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Sartin SL, Shetty DR, Strange CD, Gayer G, Ahuja J, Agrawal R, Truong MT. Pitfalls in Positron Emission Tomography/Computed Tomography in the Thorax and Abdomen. Semin Ultrasound CT MR 2024:S0887-2171(24)00052-0. [PMID: 39069275 DOI: 10.1053/j.sult.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Positron emission tomography/computed tomography (PET/CT) using [18F]-fluoro-2-deoxy-D-glucose (FDG) has become the mainstay imaging modality for evaluating oncology patients with certain cancers. The most common FDG PET/CT applications include staging/restaging, assessing response to therapy and detecting tumor recurrence. It is important to be aware of potential pitfalls and technical artifacts on PET/CT in the chest and abdomen to ensure accurate interpretation, avoid unnecessary intervention and optimize patient care.
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Affiliation(s)
- Stephen L Sartin
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Dhanwin R Shetty
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chad D Strange
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gabriela Gayer
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jitesh Ahuja
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rishi Agrawal
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mylene T Truong
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX.
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Hybrid System: PET/CT. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Strange C, Shroff GS, Truong MT, Rohren EM. Pitfalls in Interpretation of PET/CT in the Chest. Semin Ultrasound CT MR 2021; 42:588-598. [PMID: 34895614 DOI: 10.1053/j.sult.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Whole body positron emission tomography (PET)/computed tomography (CT) imaging with [18F]-fluoro-2-deoxy-D-glucose (FDG) is widely used in oncologic imaging. In the chest, common PET/CT applications include the evaluation of solitary pulmonary nodules, cancer staging, assessment of response to therapy, and detection of residual or recurrent disease. Knowledge of the technical artifacts and potential pitfalls that radiologists may encounter in the interpretation of PET/CT in the thorax is important to avoid misinterpretation and optimize patient management. This article will review pitfalls in the interpretation of PET/CT in the chest related to technical factors, physiologic uptake, false positive findings, false negative findings, and iatrogenic conditions.
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Affiliation(s)
- Chad Strange
- MD Anderson Cancer Center, University of Texas, TX.
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PET/CT: underlying physics, instrumentation, and advances. RADIOLOGIA 2017; 59:431-445. [PMID: 28089381 DOI: 10.1016/j.rx.2016.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 08/23/2016] [Accepted: 10/03/2016] [Indexed: 01/03/2023]
Abstract
Since it was first introduced, the main goal of PET/CT has been to provide both PET and CT images with high clinical quality and to present them to radiologists and specialists in nuclear medicine as a fused, perfectly aligned image. The use of fused PET and CT images quickly became routine in clinical practice, showing the great potential of these hybrid scanners. Thanks to this success, manufacturers have gone beyond considering CT as a mere attenuation corrector for PET, concentrating instead on design high performance PET and CT scanners with more interesting features. Since the first commercial PET/CT scanner became available in 2001, both the PET component and the CT component have improved immensely. In the case of PET, faster scintillation crystals with high stopping power such as LYSO crystals have enabled more sensitive devices to be built, making it possible to reduce the number of undesired coincidence events and to use time of flight (TOF) techniques. All these advances have improved lesion detection, especially in situations with very noisy backgrounds. Iterative reconstruction methods, together with the corrections carried out during the reconstruction and the use of the point-spread function, have improved image quality. In parallel, CT instrumentation has also improved significantly, and 64- and 128-row detectors have been incorporated into the most modern PET/CT scanners. This makes it possible to obtain high quality diagnostic anatomic images in a few seconds that both enable the correction of PET attenuation and provide information for diagnosis. Furthermore, nowadays nearly all PET/CT scanners have a system that modulates the dose of radiation that the patient is exposed to in the CT study in function of the region scanned. This article reviews the underlying physics of PET and CT imaging separately, describes the changes in the instrumentation and standard protocols in a combined PET/CT system, and finally points out the most important advances in this hybrid imaging modality.
