Accurate quantification of uptake on PET images depends on accurate attenuation correction in reconstruction. Current MR-based attenuation correction methods for body PET use a fat and water map derived from a 2-echo Dixon MRI sequence in which bone is neglected. Ultrashort-echo-time or zero-echo-time (ZTE) pulse sequences can capture bone information. We propose the use of patient-specific multiparametric MRI consisting of Dixon MRI and proton-density–weighted ZTE MRI to directly synthesize pseudo-CT images with a deep learning model: we call this method ZTE and Dixon deep pseudo-CT (ZeDD CT). Methods: Twenty-six patients were scanned using an integrated 3-T time-of-flight PET/MRI system. Helical CT images of the patients were acquired separately. A deep convolutional neural network was trained to transform ZTE and Dixon MR images into pseudo-CT images. Ten patients were used for model training, and 16 patients were used for evaluation. Bone and soft-tissue lesions were identified, and the SUVmax was measured. The root-mean-squared error (RMSE) was used to compare the MR-based attenuation correction with the ground-truth CT attenuation correction. Results: In total, 30 bone lesions and 60 soft-tissue lesions were evaluated. The RMSE in PET quantification was reduced by a factor of 4 for bone lesions (10.24% for Dixon PET and 2.68% for ZeDD PET) and by a factor of 1.5 for soft-tissue lesions (6.24% for Dixon PET and 4.07% for ZeDD PET). Conclusion: ZeDD CT produces natural-looking and quantitatively accurate pseudo-CT images and reduces error in pelvic PET/MRI attenuation correction compared with standard methods.

http://jnm.snmjournals.org/content/early/2017/10/25/jnumed.117.198051.full.pdf

Zero-Echo-Time and Dixon Deep Pseudo-CT (ZeDD CT): Direct Generation of Pseudo-CT Images for Pelvic PET/MRI Attenuation Correction Using Deep Convolutional Neural Networks with Multiparametric MRI

Purpose:
The GE SIGNA PET/MR is a new whole body integrated time-of-flight (ToF)-PET/MR scanner from GE Healthcare. The system is capable of simultaneous PET and MR image acquisition with sub-400 ps coincidence time resolution. Simultaneous PET/MR holds great potential as a method of interrogating molecular, functional, and anatomical parameters in clinical disease in one study. Despite the complementary imaging capabilities of PET and MRI, their respective hardware tends to be incompatible due to mutual interference. In this work, the GE SIGNA PET/MR is evaluated in terms of PET performance and the potential effects of interference from MRI operation.
Methods:
The NEMA NU 2-2012 protocol was followed to measure PET performance parameters including spatial resolution, noise equivalent count rate, sensitivity, accuracy, and image quality. Each of these tests was performed both with the MR subsystem idle and with continuous MR pulsing for the duration of the PET data acquisition. Most measurements were repeated at three separate test sites where the system is installed.
Results:
The scanner has achieved an average of 4.4, 4.1, and 5.3 mm full width at half maximum radial, tangential, and axial spatial resolutions, respectively, at 1 cm from the transaxial FOV center. The peak noise equivalent count rate (NECR) of 218 kcps and a scatter fraction of 43.6% are reached at an activity concentration of 17.8 kBq/ml. Sensitivity at the center position is 23.3 cps/kBq. The maximum relative slice count rate error below peak NECR was 3.3%, and the residual error from attenuation and scatter corrections was 3.6%. Continuous MR pulsing had either no effect or a minor effect on each measurement.
Conclusions:
Performance measurements of the ToF-PET whole body GE SIGNA PET/MR system indicate that it is a promising new simultaneous imaging platform.

NEMA NU 2-2012 performance studies for the SiPM-based ToF-PET component of the GE SIGNA PET/MR system.

Purpose

To investigate proton density (PD)-weighted zero TE (ZT) imaging for morphological depiction and segmentation of cranial bone structures.



Methods

A rotating ultra-fast imaging sequence (RUFIS) type ZT pulse sequence was developed and optimized for 1) efficient capture of short T2 bone signals and 2) flat PD response for soft-tissues. An inverse logarithmic image scaling (i.e., −log(image)) was used to highlight bone and differentiate it from surrounding soft-tissue and air. Furthermore, a histogram-based bias-correction method was developed for subsequent threshold-based air, soft-tissue, and bone segmentation.



