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Sun P, Thomas MA, Luo D, Pan T. New full-counts phase-matched data-driven gated (DDG) PET/CT. Med Phys 2024. [PMID: 38648671 DOI: 10.1002/mp.17097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/06/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Data-driven gated (DDG) PET has gained clinical acceptance and has been shown to match or outperform external-device gated (EDG) PET. However, in most clinical applications, DDG PET is matched with helical CT acquired in free breathing (FB) at a random respiratory phase, leaving registration, and optimal attenuation correction (AC) to chance. Furthermore, DDG PET requires additional scan time to reduce image noise as it only preserves 35%-50% of the PET data at or near the end-expiratory phase of the breathing cycle. PURPOSE A new full-counts, phase-matched (FCPM) DDG PET/CT was developed based on a low-dose cine CT to improve registration between DDG PET and DDG CT, to reduce image noise, and to avoid increasing acquisition times in DDG PET. METHODS A new DDG CT was developed for three respiratory phases of CT images from a low dose cine CT acquisition of 1.35 mSv for a coverage of about 15.4 cm: end-inspiration (EI), average (AVG), and end-expiration (EE) to match with the three corresponding phases of DDG PET data: -10% to 15%; 15% to 30%, and 80% to 90%; and 30% to 80%, respectively. The EI and EE phases of DDG CT were selected based on the physiological changes in lung density and body outlines reflected in the dynamic cine CT images. The AVG phase was derived from averaging of all phases of the cine CT images. The cine CT was acquired over the lower lungs and/or upper abdomen for correction of misregistration between PET and FB CT as well as DDG PET and FB CT. The three phases of DDG CT were used for AC of the corresponding phases of PET. After phase-matched AC of each PET dataset, the EI and AVG PET data were registered to the EE PET data with deformable image registration. The final result was FCPM DDG PET/CT which accounts for all PET data registered at the EE phase. We applied this approach to 14 18F-FDG lung cancer patient studies acquired at 2 min/bed position on the GE Discovery MI (25-cm axial FOV) and evaluated its efficacy in improved quantification and noise reduction. RESULTS Relative to static PET/CT, the SUVmax increases for the EI, AVG, EE, and FCPM DDG PET/CT were 1.67 ± 0.40, 1.50 ± 0.28, 1.64 ± 0.36, and 1.49 ± 0.28, respectively. There were 10.8% and 9.1% average decreases in SUVmax from EI and EE to FCPM DDG PET/CT, respectively. EI, AVG, and EE DDG PET/CT all maintained increased image noise relative to static PET/CT. However, the noise levels of FCPM and static PET were statistically equivalent, suggesting the inclusion of all counts was able to decrease the image noise relative to EI and EE DDG PET/CT. CONCLUSIONS A new FCPM DDG PET/CT has been developed to account for 100% of collected PET data in DDG PET applications. Image noise in FCPM is comparable to static PET, while small decreases in SUVmax were also observed in FCPM when compared to either EI or EE DDG PET/CT.