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Abstract
The synergy of functional and anatomic information in hybrid systems has undoubtedly enhanced the diagnostic potential of radionuclide imaging in recent years, contributing to the advancement of SPECT/CT in clinical practice. Since the introduction of commercial SPECT/CT in the late 1990 s, the field has seen rapid expansion and development toward multidetector CT subsystems, establishing the role of SPECT/CT as a routine imaging tool. It is, however, important to discuss possible challenges and technical limitations of such systems and how these influence imaging outcomes. In particular, the issues of patient motion and spatial misalignment of the SPECT and CT modalities, data corrections such as those for photon attenuation, and the choice of CT acquisition protocols in relation to radiation exposure are discussed in the article.
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Affiliation(s)
- Lefteris Livieratos
- Nuclear Medicine Department, Guy's & St Thomas' Hospitals, London, UK; Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
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Mortaheb P, Rezaeian M. Metal Artifact Reduction and Segmentation of Dental Computerized Tomography Images Using Least Square Support Vector Machine and Mean Shift Algorithm. JOURNAL OF MEDICAL SIGNALS AND SENSORS 2016; 6:1-11. [PMID: 27014607 PMCID: PMC4786958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Segmentation and three-dimensional (3D) visualization of teeth in dental computerized tomography (CT) images are of dentists' requirements for both abnormalities diagnosis and the treatments such as dental implant and orthodontic planning. On the other hand, dental CT image segmentation is a difficult process because of the specific characteristics of the tooth's structure. This paper presents a method for automatic segmentation of dental CT images. We present a multi-step method, which starts with a preprocessing phase to reduce the metal artifact using the least square support vector machine. Integral intensity profile is then applied to detect each tooth's region candidates. Finally, the mean shift algorithm is used to partition the region of each tooth, and all these segmented slices are then applied for 3D visualization of teeth. Examining the performance of our proposed approach, a set of reliable assessment metrics is utilized. We applied the segmentation method on 14 cone-beam CT datasets. Functionality analysis of the proposed method demonstrated precise segmentation results on different sample slices. Accuracy analysis of the proposed method indicates that we can increase the sensitivity, specificity, precision, and accuracy of the segmentation results by 83.24%, 98.35%, 72.77%, and 97.62% and decrease the error rate by 2.34%. The experimental results show that the proposed approach performs well on different types of CT images and has better performance than all existing approaches. Moreover, segmentation results can be more accurate by using the proposed algorithm of metal artifact reduction in the preprocessing phase.
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Affiliation(s)
- Parinaz Mortaheb
- Department of Electrical and Computer Engineering, Yazd University, Yazd, Iran,Address for correspondence: Parinaz Mortaheb, Department of Electrical and Computer Engineering, Yazd University, Yazd, Iran. E-mail:
| | - Mehdi Rezaeian
- Department of Electrical and Computer Engineering, Yazd University, Yazd, Iran
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Carter BW, Betancourt SL, Viswanathan C, Mawlawi O, Marom EM, Truong MT. Potential Pitfalls in Interpretation of Positron Emission Tomography/Computed Tomography Findings in the Thorax. Semin Roentgenol 2015; 50:210-6. [DOI: 10.1053/j.ro.2015.