Results

PD-weighted ZT imaging in combination with an inverse logarithmic scaling was found to provide excellent depiction of cranial bone structures. In combination with bias correction, also excellent segmentation results were achieved. A two-dimensional histogram analysis demonstrates a strong, approximately linear correlation between inverse log-scaled ZT and low-dose CT for Hounsfield units (HU) between −300 HU and 1,500 HU (corresponding to soft-tissue and bone).



Conclusions

PD-weighted ZT imaging provides robust and efficient depiction of bone structures in the head, with an excellent contrast between air, soft-tissue, and bone. Besides structural bone imaging, the presented method is expected to be of relevance for attenuation correction in positron emission tomography (PET)/MR and MR-based radiation therapy planning. Magn Reson Med 75:107–114, 2016. © 2015 Wiley Periodicals, Inc.

Zero TE MR bone imaging in the head.

Aim To accurately quantify the radioactivity concentration measured by PET, emission data need to be corrected for photon attenuation; however, the MRI signal cannot easily be converted into attenuation values, making attenuation correction (AC) in PET/MRI challenging. In order to further improve the current vendor-implemented MR-AC methods for absolute quantification, a number of prototype methods have been proposed in the literature. These can be categorized into three types: template/atlas-based, segmentation-based, and reconstruction-based. These proposed methods in general demonstrated improvements compared to vendor-implemented AC, and many studies report deviations in PET uptake after AC of only a few percent from a gold standard CT-AC. Using a unified quantitative evaluation with identical metrics, subject cohort, and common CT-based reference, the aims of this study were to evaluate a selection of novel methods proposed in the literature, and identify the ones suitable for clinical use. Methods In total, 11 AC methods were evaluated: two vendor-implemented (MR-AC DIXON and MR-AC UTE ), five based on template/atlas information (MR-AC SEGBONE (Koesters et al., 2016), MR-AC ONTARIO (Anazodo et al., 2014), MR-AC BOSTON (Izquierdo-Garcia et al., 2014), MR-AC UCL (Burgos et al., 2014), and MR-AC MAXPROB (Merida et al., 2015)), one based on simultaneous reconstruction of attenuation and emission (MR-AC MLAA (Benoit et al., 2015)), and three based on image-segmentation (MR-AC MUNICH (Cabello et al., 2015), MR-AC CAR-RiDR (Juttukonda et al., 2015), and MR-AC RESOLUTE (Ladefoged et al., 2015)). We selected 359 subjects who were scanned using one of the following radiotracers: [ 18 F]FDG (210), [ 11 C]PiB (51), and [ 18 F]florbetapir (98). The comparison to AC with a gold standard CT was performed both globally and regionally, with a special focus on robustness and outlier analysis. Results The average performance in PET tracer uptake was within ±5% of CT for all of the proposed methods, with the average±SD global percentage bias in PET FDG uptake for each method being: MR-AC DIXON (−11.3±3.5)%, MR-AC UTE (−5.7±2.0)%, MR-AC ONTARIO (−4.3±3.6)%, MR-AC MUNICH (3.7±2.1)%, MR-AC MLAA (−1.9±2.6)%, MR-AC SEGBONE (−1.7±3.6)%, MR-AC UCL (0.8±1.2)%, MR-AC CAR-RiDR (−0.4±1.9)%, MR-AC MAXPROB (−0.4±1.6)%, MR-AC BOSTON (−0.3±1.8)%, and MR-AC RESOLUTE (0.3±1.7)%, ordered by average bias. The overall best performing methods (MR-AC BOSTON , MR-AC MAXPROB , MR-AC RESOLUTE and MR-AC UCL , ordered alphabetically) showed regional average errors within ±3% of PET with CT-AC in all regions of the brain with FDG, and the same four methods, as well as MR-AC CAR-RiDR , showed that for 95% of the patients, 95% of brain voxels had an uptake that deviated by less than 15% from the reference. Comparable performance was obtained with PiB and florbetapir. Conclusions All of the proposed novel methods have an average global performance within likely acceptable limits (±5% of CT-based reference), and the main difference among the methods was found in the robustness, outlier analysis, and clinical feasibility. Overall, the best performing methods were MR-ACBOSTON, MR-ACMAXPROB, MR-ACRESOLUTE and MR-ACUCL, ordered alphabetically. These methods all minimized the number of outliers, standard deviation, and average global and local error. The methods MR-ACMUNICH and MR-ACCAR-RiDR were both within acceptable quantitative limits, so these methods should be considered if processing time is a factor. The method MR-ACSEGBONE also demonstrates promising results, and performs well within the likely acceptable quantitative limits. For clinical routine scans where processing time can be a key factor, this vendor-provided solution currently outperforms most methods. With the performance of the methods presented here, it may be concluded that the challenge of improving the accuracy of MR-AC in adult brains with normal anatomy has been solved to a quantitatively acceptable degree, which is smaller than the quantification reproducibility in PET imaging.