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Affiliation(s)
- Peng Sun
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - M Allan Thomas
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Dershan Luo
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Tinsu Pan
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA
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Sun P, Thomas MA, Luo D, Pan T. Correcting CT misregistration in data-driven gated (DDG) PET with PET self-gating and deformable image registration. Med Phys 2024; 51:1626-1636. [PMID: 38285623 PMCID: PMC10939831 DOI: 10.1002/mp.16958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Misregistration between CT and PET data can result in mis-localization and inaccurate quantification of functional uptake in whole body PET/CT imaging. This problem is exacerbated when an abnormal inspiration occurs during the free-breathing helical CT (FB CT) used for attenuation correction of PET data. In data-driven gated (DDG) PET, the data selected for reconstruction is typically derived from the end-expiration (EE) phase of the breathing cycle, making this potential issue worse. PURPOSE The objective of this study is to develop a deformable image registration (DIR)-based respiratory motion model to improve the registration and quantification between misregistered FB CT and PET. METHODS Twenty-two whole-body 18 F-FDG PET/CT scans encompassing 48 lesions in misregistered regions were analyzed in this study. End-inspiration (EI) and EE PET data were derived from -10% to 15% and 30% to 80% of the breathing cycle, respectively. DIR was used to estimate a motion model from the EE to EI phase of the PET data. The model was then used to generate PET images at any phase of up to four times the amplitude of motion between EE and EI for correlation with the misregistered FB CT. Once a matched phase of the FB CT was determined, FB CT was deformed to a pseudo CT at the EE phase (DIR CT). DIR CT was compared with the ground truth DDG CT for AC and localization of the DDG PET. RESULTS Between DDG PET/FB CT and DDG PET/DIR CT, a significant increase in ∆%SUV was observed (p < 0.01), with median values elevating from 26.7% to 42.4%. This new method was most effective for lesions ≤3 cm proximal to the diaphragm (p < 0.001) but showed decreasing efficacy as the distance increased. When FB CT was severely misregistered with DDG PET (>3 cm), DDG PET/DIR CT outperformed DDG PET/FB CT alone (p < 0.05). Even when patients showed varied breathing patterns during the PET/CT scan, DDG PET/DIR CT still surpassed the efficiency of DDG PET/FB CT (p < 0.01). Though DDG PET/DIR CT couldn't match the performance of the DDG PET/CT ground truth (42.4% vs. 53.6%, p < 0.01), it reached 84% of its quantification, demonstrating good agreement and a strong overall correlation (regression coefficient of 0.94, p < 0.0001). In some cases, anatomical distortion and blurring, and misregistration error were observed in DIR CT, rendering it still unable to correct inaccurate localization near the boundaries of two organs. CONCLUSIONS Based on the motion model derived from gated PET data, DIR CT can significantly improve the quantification and localization of DDG PET. This approach can achieve a performance level of about 84% of the ground truth established by DDG PET/CT. These results show that self-gated PET and DIR CT may offer an alternative clinical solution to DDG PET and FB CT for quantification without the need for additional cine-CT imaging. DIR CT was at times inferior to DDG CT due to some distortion and blurring of anatomy and misregistration error.
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Affiliation(s)
- Peng Sun
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
| | - M Allan Thomas
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO 63110
| | - Dershan Luo
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, TX 77030
| | - Tinsu Pan
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
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Miyaji N, Miwa K, Yamashita K, Motegi K, Wagatsuma K, Kamitaka Y, Yamao T, Ishiyama M, Terauchi T. Impact of irregular waveforms on data-driven respiratory gated PET/CT images processed using MotionFree algorithm. Ann Nucl Med 2023; 37:665-674. [PMID: 37796394 DOI: 10.1007/s12149-023-01870-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES MotionFree® (AMF) is a data-driven respiratory gating (DDG) algorithm for image processing that has recently been introduced into clinical practice. The present study aimed to verify the accuracy of respiratory waveform and the effects of normal and irregular respiratory motions using AMF with the DDG algorithm. METHODS We used a NEMA IEC body phantom comprising six spheres (37-, 28-, 22-, 17-, 13-, and 10 mm diameter) containing 18F. The sphere-to-background ratio was 4:1 (21.2 and 5.3 kBq/mL). We acquired PET/CT images from a stationary or moving phantom placed on a custom-designed motion platform. Respiratory motions were reproduced based on normal (sinusoidal or expiratory-paused waveforms) and irregular (changed amplitude or shifted baseline waveforms) movements. The "width" parameters in AMF were set at 10-60% and extracted data during the expiratory phases of each waveform. We verified the accuracy of the derived waveforms by comparing those input from the motion platform and output determined using AMF. Quantitative accuracy was evaluated as recovery coefficients (RCs), improvement rate, and %change that were calculated based on sphere diameter or width. We evaluated statistical differences in activity concentrations of each sphere between normal and irregular waveforms. RESULTS Respiratory waveforms derived from AMF were almost identical to the input waveforms on the motion platform. Although the RCs in each sphere for expiratory-paused and ideal stationary waveforms were almost identical, RCs except the expiratory-paused waveform were lower than those for the stationary waveform. The improvement rate decreased more for the irregular, than the normal waveforms with AMF in smaller spheres. The %change was improved by decreasing the width of waveforms with a shifted baseline. Activity concentrations significantly differed between normal waveforms and those with a shifted baseline in spheres < 28 mm. CONCLUSIONS The PET images using AMF with the DDG algorithm provided the precise waveform of respiratory motions and the improvement of quantitative accuracy in the four types of respiratory waveforms. The improvement rate was the most obvious in expiratory-paused waveforms, and the most subtle in those with a shifted baseline. Optimizing the width parameter in irregular waveform will benefit patients who breathe like the waveform with the shifted baseline.