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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The effect of metal artefact reduction on CT-based attenuation correction for PET imaging in the vicinity of metallic hip implants: a phantom study. Ann Nucl Med 2014; 28:540-50. [PMID: 24710757 DOI: 10.1007/s12149-014-0844-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND To determine if metal artefact reduction (MAR) combined with a priori knowledge of prosthesis material composition can be applied to obtain CT-based attenuation maps with sufficient accuracy for quantitative assessment of (18)F-fluorodeoxyglucose uptake in lesions near metallic prostheses. METHODS A custom hip prosthesis phantom with a lesion-sized cavity filled with 0.2 ml (18)F-FDG solution having an activity of 3.367 MBq adjacent to a prosthesis bore was imaged twice with a chrome-cobalt steel hip prosthesis and a plastic replica, respectively. Scanning was performed on a clinical hybrid PET/CT system equipped with an additional external (137)Cs transmission source. PET emission images were reconstructed from both phantom configurations with CT-based attenuation correction (CTAC) and with CT-based attenuation correction using MAR (MARCTAC). To compare results with the attenuation-correction method extant prior to the advent of PET/CT, we also carried out attenuation correction with (137)Cs transmission-based attenuation correction (TXAC). CTAC and MARCTAC images were scaled to attenuation coefficients at 511 keV using a trilinear function that mapped the highest CT values to the prosthesis alloy attenuation coefficient. Accuracy and spatial distribution of the lesion activity was compared between the three reconstruction schemes. RESULTS Compared to the reference activity of 3.37 MBq, the estimated activity quantified from the PET image corrected by TXAC was 3.41 MBq. The activity estimated from PET images corrected by MARCTAC was similar in accuracy at 3.32 MBq. CTAC corrected PET images resulted in nearly 40 % overestimation of lesion activity at 4.70 MBq. Comparison of PET images obtained with the plastic and metal prostheses in place showed that CTAC resulted in a marked distortion of the (18)F-FDG distribution within the lesion, whereas application of MARCTAC and TXAC resulted in lesion distributions similar to those observed with the plastic replica. CONCLUSIONS MAR combined with a trilinear CT number mapping for PET attenuation correction resulted in estimates of lesion activity comparable in accuracy to that obtained with (137)Cs transmission-based attenuation correction, and far superior to estimates made without attenuation correction or with a standard CT attenuation map. The ability to use CT images for attenuation correction is a potentially important development because it obviates the need for a (137)Cs transmission source, which entails extra scan time, logistical complexity and expense.
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Abstract
PET/CT is widely used in the staging and assessment of therapeutic response in patients with malignancies. Accurate interpretation of PET/CT requires knowledge of the normal physiologic distribution of [18F]-fluoro-2-deoxy-d-glucose, artifacts due to the use of CT for attenuation correction of the PET scan and potential pitfalls due to malignancies that are PET negative and benign conditions that are PET positive. Awareness of these artifacts and potential pitfalls is important in preventing misinterpretation that can alter patient management.
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Affiliation(s)
- Mylene T Truong
- Division of Diagnostic Imaging, Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030, USA.
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Bandi P, Zsoter N, Koncz P, Babos M, Hobor S, Mathe D, Papp L. Automated material map generation from MRI scout pairs for preclinical PET attenuation correction. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:5351-4. [PMID: 23367138 DOI: 10.1109/embc.2012.6347203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A novel method is presented to perform material map segmentation from preclinical MRI for corresponding PET attenuation correction. MRI does not provide attenuation ratio, hence segmenting a material map from it is challenging. Furthermore the MRI images often suffer from ghost artifacts. On the contrary MRI has no radiation dose. Our method operated with fast spin echo scout pairs that had perpendicular frequency directions. This way the direction of the ghost artifacts were perpendicular as well. Our body-air segmentation method built on this a priori information and successfully erased the ghost artifacts from the final binary mask. Visual and quantitative validation was performed by two preclinical specialists. Results indicate that our method is effective against MRI scout ghost artifacts and that PET attenuation correction based on MRI makes sense even on preclinical images.
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Affiliation(s)
- Peter Bandi
- Mediso Medical Imaging Systems Ltd., Baross str. 91-95, H-1047 Budapest, Hungary.
