Spatial and Temporal Registration of CT and SPECT Images: Development and Validation of a Technique for In Vivo Three-Dimensional Semiquantitative Analysis of Bone

The combined use of postoperative 3-dimensional CT and SPECT imaging provides a means of relating anatomy and physiology for the semiquantitative in vivo analysis of bone. This study focuses on the development and validation of a technique that accomplishes this through the registration of SPECT data to a 3-dimensional volume of interest (VOI) interactively defined on CT images. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split-skull bone grafts reconstructed to skull and malar recipient sites. To acquire all images, each specimen was landmarked with 1.6-mm ball bearings and CT scanned. Bone surfaces were coated with 99mTc-doped paint. The locations of the ball bearings were marked with paint doped with 111In. Separate SPECT scans were acquired using the energy windows of 99mTc and 111In. Serial SPECT images aligned with an average root-mean-square (RMS) error of 3.8 mm (i.e.,