imaging of dopamine transporters with iodine-123-β-CIT and SPECT in Parkinson's disease (1997) J Nucl Med, 38, pp. 1-6
Stodilka, R.Z., Kemp, B.J., Msaki, P., The relative contributions of scatter and attenuation corrections toward improved brain SPECT quantification (1998) Phys Med Biol, 43, pp. 2991-3008
Hashimoto, J., Kubo, A., Ogawa, K., Scatter and attenuation correction in technetium-99m brain SPECT (1997) J Nucl Med, 38, pp. 157-162
Kauppinen, T., Koskinen, M.O., Alenius, S., Improvement of brain perfusion SPET using iterative reconstruction with scatter and non-uniform attenuation correction (2000) Eur J Nucl Med, 27, pp. 1380-1386
Yang, J., Kuikka, J.T., Jaatinen, K., A novel method of scatter correction using a single isotope for simultaneous emission and transmission data (1997) Nucl Med Commun, 18, pp. 1071-1076
Ljungberg, M., King, M.A., Hademenos, G.J., Comparison of four scatter correction methods using Monte Carlo simulated source distributions (1994) J Nucl Med, 35, pp. 143-151
Licho, R., Glick, S.J., Xia, W., Attenuation compensation in 99mTc SPECT brain imaging a comparison of the use of attenuation maps derived from transmission versus emission data in normal scans (1999) J Nucl Med, 40, pp. 456-463
Rajeevan, N., Zubal, I.G., Ramsby, S.Q., Significance of nonuniform attenuation correction in quantitative brain SPECT imaging (1998) J Nucl Med, 39, pp. 1719-1726
Hashimoto, J., Sasaki, T., Ogawa, K., Effects of scatter and attenuation correction on quantitative analysis of β-CIT brain SPET (1999) Nucl Med Cummun, 20, pp. 159-165
Ito, H., Iida, H., Kinoshita, T., Effects of scatter correction on regional distribution of cerebral blood flow using I-123-IMP and SPECT (1999) Ann Nucl Med, 13, pp. 331-336
Iida, H., Narita, Y., Kado, H., Effect of scatter and attenuation correction on quantitative assessment of regional cerebral blood flow with SPECT (1998) J Nucl Med, 39, pp. 181-189
Hudson, H.M., Larkin, R.S., Accelerated image reconstruction using ordered subsets of projection data (1994) IEEE Trans Med Imaging, 13, pp. 601-609
Sorenson, J.A., Phelps, M.E., (1987) Physics in Nuclear Medicine 2nd Ed, , New York, NY. Grune & Stratton Inc
Jaszczak, R.J., Coleman, R.E., Whitehead FR Physical factors affecting quantitative measurements using camera-based single photon emission computed tomography (SPECT) (1981) IEEE Trans Nucl Sci, 28, pp. 69-80
Axelsson, B., Msaki, P., Israelsson, A., Subtraction of Compton-scatterad photons in single-photon emission computerized tomography (1984) J Nucl Med, 25, pp. 490-494
Meikle, S.R., Hutton, B.F., Bailey, D.L., A transmission-dependent method for scatter correction in SPECT (1994) J Nucl Med, 35, pp. 360-367
Kim, K.M., Watebe, H., Shidahara, M., SPECT collimator dependency of scatter and validation of transmission-dependent scatter compensation methodologies (2001) IEEE Trans Nucl Sci, 48, pp. 689-696
Narita, Y., Eberl, S., Iida, H., Monte Carlo and experimental evaluation of accuracy and noise properties of two scatter correction methods for SPECT (1996) Phys Med Biol, 41, pp. 2481-2496
Iida, H., Miura, S., Shoji, Y., Noninvasive quantitation of cerebral blood flow using oxygen-15-water and a dual-PET system (1998) J Nucl Med, 39, pp. 1789-1798
Innis, R. B., Seibyl, J. P., Scanley, B. E., Single photon emission computed tomographic imaging demonstrates loss of striatal dopamine transporters in Parkinson disease (1993) Proc Natl Acad Sci USA, 90, pp. 11965-11969
Seibyl, J. P., Marek, K., Sheff, K., Test/retest reproducibility of iodine-123- -CIT SPECT brain measurement of dopamine transporters in Parkinson's patients (1997) J Nucl Med, 38, pp. 1453-1459
Van Dyck, C. H., Seibyl, J. P., Malison, R. T., Age-related decline in striatal dopamine transporter binding with iodine-123- -CIT SPECT (1995) J Nucl Med, 36, pp. 1175-1181