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Affiliation(s)
- Noriaki Miyaji
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima-Shi, Fukushima, 960-8516, Japan.
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima-Shi, Fukushima, 960-8516, Japan
| | - Kosuke Yamashita
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan
| | - Kazuki Motegi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan
| | - Kei Wagatsuma
- School of Allied Health Sciences, Kitasato University, 1-15-1 Kitazato, Minami-Ku Sagamihara, Kanagawa, 252-0373, Japan
| | - Yuto Kamitaka
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-Ku, Tokyo, 173-0015, Japan
| | - Tensho Yamao
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, 10-6 Sakaemachi, Fukushima-Shi, Fukushima, 960-8516, Japan
| | - Mitsutomi Ishiyama
- Department of Radiology, Virginia Mason Medical Center, 1100 9Th Ave, Seattle, Washington, 98101, USA
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan
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Weber M, Telli T, Kersting D, Seifert R. Prognostic Implications of PET-Derived Tumor Volume and Uptake in Patients with Neuroendocrine Tumors. Cancers (Basel) 2023; 15:3581. [PMID: 37509242 PMCID: PMC10377105 DOI: 10.3390/cancers15143581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
Historically, molecular imaging of somatostatin receptor (SSTR) expression in patients with neuroendocrine tumors (NET) was performed using SSTR scintigraphy (SRS). Sustained advances in medical imaging have led to its gradual replacement with SSTR positron-emission tomography (SSTR-PET). The higher sensitivity in comparison to SRS on the one hand and conventional cross-sectional imaging, on the other hand, enables more accurate staging and allows for image quantification. In addition, in recent years, a growing body of evidence has assessed the prognostic implications of SSTR-PET-derived prognostic biomarkers for NET patients, with the aim of risk stratification, outcome prognostication, and prediction of response to peptide receptor radionuclide therapy. In this narrative review, we give an overview of studies examining the prognostic value of advanced SSTR-PET-derived (semi-)quantitative metrics like tumor volume, uptake, and composite metrics. Complementing this analysis, a discussion of the current trends, clinical implications, and future directions is provided.
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Affiliation(s)
- Manuel Weber
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, 45147 Essen, Germany
| | - Tugce Telli
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, 45147 Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, 45147 Essen, Germany
| | - Robert Seifert
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, 45147 Essen, Germany
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Meng QL, Yang R, Wu RZ, Xu L, Liu H, Yang G, Dong Y, Wang F, Chen Z, Jiang H. Evaluation of a respiratory motion-corrected image reconstruction algorithm in 2-[ 18F]FDG and [ 68Ga]Ga-DOTA-NOC PET/CT: impacts on image quality and tumor quantification. Quant Imaging Med Surg 2023; 13:370-383. [PMID: 36620155 PMCID: PMC9816722 DOI: 10.21037/qims-22-557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
Abstract
Background Respiratory motions may cause artifacts on positron emission tomography (PET) images that degrade image quality and quantification accuracy. This study aimed to evaluate the effect of a respiratory motion-corrected image reconstruction (MCIR) algorithm on image quality and tumor quantification compared with nongated/nonmotion-corrected reconstruction. Methods We used a phantom consisting of 5 motion spheres immersed in a chamber driven by a motor. The spheres and the background chamber were filled with 18F solution at a sphere-to-background ratio of 5:1. We enrolled 42 and 16 patients undergoing 2-deoxy-2-[18F]fluoro-D-glucose {2-[18F]FDG} and 68Ga-labeled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-Nal3-octreotide {[68Ga]Ga-DOTA-NOC} PET/computed tomography (CT) from whom 74 and 30 lesions were segmented, respectively. Three reconstructions were performed: data-driven gating-based motion correction (DDGMC), external vital signal module-based motion correction (VSMMC), and noncorrection reconstruction. The standardized uptake values (SUVs) and the volume of the spheres and the lesions were measured and compared among the 3 reconstruction groups. The image noise in the liver was measured, and the visual image quality of motion artifacts was