PET Attenuation Correction Research Articles

Validation of a simultaneous PET/MR system model for PET simulation using GATE.

Simultaneous PET/MR acquisition shows promise in a range of applications. Simulation using GATE is an essential tool that allows obtaining the ground truth for such acquisitions and therefore helping in the development and the validation of innovative processing methods such as PET image reconstruction, attenuation correction and motion correction. The purpose of this work is to validate the GATE simulation of the Siemens Biograph mMR PET/MR system. A model of the Siemens Biograph mMR was developed. This model includes the geometry and spatial positioning of the crystals inside the scanner and the characteristics of the detection process. The accuracy of the model was tested by comparing, on a real physical phantom study, GATE simulated results to reconstructed PET images using measured results obtained from a Siemens Biograph mMR system. The same parameters such as the acquisition time and phantom position inside the scanner were fixed for our simulations. List-mode outputs were recovered in both cases and reconstructed using the OPL-EM algorithm. Several parameters were used to compare the two reconstructed images such as profile comparison, signal-to-noise ratio and activity contrast analysis. Finally patient acquired MR images were segmented and used for the simulation of corresponding PET images. The simulated and acquired sets of reconstructed phantom images showed close emission values in regions of interest with relative differences lower than 5%. The scatter fraction was within a <3% agreement. Close matching of profiles and contrast indices were obtained between simulated and corresponding acquired PET images. Our results indicate that the GATE developed Biograph mMR model is accurate in comparison to the real scanner performance and can be used for evaluating innovative processing methods for applications in clinical PET/MR protocols.

The feasibility of low-dose CT protocols for coronary artery calcium scoring and PET attenuation correction in cardiac PET/CT.

The purpose of this study was to investigate the feasibility of using low-dose computed tomography (CT) in coronary artery calcium scoring and PET attenuation correction for patients in different weight categories undergoing cardiac PET/CT examinations. Calcium scoring computed tomography (CSCT) scans and PET scans of anthropomorphic cardiac phantoms simulating normal-weight, mildly obese, and severely obese patients were acquired with a hybrid PET/CT scanner. CSCT images were acquired at 120 kVp, with tube current ranging from 10 to 550 mA. PET scans were performed in three-dimensional mode, with acquisition time of 3 min/bed position. The image quality of cardiac PET/CT was evaluated by assessing the signal-to-noise ratio. CT-based coronary artery calcium quantification was performed using the Agatston scoring system. On the basis of our results, the CSCT protocols using tube currents of 50 and 150 mA should be able to achieve the lowest possible radiation dose while maintaining the desired image quality for normal-weight and mildly obese patients undergoing cardiac PET/CT examinations, respectively. When the proposed low-dose CSCT protocols were performed, radiation dose could be reduced by 83.34 and 50% compared with those from CSCT scans acquired with standard tube current settings for normal-weight and mildly obese patients, respectively. In the scanning of severely obese patients, an increase in tube voltage or current would help improve the reliability of image information provided by cardiac PET/CT. Our study demonstrated the feasibility of low-dose CT protocols for coronary artery calcium scoring and PET attenuation correction in cardiac PET/CT to examine patients in different weight categories. The calculations performed in this work should be able to provide practical information to achieve necessary diagnostic information while keeping radiation dose as low as reasonably achievable.

Clinical evaluation of zero-echo-time MR imaging for the segmentation of the skull.

MR-based attenuation correction is instrumental for integrated PET/MR imaging. It is generally achieved by segmenting MR images into a set of tissue classes with known attenuation properties (e.g., air, lung, bone, fat, soft tissue). Bone identification with MR imaging is, however, quite challenging, because of the low proton density and fast decay time of bone tissue. The clinical evaluation of a novel, recently published method for zero-echo-time (ZTE)-based MR bone depiction and segmentation in the head is presented here. A new paradigm for MR imaging bone segmentation, based on proton density-weighted ZTE imaging, was disclosed earlier in 2014. In this study, we reviewed the bone maps obtained with this method on 15 clinical datasets acquired with a PET/CT/MR trimodality setup. The CT scans acquired for PET attenuation-correction purposes were used as reference for the evaluation. Quantitative measurements based on the Jaccard distance between ZTE and CT bone masks and qualitative scoring of anatomic accuracy by an experienced radiologist and nuclear medicine physician were performed. The average Jaccard distance between ZTE and CT bone masks evaluated over the entire head was 52% ± 6% (range, 38%-63%). When only the cranium was considered, the distance was 39% ± 4% (range, 32%-49%). These results surpass previously reported attempts with dual-echo ultrashort echo time, for which the Jaccard distance was in the 47%-79% range (parietal and nasal regions, respectively). Anatomically, the calvaria is consistently well segmented, with frequent but isolated voxel misclassifications. Air cavity walls and bone/fluid interfaces with high anatomic detail, such as the inner ear, remain a challenge. This is the first, to our knowledge, clinical evaluation of skull bone identification based on a ZTE sequence. The results suggest that proton density-weighted ZTE imaging is an efficient means of obtaining high-resolution maps of bone tissue with sufficient anatomic accuracy for, for example, PET attenuation correction.