Stodilka, R. Z., Kemp, B. J., Msaki, P., The relative contributions of scatter and attenuation corrections toward improved brain SPECT quantification (1998) Phys Med Biol, 43, pp. 2991-3008
Hudson, H. M., Larkin, R. S., Accelerated image reconstruction using ordered subsets of projection data (1994) IEEE Trans Med Imaging, 13, pp. 601-609
Sorenson, J. A., Phelps, M. E., (1987) Physics in Nuclear Medicine 2nd Ed, , New York, NY. Grune & Stratton Inc
Jaszczak, R. J., Coleman, R. E., Whitehead FR Physical factors affecting quantitative measurements using camera-based single photon emission computed tomography (SPECT) (1981) IEEE Trans Nucl Sci, 28, pp. 69-80
Meikle, S. R., Hutton, B. F., Bailey, D. L., A transmission-dependent method for scatter correction in SPECT (1994) J Nucl Med, 35, pp. 360-367
Kim, K. M., Watebe, H., Shidahara, M., SPECT collimator dependency of scatter and validation of transmission-dependent scatter compensation methodologies (2001) IEEE Trans Nucl Sci, 48, pp. 689-696
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 2003 Apr; 44(4): 512-519.
Export to BibTeX Export to EndNote
Paper type: Journal Article,
Impact factor: 4.899, 5-year impact factor: 6.119
Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-0038315472&partnerID=40&md5=4fd1f70a57dcd75a1e806e0d20ec048a
Keywords: 123i-2β-Carbomethoxy-3β-(4-Iodophenyl)-Tropane, Attenuation Correction, Binding Potential, Scatter Correction, Spect, 3beta (4 Iodophenyl) 2beta Tropanecarboxylic Acid Methyl Ester, Iodine 123, Cocaine, Diagnostic Agent, Drug Derivative, Radioactive Iodine, Radiopharmaceutical Agent, Accuracy, Article, Brain, Brain Region, Calculation, Camera, Collimator, Controlled Study, Corpus Striatum, Evaluation, Experiment, Human, Image Analysis, Image Reconstruction, Injection, Measurement, Occipital Lobe, Phantom, Priority Journal, Quantitative Analysis, Simulation, Single Photon Emission Computer Tomography, Adult, Clinical Trial, Comparative Study, Female, Image Enhancement, Image Quality, Image Subtraction, Methodology, Quality Control, Radiation Scattering, Reproducibility, Scintiscanning, Sensitivity And Specificity, Iodine Radioisotopes, Imaging, Reproducibility Of Results, Subtraction Technique, Emission-Computed, Single-Photon, 123i-2ß-Carbomethoxy-3ß-(4-Iodophenyl)-Tropane, 123i-2-Carbomethoxy-3-(4-Iodophenyl)-Tropane,
Affiliations:
*** IBB - CNR ***
Dept. of Investigative Radiology, Natl. Cardiovasc. Ctr. Res. Inst., Osaka, Japan
National Research Council, Biostructure and Bioimaging Inst., Naples, Italy
Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
References:
Varrone, A., Marek, K.L., Jennings, D., [123I]Beta-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson's disease and multiple system atrophy (2001) Mov Disord, 16, pp. 1023-103
Innis, R.B., Seibyl, J.P., Scanley, B.E., Single photon emission computed tomographic imaging demonstrates loss of striatal dopamine transporters in Parkinson disease (1993) Proc Natl Acad Sci USA, 90, pp. 11965-11969
Laruelle, M., Baldwin, R., Amlison, R., SPECT imaging of dopamine and serotonin transporters with [ 123I]β-CIT: Pharmacological characterization of brain uptake in nonhuman primate (1993) Synapse, 13, pp. 295-309
Pirker, W., Asenbaum, S., Hauk, M., Imaging serotonin and dopamine transporters with 123I-β- CIT SPECT: Binding kinetics and effects of normal aging (2000) J Nucl Med, 41, pp. 36-44
Laruelle, M., Wallace, E., Seibyl, J.P., Graphical, kinetic, and equilibrium analyses of in vivo [ 123I]β-CIT binding to dopamine transporters in healthy human subjects (1994) J Cereb Blood Flow Metab, 14, pp. 982-994
Laruelle, M., Abi-Dargham, A., Van Dyck, C., Dopamine and serotonin transporters in patients with schizophrenia: An imaging study with [123I]beta-CIT (2000) Biol Psychiatry, 47, pp. 371-379