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Abdoli M, Dierckx RAJO, Zaidi H. Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging. Med Phys 2012; 39:3343-60. [DOI: 10.1118/1.4709599] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abdoli M, Ay MR, Ahmadian A, Dierckx RAJO, Zaidi H. Reduction of dental filling metallic artifacts in CT-based attenuation correction of PET data using weighted virtual sinograms optimized by a genetic algorithm. Med Phys 2010; 37:6166-77. [PMID: 21302773 DOI: 10.1118/1.3511507] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Mehrsima Abdoli
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
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Is metal artefact reduction mandatory in cardiac PET/CT imaging in the presence of pacemaker and implantable cardioverter defibrillator leads? Eur J Nucl Med Mol Imaging 2010; 38:252-62. [DOI: 10.1007/s00259-010-1635-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 09/28/2010] [Indexed: 11/26/2022]
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Perrella A, Lopes PML, Rocha RG, Fenyo-Pereira M, Cavalcanti MGP. Influence of dental metallic artifact from multislice CT in the assessment of simulated mandibular lesions. J Appl Oral Sci 2010; 18:149-54. [PMID: 20485926 PMCID: PMC5349751 DOI: 10.1590/s1678-77572010000200009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Accepted: 10/22/2009] [Indexed: 11/22/2022] Open
Abstract
Objective This study evaluated the influence of metallic dental artifacts on the accuracy of
simulated mandibular lesion detection by using multislice technology. Material and Methods Fifteen macerated mandibles were used. Perforations were done simulating bone
lesions and the mandibles were subjected to axial 16 rows multislice CT images
using 0.5 mm of slice thickness with 0.3 mm interval of reconstruction. Metallic
dental restorations were done and the mandibles were subjected again to CT in the
same protocol. The images were analyzed to detect simulated lesions in the
mandibles, verifying the loci number and if there was any cortical perforation
exposing medullar bone. The analysis was performed by two independent examiners
using e-film software. Results The samples without artifacts presented better results compared to the gold
standard (dried mandible with perforations). In the samples without artifacts, all
cortical perforation were identified and 46 loci were detected (of 51) in loci
number analysis. Among the samples with artifacts, 12 lesions out of 14 were
recognized regarding medullar invasion, and 40 out of 51 concerning loci number.
The sensitivity in samples without artifacts was 90% and 100% regarding loci
number and medullar invasion, respectively. In samples with artifacts, these
values dropped to 78% and 86%, respectively. The presence of metallic restorations
affected the sensitivity values of the method, but the difference was not
significant (p>0.05). Conclusion Although there were differences in the results of samples with and without
artifacts, the presence of metallic restoration did not lead to misinterpretation
of the final diagnosis. However, the validity of multislice CT imaging in this
study was established for detection of simulated mandibular bone lesions.
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Affiliation(s)
- Andréia Perrella
- Department of Stomatology, Dental School, University of São Paulo, São Paulo, SP, Brazil
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15
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A virtual sinogram method to reduce dental metallic implant artefacts in computed tomography-based attenuation correction for PET. Nucl Med Commun 2010; 31:22-31. [PMID: 19829166 DOI: 10.1097/mnm.0b013e32832fa241] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Respiratory motion handling is mandatory to accomplish the high-resolution PET destiny. Eur J Nucl Med Mol Imaging 2008; 35:1961-70. [PMID: 18787822 DOI: 10.1007/s00259-008-0931-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Accepted: 08/18/2008] [Indexed: 10/21/2022]
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Abstract
Accurate anatomical localization of functional abnormalities obtained with the use of positron emission tomography (PET) is known to be problematic. Although tracers such as (18)F-fluorodeoxyglucose ((18)F-FDG) visualize certain normal anatomical structures, the spatial resolution is generally inadequate for accurate anatomic localization of pathology. Combining PET with a high-resolution anatomical imaging modality such as computed tomography (CT) can resolve the localization issue as long as the images from the two modalities are accurately coregistered. However, software-based registration techniques have difficulty accounting for differences in patient positioning and involuntary movement of internal organs, often necessitating labor-intensive nonlinear mapping that may not converge to a satisfactory result. Acquiring both CT and PET images in the same scanner obviates the need for software registration and routinely provides accurately aligned images of anatomy and function in a single scan. A CT scanner positioned in line with a PET scanner and with a common patient couch and operating console has provided a practical solution to anatomical and functional image registration. Axial translation of the couch between the 2 modalities enables both CT and PET data to be acquired during a single imaging session. In addition, the CT images can be used to generate essentially noiseless attenuation correction factors for the PET emission data. By minimizing patient movement between the CT and PET scans and accounting for the axial separation of the two modalities, accurately registered anatomical and functional images can be obtained. Since the introduction of the first PET/CT prototype more than 6 years ago, numerous patients with cancer have been scanned on commercial PET/CT devices worldwide. The commercial designs feature multidetector spiral CT and high-performance PET components. Experience has demonstrated an increased level of accuracy and confidence in the interpretation of the combined study as compared with studies acquired separately, particularly in distinguishing pathology from normal, physiologic tracer uptake and precisely localizing abnormal foci. Combined PET/CT scanners represent an important evolution in technology that has helped to bring molecular imaging to the forefront in cancer diagnosis, staging and therapy monitoring.