MR-based attenuation correction using ultrashort-echo-time pulse sequences in dementia patients.

Attenuation correction (AC) is a critical requirement for quantitative PET reconstruction. Accounting for bone information in the attenuation map (μ map) is of paramount importance for accurate brain PET quantification. However, to measure the signal from bone structures represents a challenging task in MR. Recent (18)F-FDG PET/MR studies showed quantitative bias for the assessment of radiotracer concentration when bone was ignored. This work is focused on (18)F-FDG PET/MR neurodegenerative dementing disorders. These are known to lead to specific patterns of (18)F-FDG hypometabolism, mainly in superficial brain structures, which might suffer from attenuation artifacts and thus have immediate diagnostic consequences. A fully automatic method to estimate the μ map, including bone tissue using only MR information, is presented. The algorithm was based on a dual-echo ultrashort-echo-time MR imaging sequence to calculate the R2 map, from which the μ map was derived. The R2-based μ map was postprocessed to calculate an estimated distribution of the bone tissue. μ maps calculated from datasets of 9 patients were compared with their CT-based μ maps (μ mapCT) by determining the confusion matrix. Additionally, a region-of-interest comparison between reconstructed PET data, corrected using different μ maps, was performed. PET data were reconstructed using a Dixon-based μ map (μ mapDX) and a dual-echo ultrashort-echo-time-based μ map (μ mapUTE), which are both calculated by the scanner, and the R2-based μ map presented in this work was compared with reconstructed PET data using the μ mapCT as a reference. Errors were approximately 20% higher using the μ mapDX and μ mapUTE for AC, compared with reconstructed PET data using the reference μ mapCT. However, PET AC using the R2-based μ map resulted, for all the patients and all the analyzed regions of interest, in a significant improvement, reducing the error to -5.8% to 2.5%. The proposed method successfully showed significantly reduced errors in quantification, compared with the μ mapDX and μ mapUTE, and therefore delivered more accurate PET image quantification for an improved diagnostic workup in dementia patients.

Metal artefact reduction algorithms prevent false positive results when assessing patients for cardiac implantable electronic device infection

Software-based metal artefact reduction (MAR) techniques are available to reduce artefacts from cardiac implantable electronic devices (CIED) in the CT data. The impact of disabling MAR techniques on quantification of 18F-FDG uptake around the CIED has not been examined. We consider the importance of enabling MAR in patients with suspected CIED infection to prevent inaccuracies in quantification of tissue tracer uptake on the attenuation-corrected PET images.

Feasibility of simultaneous whole-brain imaging on an integrated PET-MRI system using an enhanced 2-point Dixon attenuation correction method.

Purpose: To evaluate a potential approach for improved attenuation correction (AC) of PET in simultaneous PET and MRI brain imaging, a straightforward approach that adds bone information missing on Dixon AC was explored.Methods: Bone information derived from individual T1-weighted MRI data using segmentation tools in SPM8, were added to the standard Dixon AC map. Percent relative difference between PET reconstructed with Dixon+bone and with Dixon AC maps were compared across brain regions of 13 oncology patients. The clinical potential of the improved Dixon AC was investigated by comparing relative perfusion (rCBF) measured with arterial spin labeling to relative glucose uptake (rPETdxbone) measured simultaneously with 18F-flurodexoyglucose in several regions across the brain.Results: A gradual increase in PET signal from center to the edge of the brain was observed in PET reconstructed with Dixon+bone. A 5–20% reduction in regional PET signals were observed in data corrected with standard Dixon AC maps. These regional underestimations of PET were either reduced or removed when Dixon+bone AC was applied. The mean relative correlation coefficient between rCBF and rPETdxbone was r = 0.53 (p < 0.001). Marked regional variations in rCBF-to-rPET correlation were observed, with the highest associations in the caudate and cingulate and the lowest in limbic structures. All findings were well matched to observations from previous studies conducted with PET data reconstructed with computed tomography derived AC maps.Conclusion: Adding bone information derived from T1-weighted MRI to Dixon AC maps can improve underestimation of PET activity in hybrid PET-MRI neuroimaging.