scored by radiologists in the patient study. Results In the phantom study, the spheres' SUVs increased by 26-36%, and the volumes decreased by 35-38% in DDGMC and VSMMC compared with the noncorrection group. In the 2-[18F]FDG PET patient study, the lesions' SUVs had a median increase of 10.87-12.65% while the volumes had a median decrease of 14.88-15.18% in DDGMC and VSMMC compared with those of noncorrection. In the [68Ga]Ga-DOTA-NOC PET patient study, the lesions' SUVs increased by 14.23-15.45%, and the volumes decreased by 19.11-20.94% in DDGMC and VSMMC. The image noise in the liver was equal between the DDGMC, VSMMC, and noncorrection groups. Radiologists found improved image quality in more than 45% of the cases in DDGMC and VSMMC compared with the noncorrection group. There was no statistically significant difference in SUVs, volumes, or visual image quality scores between DDGMC and VSMMC. Conclusions MCIR improves tumor quantification accuracy and visual image quality by reducing respiratory motion artifacts without compromised image noise performance or elongated acquisition time in 2-[18F]FDG and [68Ga]Ga-DOTA-NOC PET/CT tumor imaging. The performance of DDG-driven MCIR is as good as that of the external device-driven solution.
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Affiliation(s)
- Qing-Le Meng
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Rui Yang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Run-Ze Wu
- United Imaging Healthcare, Shanghai, China
| | - Lei Xu
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hao Liu
- United Imaging Healthcare, Shanghai, China
| | - Gang Yang
- United Imaging Healthcare, Shanghai, China
| | - Yun Dong
- United Imaging Healthcare, Shanghai, China
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zhengguo Chen
- National Health Commission Key Laboratory of Nuclear Technology Medical Transformation, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Hongbing Jiang
- Department of Medical Equipment, Nanjing First Hospital, Nanjing Medical University, Nanjing, China;,Nanjing Emergency Medical Center, Nanjing, China
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Noto B, Roll W, Zinken L, Rischen R, Kerschke L, Evers G, Heindel W, Schäfers M, Büther F. Respiratory motion correction in F-18-FDG PET/CT impacts lymph node assessment in lung cancer patients. EJNMMI Res 2022; 12:61. [PMID: 36107357 PMCID: PMC9478021 DOI: 10.1186/s13550-022-00926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUNDS Elastic motion correction in PET has been shown to increase image quality and quantitative measurements of PET datasets affected by respiratory motion. However, little is known on the impact of respiratory motion correction on clinical image evaluation in oncologic PET. This study evaluated the impact of motion correction on expert readers' lymph node assessment of lung cancer patients. METHODS Forty-three patients undergoing F-18-FDG PET/CT for the staging of suspected lung cancer were included. Three different PET reconstructions were investigated: non-motion-corrected ("static"), belt gating-based motion-corrected ("BG-MC") and data-driven gating-based motion-corrected ("DDG-MC"). Assessment was conducted independently by two nuclear medicine specialists blinded to the reconstruction method on a six-point scale [Formula: see text] ranging from "certainly negative" (1) to "certainly positive" (6). Differences in [Formula: see text] between reconstruction methods, accounting for variation caused by readers, were assessed by nonparametric regression analysis of longitudinal data. From [Formula: see text], a dichotomous score for N1, N2, and N3 ("negative," "positive") and a subjective certainty score were derived. SUV and metabolic tumor volumes (MTV) were compared between reconstruction methods. RESULTS BG-MC resulted in higher scores for N1 compared to static (p = 0.001), whereas DDG-MC resulted in higher scores for N2 compared to static (p = 0.016). Motion correction resulted in the migration of N1 from tumor free to metastatic on the dichotomized score, consensually for both readers, in 3/43 cases and in 2 cases for N2. SUV was significantly higher for motion-corrected PET, while MTV was significantly lower (all p < 0.003). No significant differences in the certainty scores were noted. CONCLUSIONS PET motion correction resulted in significantly higher lymph node assessment scores of expert readers. Significant effects on quantitative PET parameters were seen; however, subjective reader certainty was not improved.
