Different partial volume correction methods lead to different conclusions: An (18)F-FDG-PET study of aging.

Improved selection of patients for hepatic surgery of colorectal liver metastases with (18)F-FDG PET: A randomized study

Respiratory and cardiac motion leads to image degradation in positron emission tomography (PET) studies of the human heart. In this paper we present a novel approach to motion correction based on dual gating and mass-preserving hyperelastic image registration. Thereby, we account for intensity modulations caused by the highly nonrigid cardiac motion. This leads to accurate and realistic motion estimates which are quantitatively validated on software phantom data and carried over to clinically relevant data using a hardware phantom. For patient data, the proposed method is first evaluated in a high statistic (20 min scans) dual gating study of 21 patients. It is shown that the proposed approach properly corrects PET images for dual-cardiac as well as respiratory-motion. In a second study the list mode data of the same patients is cropped to a scan time reasonable for clinical practice (3 min). This low statistic study not only shows the clinical applicability of our method but also demonstrates its robustness against noise obtained by hyperelastic regularization.

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Motion Correction in Dual Gated Cardiac PET Using Mass-Preserving Image Registration

After the successful clinical introduction of PET/CT, a novel hybrid imaging technology combining PET with the versatile attributes of MRI is emerging. At the Forschungszentrum Julich, one of four prototypes available worldwide combining a commercial 3T MRI with a newly developed BrainPET insert has been installed, allowing simultaneous data acquisition with PET and MRI. The BrainPET is equipped with LSO crystals of 2.5 mm width and Avalanche photodiodes (APD) as readout electronics. Here we report on some performance characteristics obtained by phantom studies and also on the initial BrainPET studies on various patients as compared with a conventional HR+ PET-only scanner. Material, methods: The radiotracers [18F]-fluoro-ethyl-tyrosine (FET), [11C]-flumazenil and [18F]-FP-CIT were applied. Results: Comparing the PET data obtained with the BrainPET to those of the HR+ scanner demonstrated the high image quality and the superior resolution capability of the BrainPET. Furthermore, it is shown that various MR images of excellent quality could be acquired simultaneously with BrainPET scans without any relevant artefacts. Discussion, conclusion: Initial experiences with the hybrid MRI/BrainPET indicate a promising basis for further developments of this unique technique allowing simultaneous PET imaging combined with both anatomical and functional MRI.

High resolution BrainPET combined with simultaneous MRI.

Purpose
We investigated the added value of a new respiratory amplitude-based PET reconstruction method called optimal gating (OG) with the aim of providing accurate image quantification in lung cancer.

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Optimal gating compared to 3D and 4D PET reconstruction for characterization of lung tumours

Combined PET/computed tomography (CT) is of value in cancer diagnosis, follow-up, and treatment planning. For cancers located in the thorax or abdomen, the patient’s breathing causes artifacts and errors in PET and CT images. Many different approaches for artifact avoidance or correction have been developed; most are based on gated acquisition and synchronization between the respiratory signal and PET acquisition. The respiratory signal is usually produced by an external sensor that tracks a physiological characteristic related to the patient’s breathing. Respiratory gating is a compensation technique in which time or amplitude binning is used to exclude the motion in reconstructed PET images. Although this technique is performed in routine clinical practice, it fails to adequately correct for respiratory motion because each gate can mix several tissue positions. Researchers have suggested either selecting PET events from gated acquisitions or performing several PET acquisitions (corresponding to a breath-hold CT position). However, the PET acquisition time must be increased if adequate counting statistics are to be obtained in the different gates after binning. Hence, other researchers have assessed correction techniques that take account of all the counting statistics (without increasing the acquisition duration) and integrate motion information before, during, or after the reconstruction process. Here, we provide an overview of how motion is managed to overcome respiratory motion in PET/CT images.

Management of respiratory motion in PET/computed tomography: the state of the art

Respiratory motion causes uptake in positron emission tomography (PET) images of chest structures to spread out and misregister with the CT images. This misregistration can alter the attenuation correction and thus the quantisation of PET images. In this paper, we present the first clinical results for a respiratory-gated PET (RG-PET) processing method based on a single breath-hold CT (BH-CT) acquisition, which seeks to improve diagnostic accuracy via better PET-to-CT co-registration. We refer to this method as “CT-based” RG-PET processing. Thirteen lesions were studied. Patients underwent a standard clinical PET protocol and then the CT-based protocol, which consists of a 10-min List Mode RG-PET acquisition, followed by a shallow end-expiration BH-CT. The respective performances of the CT-based and clinical PET methods were evaluated by comparing the distances between the lesions’ centroids on PET and CT images. SUVMAX and volume variations were also investigated. The CT-based method showed significantly lower (p = 0.027) centroid distances (mean change relative to the clinical method = −49%; range = −100% to 0%). This led to higher SUVMAX (mean change = +33%; range = −4% to 69%). Lesion volumes were significantly lower (p = 0.022) in CT-based PET volumes (mean change = −39%: range = −74% to −1%) compared with clinical ones. A CT-based RG-PET processing method can be implemented in clinical practice with a small increase in radiation exposure. It improves PET-CT co-registration of lung lesions and should lead to more accurate attenuation correction and thus SUV measurement.

Initial clinical results for breath-hold CT-based processing of respiratory-gated PET acquisitions

Background: Respiratory motion causes uptake in positron emission tomography (PET) images of chest and abdominal structures to be blurred and reduced in intensity.Purpose: To compare two respiratory-gated PET binning methods (based on frequency and amplitude analyses of the respiratory signal) and to propose a “BH-based” method based on an additional breath-hold computed tomography (CT) acquisition.Material and Methods: Respiratory-gated PET consists in list-mode (LM) acquisition with simultaneous respiratory signal recording. A phantom study featured rectilinear movement of a 0.5-ml sphere filled with 18F-fluorodeoxyglucose (18F-FDG) solution, placed in a radioactive background (sphere-to-background contrast 6:1). Two patients were also examined. Three figures of merit were calculated: the target-to-background ratio profile (TBRP) in the axial direction through the uptake (i.e., the sphere or lesion), full-width-at-half-maximum (FWHM) values, and maximized standard uptake values (SUVmax).Results: In the ...

Respiratory-Gated Positron Emission Tomography and Breath-Hold Computed Tomography Coupling to Reduce the Influence of Respiratory Motion: Methodology and Feasibility

BackgroundRespiratory motion is known to deteriorate positron emission tomography (PET) images and may lead to potential diagnostic errors when a standardized uptake value (SUV) cut-off threshold i...

Pascal Bailly

Papers

Management of respiratory motion in PET/computed tomography: the state of the art

Initial clinical results for breath-hold CT-based processing of respiratory-gated PET acquisitions

Respiratory-Gated Positron Emission Tomography and Breath-Hold Computed Tomography Coupling to Reduce the Influence of Respiratory Motion: Methodology and Feasibility

Respiratory-gated 18F-FDG PET imaging in lung cancer: effects on sensitivity and specificity.

Improved attenuation correction via appropriate selection of respiratory-correlated PET data