Application of positron emission tomography/computed tomography in radiation treatment planning for head and neck cancers

18-fluorodeoxygluocose positron emission tomography/computed tomography ((18)FDG-PET/CT) provides significant information in multiple settings in the management of head and neck cancers (HNC). This article seeks to define the additional benefit of PET/CT as related to radiation treatment planning for squamous cell carcinomas (SCCs) of the head and neck through a review of relevant literature. By helping further define both primary and nodal volumes, radiation treatment planning can be improved using PET/CT. Special attention is paid to the independent benefit of PET/CT in targeting mucosal primaries as well as in detecting nodal metastases. The utility of PET/CT is also explored for treatment planning in the setting of SCC of unknown primary as PET/CT may help define a mucosal target volume by guiding biopsies for examination under anesthesia thus changing the treatment paradigm and limiting the extent of therapy. Implications of the use of PET/CT for proper target delineation in patients with artifact from dental procedures are discussed and the impact of dental artifact on CT-based PET attenuation correction is assessed. Finally, comment is made upon the role of PET/CT in the high-risk post-operative setting, particularly in the context of radiation dose escalation. Real case examples are used in these settings to elucidate the practical benefits of PET/CT as related to radiation treatment planning in HNCs.

Hybrid PET/MR imaging: an algorithm to reduce metal artifacts from dental implants in Dixon-based attenuation map generation using a multiacquisition variable-resonance image combination sequence.

It was the aim of this study to implement an algorithm modifying Dixon-based MR imaging datasets for attenuation correction in hybrid PET/MR imaging with a multiacquisition variable resonance image combination (MAVRIC) sequence to reduce metal artifacts. After ethics approval, in 8 oncologic patients with dental implants data were acquired in a trimodality setup with PET/CT and MR imaging. The protocol included a whole-body 3-dimensional dual gradient-echo sequence (Dixon) used for MR imaging-based PET attenuation correction and a high-resolution MAVRIC sequence, applied in the oral area compromised by dental implants. An algorithm was implemented correcting the Dixon-based μ maps using the MAVRIC in areas of Dixon signal voids. The artifact size of the corrected μ maps was compared with the uncorrected MR imaging μ maps. The algorithm was robust in all patients. There was a significant reduction in mean artifact size of 70.5% between uncorrected and corrected μ maps from 697 ± 589 mm(2) to 202 ± 119 mm(2) (P = 0.016). The proposed algorithm could improve MR imaging-based attenuation correction in critical areas, when standard attenuation correction is hampered by metal artifacts, using a MAVRIC.

Metal artifact reduction in patients with dental implants using multispectral three-dimensional data acquisition for hybrid PET/MRI.

BackgroundHybrid positron emission tomography/magnetic resonance imaging (PET/MRI) shows high potential for patients with oropharyngeal cancer. Dental implants can cause substantial artifacts in the oral cavity impairing diagnostic accuracy. Therefore, we evaluated new MRI sequences with multi-acquisition variable-resonance image combination (MAVRIC SL) in comparison to conventional high-bandwidth techniques and in a second step showed the effect of artifact size on MRI-based attenuation correction (AC) with a simulation study.MethodsTwenty-five patients with dental implants prospectively underwent a trimodality PET/CT/MRI examination after informed consent was obtained under the approval of the local ethics committee. A conventional 3D gradient-echo sequence (LAVA-Flex) commonly used for MRI-based AC of PET (acquisition time of 14 s), a T1w fast spin-echo sequence with high bandwidth (acquisition time of 3.2 min), as well as MAVRIC SL sequence without and with increased phase acceleration (MAVRIC, acquisition time of 6 min; MAVRIC-fast, acquisition time of 3.5 min) were applied. The absolute and relative reduction of the signal void artifact was calculated for each implant and tested for statistical significance using the Wilcoxon signed-rank test. The effect of artifact size on PET AC was simulated in one case with a large tumor in the oral cavity. The relative difference of the maximum standardized uptake value (SUVmax) in the tumor was calculated for increasing artifact sizes centered over the second molar.ResultsThe absolute reduction of signal void from LAVA-Flex sequences to the T1-weighted fast spin-echo (FSE) sequences was 416 mm2 (range 4 to 2,010 mm2) to MAVRIC 481 mm2 (range 12 to 2,288 mm2) and to MAVRIC-fast 486 mm2 (range 39 to 2,209 mm2). The relative reduction in signal void was significantly improved for both MAVRIC and MAVRIC-fast compared to T1 FSE (−75%/−78% vs. −62%, p < 0.001 for both). The relative error for SUVmax was negligible for artifacts of 0.5-cm diameter (−0.1%), but substantial for artifacts of 5.2-cm diameter (−33%).ConclusionsMAVRIC-fast could become useful for artifact reduction in PET/MR for patients with dental implants. This might improve diagnostic accuracy especially for patients with tumors in the oropharynx and substantially improve accuracy of PET quantification.