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Affiliation(s)
- Benjamin Noto
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Wolfgang Roll
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Laura Zinken
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Robert Rischen
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Laura Kerschke
- grid.5949.10000 0001 2172 9288Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Georg Evers
- grid.16149.3b0000 0004 0551 4246Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, Münster, Germany
| | - Walter Heindel
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Michael Schäfers
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Florian Büther
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany
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Thomas MA, Meier JG, Mawlawi OR, Sun P, Pan T. Impact of acquisition time and misregistration with CT on data-driven gated PET. Phys Med Biol 2022; 67:10.1088/1361-6560/ac5f73. [PMID: 35313286 PMCID: PMC9128538 DOI: 10.1088/1361-6560/ac5f73] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/21/2022] [Indexed: 11/11/2022]
Abstract
Objective. Data-driven gating (DDG) can address patient motion issues and enhance PET quantification but suffers from increased image noise from utilization of <100% of PET data. Misregistration between DDG-PET and CT may also occur, altering the potential benefits of gating. Here, the effects of PET acquisition time and CT misregistration were assessed with a combined DDG-PET/DDG-CT technique.Approach. In the primary PET bed with lesions of interest and likely respiratory motion effects, PET acquisition time was extended to 12 min and a low-dose cine CT was acquired to enable DDG-CT. Retrospective reconstructions were created for both non-gated (NG) and DDG-PET using 30 s to 12 min of PET data. Both the standard helical CT and DDG-CT were used for attenuation correction of DDG-PET data. SUVmax, SUVpeak, and CNR were compared for 45 lesions in the liver and lung from 27 cases.Main results. For both NG-PET (p= 0.0041) and DDG-PET (p= 0.0028), only the 30 s acquisition time showed clear SUVmaxbias relative to the 3 min clinical standard. SUVpeakshowed no bias at any change in acquisition time. DDG-PET alone increased SUVmaxby 15 ± 20% (p< 0.0001), then was increased further by an additional 15 ± 29% (p= 0.0007) with DDG-PET/CT. Both 3 min and 6 min DDG-PET had lesion CNR statistically equivalent to 3 min NG-PET, but then increased at 12 min by 28 ± 48% (p= 0.0022). DDG-PET/CT at 6 min had comparable counts to 3 min NG-PET, but significantly increased CNR by 39 ± 46% (p< 0.0001).Significance. 50% counts DDG-PET did not lead to inaccurate or biased SUV-increased SUV resulted from gating. Improved registration from DDG-CT was equally as important as motion correction with DDG-PET for increasing SUV in DDG-PET/CT. Lesion detectability could be significantly improved when DDG-PET used equivalent counts to NG-PET, but only when combined with DDG-CT in DDG-PET/CT.
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Affiliation(s)
- M. Allan Thomas
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
| | - Joseph G. Meier
- Department of Medical Physics, University of Wisconsin, Madison, WI 53726
| | - Osama R. Mawlawi
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
| | - Peng Sun
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
| | - Tinsu Pan
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX 77030
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Miwa K, Miyaji N, Yamashita K, Yamao T, Kamitaka Y. [Management of Respiratory Motion in PET/CT: Data-driven Respiratory Gating PET/CT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:1356-1365. [PMID: 34803117 DOI: 10.6009/jjrt.2021_jsrt_77.11.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University
| | - Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Kosuke Yamashita
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research
| | - Tensho Yamao
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University
| | - Yuto Kamitaka
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology
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Aide N, Lasnon C, Desmonts C, Armstrong IS, Walker MD, McGowan DR. Advances in PET-CT technology: An update. Semin Nucl Med 2021; 52:286-301. [PMID: 34823841 DOI: 10.1053/j.semnuclmed.2021.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/11/2022]
Abstract
This article reviews the current evolution and future directions in PET-CT technology focusing on three areas: time of flight, image reconstruction, and data-driven gating. Image reconstruction is considered with advances in point spread function modelling, Bayesian penalised likelihood reconstruction, and artificial intelligence approaches. Data-driven gating is examined with reference to respiratory motion, cardiac motion, and head motion. For each of these technological advancements, theory will be briefly discussed, benefits of their use in routine practice will be detailed and potential future developments will be discussed. Representative clinical cases will be presented, demonstrating the huge opportunities given to the PET community by hardware and software advances in PET technology when it comes to lesion detection, disease characterization, accurate quantitation and quicker scans. Through this review, hospitals are encouraged to embrace, evaluate and appropriately implement the wide range of new PET technologies that are available now or in the near future, for the improvement of patient care.