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Affiliation(s)
- David W Townsend
- Department of Medicine, University of Tennessee Medical Center, Knoxville, TN 37920-6999, USA.
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Boss DS, Olmos RV, Sinaasappel M, Beijnen JH, Schellens JHM. Application of PET/CT in the development of novel anticancer drugs. Oncologist 2008; 13:25-38. [PMID: 18245010 DOI: 10.1634/theoncologist.2007-0097] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Combined positron emission tomography/computed tomography (PET/CT) is a relatively new imaging modality, combining the functional images of PET with the anatomical information of CT. Since its commercial introduction about 5 years ago, PET/CT has become an important tool in oncology. Currently, the technique is used for primary staging and restaging of cancer patients, as well as for surgery and radiation therapy planning. The abilities of PET/CT to measure early treatment response as well as drug distribution within the body make this technique very useful in the development of novel anticancer drugs. In this paper, the recent literature on the current role of PET/CT in drug development is reviewed.
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Affiliation(s)
- David S Boss
- Division of Clinical Pharmacology, Department of Medical Oncology,The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
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Abstract
Molecular imaging using PET has evolved from a vigorous academic field into the clinical arena. Considerable advances have been made in the design of high-resolution standalone PET and combined PET/CT units dedicated to clinical whole-body scanning. Likewise, much worthwhile research focused on the development of quantitative imaging protocols incorporating accurate data correction techniques and sophisticated image reconstruction algorithms. Since its inception, photon attenuation in biological tissues has been identified as the most important physical degrading factor affecting PET image quality and quantitative accuracy. Various strategies have been devised to determine an accurate attenuation map to enable correction for nonlinear photon attenuation in whole-body PET studies. This article presents the physical and methodological basis of photon attenuation and summarizes state-of-the-art developments in algorithms used to derive the attenuation map aiming at accurate attenuation compensation of PET data. Future prospects, research trends, and challenges are identified, and directions for future research are discussed.
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Affiliation(s)
- Habib Zaidi
- Division of Nuclear Medicine, Geneva University Hospital, CH-1211 Geneva 4, Switzerland.
