Respiratory-gated Images Research Articles

WE-C-217BCD-03: Restricted Data Set Reconstruction Based on Respiration Quality to Improve Prospectively Gated in Vivo Micro-CT of Mice.

Micro-CT is commonly employed for lung imaging of mice; prospective gating allows for in-vivo imaging of free-breathing subjects. While this technique is successfully executed for healthy animals, results are less consistent for some disease models whose symptoms include irregular or unstable respiration. The purpose of this work is to repair the quality of high-blur images that arise from respiration instability using a retrospective method of motion reduction which identifies the individual x-ray projection images contributing most to the motion blur. Reconstructions were performed after the exclusion of these projections (the so-called restricted set). Sixteen mice were imaged using field emission cone beam micro-CT and prospective gating with a bellows-type respiration sensor. The scanner was operated in step-and-shoot mode; 400 projection images were acquired per scan. An algorithm was developed to analyze the respiration trace file and segment the individual breath corresponding to each projection image. We tested three different criteria to define a bad breath shape (correlation, mean breath height, or mode breath height), and restricted data set reconstructions were performed using each of these criteria to exclude projections corresponding to bad breaths. Each restricted set was compared against the full unrestricted data set image; the slope perpendicular to the diaphragm was used as a quantitative assessment of motion blur. All image sets saw a reduction in motion blur with at least one restriction technique. In 22 of 27 images, improvement was measured regardless of the removal criterion. Five percent total projection removal is optimal; a more aggressive correction increases the likelihood of under-sampling artifacts. Removing a subset of bad projections from otherwise complete image sets measurably decreases motion blur in respiratory-gated imaging. An approach based on breath height generally provides the best results. The technique is applicable to a variety of imaging modalities.

Fully 4D list-mode reconstruction applied to respiratory-gated PET scans

18F-fluoro-deoxy-glucose (18F-FDG) positron emission tomography (PET) is one of the most sensitive and specific imaging modalities for the diagnosis of non-small cell lung cancer. A drawback of PET is that it requires several minutes of acquisition per bed position, which results in images being affected by respiratory blur. Respiratory gating techniques have been developed to deal with respiratory motion in the PET images. However, these techniques considerably increase the level of noise in the reconstructed images unless the acquisition time is increased. The aim of this paper is to evaluate a four-dimensional (4D) image reconstruction algorithm that combines the acquired events in all the gates whilst preserving the motion deblurring. This algorithm was compared to classic ordered subset expectation maximization (OSEM) reconstruction of gated and non-gated images, and to temporal filtering of gated images reconstructed with OSEM. Two datasets were used for comparing the different reconstruction approaches: one involving the NEMA IEC/2001 body phantom in motion, the other obtained using Monte-Carlo simulations of the NCAT breathing phantom. Results show that 4D reconstruction reaches a similar performance in terms of the signal-to-noise ratio (SNR) as non-gated reconstruction whilst preserving the motion deblurring. In particular, 4D reconstruction improves the SNR compared to respiratory-gated images reconstructed with the OSEM algorithm. Temporal filtering of the OSEM-reconstructed images helps improve the SNR, but does not achieve the same performance as 4D reconstruction. 4D reconstruction of respiratory-gated images thus appears as a promising tool to reach the same performance in terms of the SNR as non-gated acquisitions while reducing the motion blur, without increasing the acquisition time.

Sci-Sat AM(1): Imaging-04: Respiratory errors in cardiac PET/CT with manual alignment of the CT image.

Respiratory motion can produce misregistration errors between CT and PET images in cardiac PET/CT imaging. The objective of this study was to determine if manual registration of a single-phase end-expiration CT scan to the PET image would eliminate respiratory-induced artifacts. Listmode data from 71 cardiac PET patient scans were rebinned into a 8-frame respiratory-gated image series based on a respiratory trigger signal obtained with an optical tracking system. CT-based attenuation correction (AC) was performed after registering the CT image with the mean position of the PET images. The 8 phases of the gated PET study were coregistered and the breathing motion was measured. Images from end-inspiration and end-expiration were compared to assess the effect of motion. Studies in which the motion was >8mm were reconstructed again, with the CT scan aligned to end-expiration or end-inspiration, to determine if phase-specific registration could reduce the residual errors. The motion was found to be greatest in the axial direction (mean 4.1mm +\- 1.8mm) and 4 Rb stress studies (17%) had motion >8mm. The maximum displacement during breathing was greater for Rb-stress imaging (<15mm) than for resting (<7.5mm) or NH3-stress (<5.4mm) imaging. No significant differences were noted between the respiratory phases of the rest studies. Errors in myocardial radiotracer uptake of up to 35% were noted between end-inspiration and end-expiration for studies with >8mm of motion. Phase-specific registration of the CT reduced the extent of the errors but did not fully resolve them, suggesting that more sophisticated AC is required.