PET attenuation correction using synthetic CT from ultrashort echo-time MR imaging.

Integrated PET/MR systems are becoming increasingly popular in clinical and research applications. Quantitative PET reconstruction requires correction for γ-photon attenuations using an attenuation coefficient map (μ map) that is a measure of the electron density. One challenge of PET/MR, in contrast to PET/CT, lies in the accurate computation of μ maps. Unlike CT, MR imaging measures physical properties not directly related to electron density. Previous approaches have computed the attenuation coefficients using a segmentation of MR images or using deformable registration of atlas CT images to the space of the subject MR images. In this work, we propose a patch-based method to generate whole-head μ maps from ultrashort echo-time (UTE) MR imaging sequences. UTE images are preferred to other MR sequences because of the increased signal from bone. To generate a synthetic CT image, we use patches from a reference dataset, which consists of dual-echo UTE images and a coregistered CT scan from the same subject. Matching of patches between the reference and target images allows corresponding patches from the reference CT scan to be combined via a Bayesian framework. No registration or segmentation is required. For evaluation, UTE, CT, and PET data acquired from 5 patients under an institutional review board-approved protocol were used. Another patient (with UTE and CT data only) was selected to be the reference to generate synthetic CT images for these 5 patients. PET reconstructions were attenuation-corrected using the original CT, our synthetic CT, Siemens Dixon-based μ maps, Siemens UTE-based μ maps, and deformable registration-based CT. Our synthetic CT-based PET reconstruction showed higher correlation (average ρ = 0.996, R(2) = 0.991) to the original CT-based PET, as compared with the segmentation- and registration-based methods. Synthetic CT-based reconstruction had minimal bias (regression slope, 0.990), as compared with the segmentation-based methods (regression slope, 0.905). A peak signal-to-noise ratio of 35.98 dB in the reconstructed PET activity was observed, compared with 29.767, 29.34, and 27.43 dB for the Siemens Dixon-, UTE-, and registration-based μ maps. A patch-matching approach to synthesize CT images from dual-echo UTE images leads to significantly improved accuracy of PET reconstruction as compared with actual CT scans. The PET reconstruction is improved over segmentation- (Dixon and Siemens UTE) and registration-based methods, even in subjects with pathologic findings.

Quantitative simultaneous positron emission tomography and magnetic resonance imaging.

Simultaneous positron emission tomography and magnetic resonance imaging (PET-MR) is an innovative and promising imaging modality that is generating substantial interest in the medical imaging community, while offering many challenges and opportunities. In this study, we investigated whether MR surface coils need to be accounted for in PET attenuation correction. Furthermore, we integrated motion correction, attenuation correction, and point spread function modeling into a single PET reconstruction framework. We applied our reconstruction framework to in vivo animal and patient PET-MR studies. We have demonstrated that our approach greatly improved PET image quality.

An SPM8-based approach for attenuation correction combining segmentation and nonrigid template formation: application to simultaneous PET/MR brain imaging.