Seibyl, J.P., Marek, K., Sheff, K., Test/retest reproducibility of iodine-123-β-CIT SPECT brain measurement of dopamine transporters in Parkinson's patients (1997) J Nucl Med, 38, pp. 1453-1459
Van Dyck, C.H., Seibyl, J.P., Malison, R.T., Age-related decline in striatal dopamine transporter binding with iodine-123-β-CIT SPECT (1995) J Nucl Med, 36, pp. 1175-1181
Asenbaum, S., Brucke, T., Pirker, W., Imaging of dopamine transporters with iodine-123-β-CIT and SPECT in Parkinson's disease (1997) J Nucl Med, 38, pp. 1-6
Stodilka, R.Z., Kemp, B.J., Msaki, P., The relative contributions of scatter and attenuation corrections toward improved brain SPECT quantification (1998) Phys Med Biol, 43, pp. 2991-3008
Hashimoto, J., Kubo, A., Ogawa, K., Scatter and attenuation correction in technetium-99m brain SPECT (1997) J Nucl Med, 38, pp. 157-162
Kauppinen, T., Koskinen, M.O., Alenius, S., Improvement of brain perfusion SPET using iterative reconstruction with scatter and non-uniform attenuation correction (2000) Eur J Nucl Med, 27, pp. 1380-1386
Yang, J., Kuikka, J.T., Jaatinen, K., A novel method of scatter correction using a single isotope for simultaneous emission and transmission data (1997) Nucl Med Commun, 18, pp. 1071-1076
Ljungberg, M., King, M.A., Hademenos, G.J., Comparison of four scatter correction methods using Monte Carlo simulated source distributions (1994) J Nucl Med, 35, pp. 143-151
Licho, R., Glick, S.J., Xia, W., Attenuation compensation in 99mTc SPECT brain imaging a comparison of the use of attenuation maps derived from transmission versus emission data in normal scans (1999) J Nucl Med, 40, pp. 456-463
Rajeevan, N., Zubal, I.G., Ramsby, S.Q., Significance of nonuniform attenuation correction in quantitative brain SPECT imaging (1998) J Nucl Med, 39, pp. 1719-1726
Hashimoto, J., Sasaki, T., Ogawa, K., Effects of scatter and attenuation correction on quantitative analysis of β-CIT brain SPET (1999) Nucl Med Cummun, 20, pp. 159-165
Ito, H., Iida, H., Kinoshita, T., Effects of scatter correction on regional distribution of cerebral blood flow using I-123-IMP and SPECT (1999) Ann Nucl Med, 13, pp. 331-336
Iida, H., Narita, Y., Kado, H., Effect of scatter and attenuation correction on quantitative assessment of regional cerebral blood flow with SPECT (1998) J Nucl Med, 39, pp. 181-189
Hudson, H.M., Larkin, R.S., Accelerated image reconstruction using ordered subsets of projection data (1994) IEEE Trans Med Imaging, 13, pp. 601-609
Sorenson, J.A., Phelps, M.E., (1987) Physics in Nuclear Medicine 2nd Ed, , New York, NY. Grune & Stratton Inc
Jaszczak, R.J., Coleman, R.E., Whitehead FR Physical factors affecting quantitative measurements using camera-based single photon emission computed tomography (SPECT) (1981) IEEE Trans Nucl Sci, 28, pp. 69-80
Axelsson, B., Msaki, P., Israelsson, A., Subtraction of Compton-scatterad photons in single-photon emission computerized tomography (1984) J Nucl Med, 25, pp. 490-494
Meikle, S.R., Hutton, B.F., Bailey, D.L., A transmission-dependent method for scatter correction in SPECT (1994) J Nucl Med, 35, pp. 360-367
Kim, K.M., Watebe, H., Shidahara, M., SPECT collimator dependency of scatter and validation of transmission-dependent scatter compensation methodologies (2001) IEEE Trans Nucl Sci, 48, pp. 689-696
Narita, Y., Eberl, S., Iida, H., Monte Carlo and experimental evaluation of accuracy and noise properties of two scatter correction methods for SPECT (1996) Phys Med Biol, 41, pp. 2481-2496
Iida, H., Miura, S., Shoji, Y., Noninvasive quantitation of cerebral blood flow using oxygen-15-water and a dual-PET system (1998) J Nucl Med, 39, pp. 1789-1798
Innis, R. B., Seibyl, J. P., Scanley, B. E., Single photon emission computed tomographic imaging demonstrates loss of striatal dopamine transporters in Parkinson disease (1993) Proc Natl Acad Sci USA, 90, pp. 11965-11969