A multi-centre evaluation of eleven clinically feasible brain PET/MRI attenuation correction techniques using a large cohort of patients

Advances in Multimodal Data Fusion in Neuroimaging: Overview, Challenges, and Novel Orientation

The goal of this study was to compare two approaches for MR-based PET patient attenuation correction (AC) in whole-body FDG-PET imaging using a tri-modality PET/CT & MR setup. Sixteen clinical whole-body FDG patients were included in this study. Mean standard uptake values (SUV) were measured for liver and lung volumes-of-interest for comparison. Maximum SUV values were measured in 18 FDGavid features in ten of the patients. The AC methods compared to gold-standard CT-based AC were segmentation of the CT (air, lung, fat, water), MR image segmentation with 4 tissue classes (air, lung, fat, water) and segmentation with air, lung and a continuous fat/water method. Results: The magnitude of uptake value differences induced by CT-based image segmentation were similar but lower on average than those found using the MRderived AC methods. The average liver SUV difference with that found using CTAC was 1.3%, 10.4% and 5.7% for 4-class segmented CT, 4-class MRAC and continuous fat/water MRAC methods, respectively. The average FDG-avid feature SUV max difference was -0.5%,1.7% and -1.6% for 4-class segmented CT, 4-class MRAC and continuous fat/water MRAC methods, respectively. Conclusion: The results demonstrated that both 4class and continuous fat/water AC methods provided adequate quantitation in the body, and that the continuous fat/water method was within 5.7% on average for SUV mean in liver and 1.6% on average for SUV max for FDG-avid features.

Comparison of 4-class and continuous fat/water methods for whole-body, MR-based PET attenuation correction

The goal of this study was to compare MR-based PET patient attenuation correction (AC) to CT-based AC in the head using clinical whole-body FDG-PET patient data obtained from a tri-modality PET/CT & MR setup. The MR-based AC utilizes an atlas-based approach, registering the patient's MR images to a CT-based atlas, producing `pseudoCT' images. Thirteen clinical whole-body FDG patients were included in this study. PET mean activity concentration values were measured and compared in six ~ 15 ml volumes-of-interest throughout the brain tissue. The AC methods compared to CT-based AC were segmentation of the CT (air, fat, soft tissue) and atlas-based MR-AC. Results: PET activity concentration was systematically under-estimated on average by 1.32 kBq/ml (4.9%) when using the segmented CT-based AC, mainly due to lack of attenuation correction for skull bone. Using the atlas-based method, the error was reduced to 0.03 kBq/ml (0.2%) on average. PET image visualization demonstrated spatial variations in activity concentration accuracy induced by the AC methods that were consistent with the approximations in each method. Conclusion: The results demonstrate that the atlas-based AC in the head provides adequate PET quantitation and image quality as compared to methods that do not account for bone.

Evaluation of an atlas-based PET head attenuation correction using PET/CT & MR patient data

TOF-NAC PET images produce a superior body contour as compared to non-TOF NAC PET images, thereby leading to more accurate truncation completion in the MR-derived attenuation map. We developed and systematically evaluated a procedure for truncation completion of MR-bases PET attenuation maps using body contours generated from TOF-NAC PET images. Fourteen clinical PET/CT and MR datasets from a tri-modality setup and fourteen PET/CT dual-modality datasets were used for this study.

Truncation completion of MR-based PET attenuation maps using time-of-flight non-attenuation-corrected PET images

The purpose of this study was to compare two different strategies of MR data acquisition for MR-based PET attenuation correction (MRAC) One of the leading causes of image variability in MR acquisition is the choice of transmit/receive radio-frequency coils We use a PET/CT-MR tri-modality setup to evaluate the advantages and limitations of local and body coil MR data acquisition for the generation of PET attenuation maps by means of fully automatic image processing This method has been tested retrospectively on data from clinical oncology patients referred for a PET/CT scan

https://ieeexplore.ieee.org/iel7/6819718/6829008/06829140.pdf

Sonal Ambwani

Papers

Comparison of 4-class and continuous fat/water methods for whole-body, MR-based PET attenuation correction

Evaluation of an atlas-based PET head attenuation correction using PET/CT & MR patient data

Truncation completion of MR-based PET attenuation maps using time-of-flight non-attenuation-corrected PET images

Evaluation of MR acquisition strategies for MR based attenuation correction