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Affiliation(s)
- Nicolas Aide
- Nuclear Medicine, Caen University Hospital, Caen, France; INSERM ANTICIPE, Normandie University, Caen, France.
| | - Charline Lasnon
- INSERM ANTICIPE, Normandie University, Caen, France; François Baclesse Cancer Center, Caen, France
| | - Cedric Desmonts
- Nuclear Medicine, Caen University Hospital, Caen, France; INSERM ANTICIPE, Normandie University, Caen, France
| | - Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Manchester
| | - Matthew D Walker
- Department of Medical Physics and Clinical Engineering, Oxford University Hospitals NHS FT, Oxford
| | - Daniel R McGowan
- Department of Medical Physics and Clinical Engineering, Oxford University Hospitals NHS FT, Oxford; Department of Oncology, University of Oxford, Oxford
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Thomas MA, Pan T. Data-driven gated PET/CT: implications for lesion segmentation and quantitation. EJNMMI Phys 2021; 8:64. [PMID: 34453630 PMCID: PMC8403089 DOI: 10.1186/s40658-021-00411-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/16/2021] [Indexed: 12/27/2022] Open
Abstract
Background Data-driven gating (DDG) can improve PET quantitation and alleviate many issues with patient motion. However, misregistration between DDG-PET and CT may occur due to the distinct temporal resolutions of PET and CT and can be mitigated by DDG-CT. Here, the effects of misregistration and respiratory motion on PET quantitation and lesion segmentation were assessed with a new DDG-PET/CT method. Methods A low-dose cine-CT was acquired in misregistered regions to enable both average CT (ACT) and DDG-CT. The following were compared: (1) baseline PET/CT, (2) PET/ACT (attenuation correction, AC = ACT), (3) DDG-PET (AC = helical CT), and (4) DDG-PET/CT (AC = DDG-CT). For DDG-PET, end-expiration (EE) data were derived from 50% of the total PET data at 30% from end-inspiration. For DDG-CT, EE phase CT data were extracted from cine-CT data by lung Hounsfield unit (HU) value and body contour. A total of 91 lesions from 16 consecutive patients were assessed for changes in standard uptake value (SUV), lesion glycolysis (LG), lesion volume, centroid-to-centroid distance (CCD), and DICE coefficients. Results Relative to baseline PET/CT, median changes in SUVmax ± σ for all 91 lesions were 20 ± 43%, 26 ± 23%, and 66 ± 66%, respectively, for PET/ACT, DDG-PET, and DDG-PET/CT. Median changes in lesion volume were 0 ± 58%, − 36 ± 26%, and − 26 ± 40%. LG for individual lesions increased for PET/ACT and decreased for DDG-PET, but was not different for DDG-PET/CT. Changes in mean HU from baseline PET/CT were dramatic for most lesions in both PET/ACT and DDG-PET/CT, especially for lesions with mean HU < 0 at baseline. CCD and DICE were both affected more by motion correction with DDG-PET than improved registration with ACT or DDG-CT. Conclusion As misregistration becomes more prominent, the impact of motion correction with DDG-PET is diminished. The potential benefits of DDG-PET toward accurate lesion segmentation and quantitation could only be fully realized when combined with DDG-CT. These results impress upon the necessity of ensuring both misregistration and motion correction are accounted for together to optimize the clinical utility of PET/CT. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00411-5.
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Affiliation(s)
- M Allan Thomas
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Tinsu Pan
- Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, TX, 77030, USA.
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