Abstract

The estimation of myocardial blood flow (MBF) in dynamic PET can be biased by many different processes. A major source of error, particularly in clinical applications, is patient motion. Patient motion, or gross motion, creates displacements between different PET frames as well as between the PET frames and the CT-derived attenuation map, leading to errors in MBF calculation from voxel time series. Motion correction techniques are challenging to evaluate quantitatively and the impact on MBF reliability is not fully understood. Most metrics, such as signal-to-noise ratio (SNR), are characteristic of static images, and are not specific to motion correction in dynamic data. This study presents a new approach of estimating motion correction quality in dynamic cardiac PET imaging. It relies on calculating a MBF surrogate, K1 , along with the uncertainty on the parameter. This technique exploits a Bayesian framework, representing the kinetic parameters as a probability distribution, from which the uncertainty measures can be extracted. If the uncertainty extracted is high, the parameter studied is considered to have high variability - or low confidence - and vice versa. The robustness of the framework is evaluated on simulated time activity curves to ensure that the uncertainties are consistently estimated at the multiple levels of noise. Our framework is applied on 40 patient datasets, divided in 4 motion magnitude categories. Experienced observers manually realigned clinical datasets with 3D translations to correct for motion. K1 uncertainties were compared before and after correction. A reduction of uncertainty after motion correction of up to 60% demonstrates the benefit of motion correction in dynamic PET and as well as provides evidence of the usefulness of the new method presented.

Highlights

  • Myocardial Perfusion Imaging (MPI) with hybrid Positron Emission Tomography (PET) / Computed Tomography (CT) is an established technology for assessing coronary artery disease (CAD) [1]

  • This study proposes a novel method to assess the motion correction of dynamic cardiac PET data, by evaluating the uncertainty of the Myocardial Blood Flow (MBF) estimate, which is derived from the Variational Bayes (VB) framework

  • For the Stress Time Activity Curves (TACs), both methods evaluated the confidence intervals with a small difference compared to the frequentist definition, with fCIV B and fCIMH being respectively 89.5% and 88.1%

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Summary

Introduction

Myocardial Perfusion Imaging (MPI) with hybrid Positron Emission Tomography (PET) / Computed Tomography (CT) is an established technology for assessing coronary artery disease (CAD) [1]. Recent studies have shown that kinetic modelling with dynamic PET provides clinicians with quantitative estimates of Myocardial Blood Flow (MBF), which offers potentially superior diagnosis compared to standard MPI [2], [3], [4]. Quantification and standardization of MBF is an important area of research for dynamic cardiac PET imaging [5], [6], [7]. MBF and MFR can improve diagnosis, for example in patients with triple vessel coronary disease [8]. MBF estimates can be affected by many factors, such as the choice of reconstruction method [10], temporal sampling strategy [11], post-processing methods [6] and patient motion [12]

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