We present an approach for head MR-based attenuation correction (AC) based on the Statistical Parametric Mapping 8 (SPM8) software, which combines segmentation- and atlas-based features to provide a robust technique to generate attenuation maps (μ maps) from MR data in integrated PET/MR scanners. Coregistered anatomic MR and CT images of 15 glioblastoma subjects were used to generate the templates. The MR images from these subjects were first segmented into 6 tissue classes (gray matter, white matter, cerebrospinal fluid, bone, soft tissue, and air), which were then nonrigidly coregistered using a diffeomorphic approach. A similar procedure was used to coregister the anatomic MR data for a new subject to the template. Finally, the CT-like images obtained by applying the inverse transformations were converted to linear attenuation coefficients to be used for AC of PET data. The method was validated on 16 new subjects with brain tumors (n = 12) or mild cognitive impairment (n = 4) who underwent CT and PET/MR scans. The μ maps and corresponding reconstructed PET images were compared with those obtained using the gold standard CT-based approach and the Dixon-based method available on the Biograph mMR scanner. Relative change (RC) images were generated in each case, and voxel- and region-of-interest-based analyses were performed. The leave-one-out cross-validation analysis of the data from the 15 atlas-generation subjects showed small errors in brain linear attenuation coefficients (RC, 1.38% ± 4.52%) compared with the gold standard. Similar results (RC, 1.86% ± 4.06%) were obtained from the analysis of the atlas-validation datasets. The voxel- and region-of-interest-based analysis of the corresponding reconstructed PET images revealed quantification errors of 3.87% ± 5.0% and 2.74% ± 2.28%, respectively. The Dixon-based method performed substantially worse (the mean RC values were 13.0% ± 10.25% and 9.38% ± 4.97%, respectively). Areas closer to the skull showed the largest improvement. We have presented an SPM8-based approach for deriving the head μ map from MR data to be used for PET AC in integrated PET/MR scanners. Its implementation is straightforward and requires only the morphologic data acquired with a single MR sequence. The method is accurate and robust, combining the strengths of both segmentation- and atlas-based approaches while minimizing their drawbacks.

K-space sampling optimization for ultrashort TE imaging of cortical bone: applications in radiation therapy planning and MR-based PET attenuation correction.

The ultrashort echo-time (UTE) sequence is a promising MR pulse sequence for imaging cortical bone which is otherwise difficult to image using conventional MR sequences and also poses strong attenuation for photons in radiation therapy and PET imaging. The authors report here a systematic characterization of cortical bone signal decay and a scanning time optimization strategy for the UTE sequence through k-space undersampling, which can result in up to a 75% reduction in acquisition time. Using the undersampled UTE imaging sequence, the authors also attempted to quantitatively investigate the MR properties of cortical bone in healthy volunteers, thus demonstrating the feasibility of using such a technique for generating bone-enhanced images which can be used for radiation therapy planning and attenuation correction with PET/MR. An angularly undersampled, radially encoded UTE sequence was used for scanning the brains of healthy volunteers. Quantitative MR characterization of tissue properties, including water fraction and R2(∗) = 1/T2(∗), was performed by analyzing the UTE images acquired at multiple echo times. The impact of different sampling rates was evaluated through systematic comparison of the MR image quality, bone-enhanced image quality, image noise, water fraction, and R2(∗) of cortical bone. A reduced angular sampling rate of the UTE trajectory achieves acquisition durations in proportion to the sampling rate and in as short as 25% of the time required for full sampling using a standard Cartesian acquisition, while preserving unique MR contrast within the skull at the cost of a minimal increase in noise level. The R2(∗) of human skull was measured as 0.2-0.3 ms(-1) depending on the specific region, which is more than ten times greater than the R2(∗) of soft tissue. The water fraction in human skull was measured to be 60%-80%, which is significantly less than the >90% water fraction in brain. High-quality, bone-enhanced images can be generated using a reduced sampled UTE sequence with no visible compromise in image quality and they preserved bone-to-air contrast with as low as a 25% sampling rate. This UTE strategy with angular undersampling preserves the image quality and contrast of cortical bone, while reducing the total scanning time by as much as 75%. The quantitative results of R2(∗) and the water fraction of skull based on Dixon analysis of UTE images acquired at multiple echo times provide guidance for the clinical adoption and further parameter optimization of the UTE sequence when used for radiation therapy and MR-based PET attenuation correction.