Seibyl, J. P., Marek, K., Sheff, K., Test/retest reproducibility of iodine-123- -CIT SPECT brain measurement of dopamine transporters in Parkinson's patients (1997) J Nucl Med, 38, pp. 1453-1459
Van Dyck, C. H., Seibyl, J. P., Malison, R. T., Age-related decline in striatal dopamine transporter binding with iodine-123- -CIT SPECT (1995) J Nucl Med, 36, pp. 1175-1181
Stodilka, R. Z., Kemp, B. J., Msaki, P., The relative contributions of scatter and attenuation corrections toward improved brain SPECT quantification (1998) Phys Med Biol, 43, pp. 2991-3008
Hudson, H. M., Larkin, R. S., Accelerated image reconstruction using ordered subsets of projection data (1994) IEEE Trans Med Imaging, 13, pp. 601-609
Sorenson, J. A., Phelps, M. E., (1987) Physics in Nuclear Medicine 2nd Ed, , New York, NY. Grune & Stratton Inc
Jaszczak, R. J., Coleman, R. E., Whitehead FR Physical factors affecting quantitative measurements using camera-based single photon emission computed tomography (SPECT) (1981) IEEE Trans Nucl Sci, 28, pp. 69-80
Meikle, S. R., Hutton, B. F., Bailey, D. L., A transmission-dependent method for scatter correction in SPECT (1994) J Nucl Med, 35, pp. 360-367
Kim, K. M., Watebe, H., Shidahara, M., SPECT collimator dependency of scatter and validation of transmission-dependent scatter compensation methodologies (2001) IEEE Trans Nucl Sci, 48, pp. 689-696
Contribution of scatter and attenuation compensation to SPECT images of nonuniformly distributed brain activities
Correction of scatter and attenuation is essential for quantitative SPECT. In this work, we evaluated the accuracy gained from a method of transmission-dependent convolution subtraction (TDCS) in the quantitation of activity that is highly concentrated in the striatum (STR), Methods: SPECT data were acquired from an 123I-containing phantom with a constant activity in the STR but differing background (BKG) activities, so as to simulate various STR/BKG ratios (19.7:1, 9.7:1, 4.8:1, 1.9:1, and 1:1). In a study of healthy humans (n = 6), a transmission scan followed by an emission scan was performed 24 h after injection of 123I-2β-carbomethoxy-3β- (4-iodophenyl)-tropane (123I-β-CIT). All SPECT data was reconstructed with ordered-subset expectation maximization. TDCS was applied for scatter correction. Values of activity in the STR and occipital lobe (for BKG) were used to calculate binding potential V3″ (= [STR - BKG]/BKG). The effect of SPECT collimator dependency on scatter correction was also evaluated for 6 collimators from 3 different SPECT cameras in the phantom experiment. Results: Scatter correction in the phantom experiment increased the measured values of STR activity (36.2%), resulting in a substantial increase in V3″ (66.1%). Scatter and attenuation corrections with recovery correction showed an overall bias of -7.3% for the STR, -4.0% for BKG activity, and -7.8% for V3″. TDCS corrections of phantom activities were relatively uniform for the 6 different collimators, with variabilities of <5.5% for the STR and <3.0% for BKG activities. TDCS correction of human 123I-β-CIT images was of a similar, although slightly larger, magnitude than for the phantom data, with increased V3″ values of 9.4 ± 2.3 and 4.9 ± 0.6, with and without scatter correction, respectively. Conclusion: The TDSC method significantly improved the accuracy of SPECT images with a nonuniform distribution of activity highly concentrated in central regions. The value of V3″ was significantly increased in phantom and human data, with most of the improvement derived from an increase in STR activity. This scatter correction method was approximately equally useful with data from the 6 different collimators and is recommended for more accurate quantitation of nonuniformly distributed brain activities.