| | | | - Abass Alavi
- Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Mirzaei S, Prosch H, Knoll P, Mostbeck G. Non-small Cell Lung Cancer. Cancer Imaging 2008. [DOI: 10.1016/b978-012374212-4.50030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hybrid imaging is the future of molecular imaging. Biomed Imaging Interv J 2007; 3:e49. [PMID: 21614291 PMCID: PMC3097677 DOI: 10.2349/biij.3.3.e49] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 10/06/2007] [Indexed: 12/23/2022] Open
Abstract
Correlative imaging has long been used in clinical practice and particularly for the interpretation of nuclear medicine studies wherein detailed anatomical information is often lacking. Previously, side-by-side comparison or software co-registration techniques were applied but suffered from technical limitations related to the differing geometries of the imaging equipment, differences in the positioning of patients and displacement of mobile structures between studies. The development of the first hybrid PET and CT device struck a chord with the medical imaging community that is still ringing loudly throughout the world. So successful has been the concept of PET-CT that none of the major medical imaging manufacturers now offers stand-alone PET scanners. Following close behind this success, SPECT-CT devices have recently been adopted by the nuclear medicine community, already compelled by the benefits of hybrid imaging through their experience with PET-CT. Recent reports of adaptation of PET detectors to operate within the strong magnetic field of MRI scanners have generated further enthusiasm. Prototype PET-MRI devices are now in development. The complementary anatomical, functional and molecular information provided by these techniques can now be presented in an intuitive and aesthetically-pleasing format. This has made end-users more comfortable with the results of functional imaging techniques than when the same information is presented independently. Despite the primacy of anatomical imaging for locoregional disease definition, the molecular characterisation available from PET and SPECT offers unique complementary information for cancer evaluation. A new era of cancer imaging, when hybrid imaging will be the primary diagnostic tool, is approaching.
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Knoll P, Köhn H, Mirzaei S. Data acquisition and analysis: the strength of methodology in nuclear medicine and molecular imaging. Eur J Nucl Med Mol Imaging 2007; 34:961-2. [PMID: 17384948 DOI: 10.1007/s00259-007-0399-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van Dalen JA, Vogel WV, Corstens FHM, Oyen WJG. Multi-modality nuclear medicine imaging: artefacts, pitfalls and recommendations. Cancer Imaging 2007; 7:77-83. [PMID: 17535775 PMCID: PMC1931515 DOI: 10.1102/1470-7330.2007.0014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Multi-modality imaging is rapidly becoming an essential tool in oncology. Clinically, the best example of multimodality imaging is seen in the rapid evolution of hybrid positron emission tomography (PET)/computed tomography (CT) and single positron emission computed tomography (SPECT)/CT scanners. However, use of multi-modality imaging is prone to artefacts and pitfalls. Important artefacts that may lead to clinical misinterpretation result from the use of CT data to correct for attenuation and the existence of mismatches between the fused images, for example due to respiratory movement. Furthermore, for institutions who proceed from a standalone PET to a hybrid PET-CT, there is an issue of interchangeability between these systems, especially for quantitative studies. Another issue is visualisation: hospital PACS is not sufficiently capable of adequately viewing integrated images. This article reviews and illustrates the most common artefacts and pitfalls that can be encountered in multi-modality nuclear medicine imaging. For correct management of oncological patients it is essential to be able to detect and correctly interpret these artefacts and pitfalls. Therefore, solutions and recommendations to these problems are provided.
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Affiliation(s)
- Jorn A van Dalen
- Radboud University Medical Centre Nijmegen, Department of Nuclear Medicine, Nijmegen, The Netherlands.
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Zaidi H. Is radionuclide transmission scanning obsolete for dual-modality PET/CT systems? Eur J Nucl Med Mol Imaging 2007; 34:815-8. [PMID: 17225115 DOI: 10.1007/s00259-006-0337-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
In the past few years, positron emission tomography/computed tomography (PET/CT) imaging has increasingly been used for the diagnosis, staging, and restaging of malignant diseases. The success of this emerging modality has primarily been due to its ability to combine the advantages of both PET and CT imaging while minimizing their separate weaknesses. The aim of this paper is to provide an overview of the basis behind PET/CT imaging, its advantages, and discuss its imaging artifacts with special emphasis on proposed correction techniques. A brief discussion regarding the use of PET/CT imaging for radiation treatment planning is also presented.
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Affiliation(s)
- Osama Mawlawi
- Department of Imaging Physics, Unit 1352, MD Anderson Cancer Center, Houston, TX 77230, USA.
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