MR-based attenuation correction in brain PET based on UTE sequences

Attenuation correction (AC) in brain PET/MR has recently emerged as one of the challenging tasks in the PET/MR field. It has been shown that to ignore the attenuation produced by bone can lead to errors ranging from 5-30% in regions close to bone structures. Since the information provided by the MR signal is not directly related to tissue attenuation, alternative methods have to be developed. Signal from bone tissue is difficult to measure given its short transverse relaxation time (T2). Ultrashort-echo time (UTE) pulse sequences were developed to measure signal from tissues with short T2. A combination of two consecutive UTE echoes has been used in several works to measure signal from bone tissue. The first echo is able to measure signal from bone tissue in addition to soft tissue, while the second echo contains most of the soft tissue contained in the first echo but not bone. In this work we extract the attenuation information from the difference between the logarithm of two images obtained after applying two consecutive UTE pulse sequences using the mMR scanner (Siemens Healthcare). Subsequently, image processing techniques are applied to reduce the noise and extract air cavities within the head. The resulting image is converted to linear attenuation coefficients, generating what is known as µ-map, to be used during reconstruction. For comparison purposes PET/CT scans of the same patients were acquired prior to the PET/MR scan. Additional µ-maps obtained for comparison were extracted from a Dixon sequence (used in clinical routine) and an additional µ-map calculated by the scanner based on UTE pulse sequences. Preliminary quantitative results measured in the cerebellum, using the value obtained with CT-based AC as reference, show differences of 34% without AC, 13% using the Dixon-based and UTE-based provided by the scanner, and 0.8% with the AC strategy presented here.

Automated body-lung-air material map segmentation from pre-clinical MRI images for PET attenuation correction in Tera-Tomo 3D PET reconstruction engine of nanoScan PET/MRI system.

The aim of current work was to automatically derive a body-lung-air three-valued material map from MRI images for pre-clinical PET attenuation correction. Our goal was also to measure the effect of attenuation on corresponding pre-clinical PET images. 12 mouse and 9 rat PET/MRI images were acquired by nanoScan PET/MRI (Mediso). Each MRI image was filtered with edge-preserving Non-Local Means filter. Two segmentation stages were determined: the first stage separated the body and the air. The gravitational center of each disjunctive region determined by histogram-derived value ranges of the body and the air were inputs of two independent fuzzy-based affinity map generation steps. The fuzzy maps were merged with simple maximum into an initial binary body-air material map. In the second stage the gravitational center of disjunctive air regions laid inside the body mask were the seed points of the third fuzzy affinity map generation. Three fuzzy maps were merged with maximum operation into a three-valued mask. The three-valued material map was given as input for the Tera-Tomo 3D PET reconstruction engine to serve as the base for attenuation correction. Mouse and rat material map segmentation result were validated by two experienced pre-clinical researchers who manually drawn the ideal mask boundaries. The ratio of voxel misclassification was measured as 2.23% (mouse) and 1.87% (rat). Quantitative ROI measurements shown 1.3 - 2.7% AC and NAC PET differences. An automated and robust segmentation method was designed to provide a material map for pre-clinical PET attenuation correction. Although current work operated with PET/MRI images, the same method can be applied for nanoScan SPECT/MRI acquisitions. Results show that on the level of real quantitative measurements, attenuation correction of PET makes sense. As the next step of our future work we will investigate the effects of AC on pre-clinical nanoScan SPECT/MRI images.

Optimization of transmission-scan time for the FixER method: a MR-based PET attenuation correction with a weak fixed-position external radiation source.

In recent work, we proposed an MRI-based attenuation-coefficient (μ-value) estimation method that uses a weak fixed-position external radiation source to construct an attenuation map for PET/MRI. In this presentation we refer to this method as FixER, and perform a series of simulations to investigate the duration of the transmission scan required to accurately estimate μ-values. In FixER, a segmented anatomical image and transmission data acquired with a fixed-position radiation source are needed to obtain µ-values for each segment. FixER has the advantage that segmentation reduces the number of unknowns and tissue identification is unnecessary. First, the geometry of a whole body PET scanner was replicated in virtual space, and a T1-weighted head image was segmented into air, bone, brain, and soft tissues other than brain. Simulated PET transmission scans were performed with the fixed-position 22Na point source (1MBq) to obtain the intensities with (I) and without (I0) a digital phantom made from the segmented tissues. The blank scan to obtain I0 was performed for 180 secs. The path length of each tissue was then calculated from the segmented image and straight lines drawn from the source to each crystal. Finally, the μ-values of each tissue type were calculated based on Lambert-Beer's law. All µ-values converged with increasing scan time. The µ-values for brain, bone and soft tissues were 0.101, 0.120 and 0.095 cm-1, respectively, for a 180 secs transmission scan. Using these values as points of reference, it was seen that a transmission scan of at least 46 secs is needed to estimate all µ-values within an accuracy of 3%. The optimal transmission-scan time for FixER was investigated for head imaging. In future work it is planned to also optimize the position and number of point sources for various body regions and numbers of segments.