Correction of scatter and attenuation is essential for quantitative SPECT. In this work, we evaluated the accuracy gained from a method of transmission-dependent convolution subtraction (TDCS) in the quantitation of activity that is highly concentrated in the striatum (STR), Methods: SPECT data were acquired from an 123I-containing phantom with a constant activity in the STR but differing background (BKG) activities, so as to simulate various STR/BKG ratios (19.7:1, 9.7:1, 4.8:1, 1.9:1, and 1:1). In a study of healthy humans (n = 6), a transmission scan followed by an emission scan was performed 24 h after injection of 123I-2β-carbomethoxy-3β- (4-iodophenyl)-tropane (123I-β-CIT). All SPECT data was reconstructed with ordered-subset expectation maximization. TDCS was applied for scatter correction. Values of activity in the STR and occipital lobe (for BKG) were used to calculate binding potential V3″ (= [STR - BKG]/BKG). The effect of SPECT collimator dependency on scatter correction was also evaluated for 6 collimators from 3 different SPECT cameras in the phantom experiment. Results: Scatter correction in the phantom experiment increased the measured values of STR activity (36.2%), resulting in a substantial increase in V3″ (66.1%). Scatter and attenuation corrections with recovery correction showed an overall bias of -7.3% for the STR, -4.0% for BKG activity, and -7.8% for V3″. TDCS corrections of phantom activities were relatively uniform for the 6 different collimators, with variabilities of <5.5% for the STR and <3.0% for BKG activities. TDCS correction of human 123I-β-CIT images was of a similar, although slightly larger, magnitude than for the phantom data, with increased V3″ values of 9.4 ± 2.3 and 4.9 ± 0.6, with and without scatter correction, respectively. Conclusion: The TDSC method significantly improved the accuracy of SPECT images with a nonuniform distribution of activity highly concentrated in central regions. The value of V3″ was significantly increased in phantom and human data, with most of the improvement derived from an increase in STR activity. This scatter correction method was approximately equally useful with data from the 6 different collimators and is recommended for more accurate quantitation of nonuniformly distributed brain activities.
Contribution of scatter and attenuation compensation to SPECT images of nonuniformly distributed brain activities
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Contribution of scatter and attenuation compensation to SPECT images of nonuniformly distributed brain activities
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Attenuation correction for myocardial perfusion SPECT imaging: still a controversial issue (430 views)
Eur J Nucl Med (ISSN: 1619-7089, 1619-7070, 0340-6997), 2011 Oct; 38(10): 1887-1889.
Impact Factor: 4.991
View Export to BibTeX Export to EndNote
Slomka PJ, Le Meunier L, Hayes SW, Acampa W, Oba M, Haemer GG, Berman DS, Germano G
* Comparison of Myocardial Perfusion (82)Rb PET Performed with CT- and Transmission CT-Based Attenuation Correction (562 views)
J Nucl Med (ISSN: 0161-5505, 1535-5667, 1535-5667electronic), 2008 Dec; 49(12): 1992-1998.
Impact Factor: 6.662
View Export to BibTeX Export to EndNote
Fujita M, Varrone A, Kim KM, Watabe H, Zoghbi SS, Seneca N, Tipre D, Seibyl JP, Innis RB, Iida H
* Effect of scatter correction on the compartmental measurement of striatal and extrastriatal dopamine D2 receptors using [ 123I]epidepride SPET (354 views)
Eur J Nucl Med (ISSN: 1619-7070, 1619-7089, 0340-6997), 2004 May; 31(5): 644-654.
Impact Factor: 3.935
View Export to BibTeX Export to EndNote
Kim KM, Watabe H, Varrone A, Fujita M, Innis RB, Iida H
* Evaluation of Two Scatter Correction Methods in Quantitative Brain SPECT with Dopaminergic Tracer (236 views)
Ieee Nucl Sci Symp Med Imaging Conf, 2002; 3: 1792-1796.
Impact Factor: 0.155
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4 Records (4 excluding Abstracts).
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Total 5 year impact factor: 15.907 (15.907 excluding Abstracts).
Total impact factor: 15.743 (15.743 excluding Abstracts).
Total 5 year impact factor: 15.907 (15.907 excluding Abstracts).
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