CT substitutes derived from MR images reconstructed with parallel imaging.

Computed tomography (CT) substitute images can be generated from ultrashort echo time (UTE) MRI sequences with radial k-space sampling. These CT substitutes can be used as ordinary CT images for PET attenuation correction and radiotherapy dose calculations. Parallel imaging allows faster acquisition of magnetic resonance (MR) images by exploiting differences in receiver coil element sensitivities. This study investigates whether non-Cartesian parallel imaging reconstruction can be used to improve CT substitutes generated from shorter examination times. The authors used gridding as well as two non-Cartesian parallel imaging reconstruction methods, SPIRiT and CG-SENSE, to reconstruct radial UTE and gradient echo (GE) data into images of the head for 23 patients. For each patient, images were reconstructed from the full dataset and from a number of subsampled datasets. The subsampled datasets simulated shorter acquisition times by containing fewer radial k-space spokes (1000, 2000, 3000, 5000, and 10,000 spokes) than the full dataset (30,000 spokes). For each combination of patient, reconstruction method, and number of spokes, the reconstructed UTE and GE images were used to generate a CT substitute. Each CT substitute image was compared to a real CT image of the same patient. The mean absolute deviation between the CT number in CT substitute and CT decreased when using SPIRiT as compared to gridding reconstruction. However, the reduction was small and the CT substitute algorithm was insensitive to moderate subsampling (≥ 5000 spokes) regardless of reconstruction method. For more severe subsampling (≤ 3000 spokes), corresponding to acquisition times less than a minute long, the CT substitute quality was deteriorated for all reconstruction methods but SPIRiT gave a reduction in the mean absolute deviation of down to 25 Hounsfield units compared to gridding. SPIRiT marginally improved the CT substitute quality for a given number of radial spokes as compared to gridding. However, the increased reconstruction time of non-Cartesian parallel imaging reconstruction is difficult to motivate from this improvement. Because the CT substitute algorithm was insensitive to moderate subsampling, data for a CT substitute could be collected in as little as minute and reconstructed with gridding without deteriorating the CT substitute quality.

Radiotracer dose reduction in integrated PET/MR: implications from national electrical manufacturers association phantom studies.

With the replacement of ionizing CT by MR imaging, integrated PET/MR in selected clinical applications may reduce the overall patient radiation dose when compared with PET/CT. Further potential for radiotracer dose reduction, while maintaining PET image quality (IQ) in integrated PET/MR, may be achieved by increasing the PET acquisition duration to match the longer time needed for MR data acquisition. To systematically verify this hypothesis under controlled conditions, this dose-reduction study was performed using a standardized phantom following the National Electrical Manufacturers Association (NEMA) IQ protocol. All measurements were performed on an integrated PET/MR whole-body hybrid system. The NEMA IQ phantom was filled with water and a total activity of 50.35 MBq of (18)F-FDG. The sphere-to-background activity ratio was 8:1. Multiple PET data blocks of 20-min acquisition time were acquired in list-mode format and were started periodically at multiples of the (18)F-FDG half-lives. Different sinograms (2, 4, 8, and 16 min in duration) were reconstructed. Attenuation correction of the filled NEMA phantom was performed using a CT-based attenuation map template. The attenuation-corrected PET images were then quantitatively evaluated following the NEMA IQ protocol, investigating contrast recovery, background variability, and signal-to-noise ratio. Image groups with half the activity and twice the acquisition time were evaluated. For better statistics, the experiment was repeated 3 times. Contrast recovery, background variability, and signal-to-noise ratio remained almost constant over 3 half-life periods when the decreasing radiotracer activity (100%, 50%, 25%, and 12.5%) was compensated by increasing acquisition time (2, 4, 8, and 16 min). The variation of contrast recovery over 3 half-life periods was small (-6% to +7%), with a mean variation of 2%, compared with the reference setting (100%, 2 min). The signal-to-noise ratio of the hot spheres showed only minor variations over 3 half-life periods (5%). Image readers could not distinguish subjective IQ between the different PET acquisition setups. An approach to reduce the injected radiotracer activity in integrated PET/MR imaging, while maintaining PET IQ, was presented and verified under idealized experimental conditions. This experiment may serve as a basis for further clinical PET/MR studies using reduced radiotracer dose as compared with conventional PET/CT studies.

Comparison of end-expiratory respiratory gating methods for PET/CT

Background. Respiratory motion in positron emission tomography/computed tomography (PET/CT) causes underestimation of standardized uptake value (SUV) and variation of lesion volume, while PET and CT attenuation correction (CTAC) mismatch may introduce artefacts. The aim was to compare end-expiratory gating methods of PET and CTAC.Material and methods. Three methods named the minimum-constant, slope-based and amplitude-median were developed and evaluated on gating efficiency. Method evaluation and optimization was performed on 23 simulated and 23 recorded signals from a mixed patient group. The optimized methods were applied in PET/CT imaging of seven patients, consisting of non-gated CTAC, whole-body PET and four-dimensional (4D) PET/CT. Gating efficiency was evaluated by preservation of the respiratory signal, PET-CTAC alignment, image noise and measurement of lesion SUV maximum (SUVmax), SUV mean (SUVmean) and volume. The methods were evaluated with non-gated PET and end-expiratory phase of five-bin phase-gated PET. End-expiratory gated 4D-CTAC and averaged CTAC were compared for attenuation correction of end-expiratory gated PET.Results. Mean fraction of data preserved was larger (23–34%) with end-expiratory gating compared to phase-gated PET. End-expiratory gating showed increased SUVmax (8.2–8.4 g/ml), SUVmean (5.7–5.8 g/ml) and decreased lesion volume (-11.3–16.8%) compared to non-gated PET (SUVmax 6.2 g/ml, SUVmean 4.7 g/ml) and phase-gated PET (SUVmax 8.0 g/ml, SUVmean 5.6 g/ml). Using averaged CTAC and end-expiratory 4D-CTAC produced similar results concerning SUVmax, with less than 5% difference. Additionally, CTAC-PET-mismatch was minimal when end-expiratory 4D-CTAC was used.Conclusion. End-expiratory gating in PET/CT results in SUVmax and SUVmean increase and reduced lesion volume compared to non-gated PET and phase-gated PET. End-expiratory 4D-CTAC or averaged CTAC will offer similar accuracy for attenuation correction of end-expiratory gated PET.

MO‐G‐17A‐03: MR‐Based Cortical Bone Segmentation for PET Attenuation Correction with a Non‐UTE 3D Fast GRE Sequence

Purpose:To determine the feasibility of identifying cortical bone on MR images with a short‐TE 3D fast‐GRE sequence for attenuation correction of PET data in PET/MR.Methods:A water‐fat‐bone phantom was constructed with two pieces of beef shank. MR scans were performed on a 3T MR scanner (GE Discovery™ MR750). A 3D GRE sequence was first employed to measure the level of residual signal in cortical bone (TE1/TE2/TE3=2.2/4.4/6.6ms, TR=20ms, flip angle=25°). For cortical bone segmentation, a 3D fast‐GRE sequence (TE/TR=0.7/1.9ms, acquisition voxel size=2.5×2.5×3mm3) was implemented along with a 3D Dixon sequence (TE1/TE2/TR=1.2/2.3/4.0ms, acquisition voxel size=1.25×1.25×3mm3) for water/fat imaging. Flip angle (10°), acquisition bandwidth (250kHz), FOV (480×480×144mm3) and reconstructed voxel size (0.94×0.94×1.5mm3) were kept the same for both sequences. Soft tissue and fat tissue were first segmented on the reconstructed water/fat image. A tissue mask was created by combining the segmented water/fat masks, which was then applied on the fast‐GRE image (MRFGRE). A second mask was created to remove the Gibbs artifacts present in regions in close vicinity to the phantom. MRFGRE data was smoothed with a 3D anisotropic diffusion filter for noise reduction, after which cortical bone and air was separated using a threshold determined from the histogram.Results:There is signal in the cortical bone region in the 3D GRE images, indicating the possibility of separating cortical bone and air based on signal intensity from short‐TE MR image. The acquisition time for the 3D fast‐GRE sequence was 17s, which can be reduced to less than 10s with parallel imaging. The attenuation image created from water‐fat‐bone segmentation is visually similar compared to reference CT.Conclusion:Cortical bone and air can be separated based on intensity in MR image with a short‐TE 3D fast‐GRE sequence. Further research is required to optimize the strategy to reduce Gibbs artifacts.