Noninvasive Quantification of Tumor Volume in Preclinical Liver Metastasis Models Using Contrast-Enhanced X-Ray Computed Tomography

To determine a timepoint after contrast injection that yields equal liver parenchymal and vascular enhancement in micro-computed tomography images. To evaluate the utility of images acquired during this time period for the noninvasive measurement of liver-tumor volume. The imaging timepoint was determined by quantifying the enhancement kinetics of Fenestra VC (0.015 mL/g) in NIH III mice. In respiratory-gated images of tumor bearing mice, the ability to measure tumor volume was evaluated with a measurement variability study, and by comparing in vivo and histologically measured tumor volume. Eight hours after contrast injection the liver parenchyma and vasculature were equally enhanced allowing for clear delineation of the unenhanced tumors. The smallest tumor detected in this study was 1.1 mm in diameter. The coefficient of variation for tumor-volume measurement ranged from 3.6% to 12.9% and from 6.3% to 25.8% for intra and interobserver variability, respectively. In vivo and histologic tumor-volume measurements were closely correlated (r = 0.98, P < 0.0001). Imaging at a time period of equal liver parenchyma and vascular enhancement after contrast injection allows for clear delineation of liver-tumor borders, thereby enabling quantitative tumor-volume monitoring.

In vivo characterization of lung morphology and function in anesthetized free-breathing mice using micro-computed tomography

Lung morphology and function in human subjects can be monitored with computed tomography (CT). Because many human respiratory diseases are routinely modeled in rodents, a means of monitoring the changes in the structure and function of the rodent lung is desired. High-resolution images of the rodent lung can be attained with specialized micro-CT equipment, which provides a means of monitoring rodent models of lung disease noninvasively with a clinically relevant method. Previous studies have shown respiratory-gated images of intubated and respirated mice. Although the image quality and resolution are sufficient in these studies to make quantitative measurements, these measurements of lung structure will depend on the settings of the ventilator and not on the respiratory mechanics of the individual animals. In addition, intubation and ventilation can have unnatural effects on the respiratory dynamics of the animal, because the airway pressure, tidal volume, and respiratory rate are selected by the operator. In these experiments, important information about the symptoms of the respiratory disease being studied may be missed because the respiration is forced to conform to the ventilator settings. In this study, we implement a method of respiratory-gated micro-CT for use with anesthetized free-breathing rodents. From the micro-CT images, quantitative analysis of the structure of the lungs of healthy unconscious mice was performed to obtain airway diameters, lung and airway volumes, and CT densities at end expiration and during inspiration. Because the animals were free breathing, we were able to calculate tidal volume (0.09 +/- 0.03 ml) and functional residual capacity (0.16 +/- 0.03 ml).

Prospective respiratory‐gated micro‐CT of free breathing rodents

Microcomputed tomography (Micro-CT) has the potential to noninvasively image the structure of organs in rodent models with high spatial resolution and relatively short image acquisition times. However, motion artifacts associated with the normal respiratory motion of the animal may arise when imaging the abdomen or thorax. To reduce these artifacts and the accompanying loss of spatial resolution, we propose a prospective respiratory gating technique for use with anaesthetized, free-breathing rodents. A custom-made bed with an embedded pressure chamber was connected to a pressure transducer. Anaesthetized animals were placed in the prone position on the bed with their abdomens located over the chamber. During inspiration, the motion of the diaphragm caused an increase in the chamber pressure, which was converted into a voltage signal by the transducer. An output voltage was used to trigger image acquisition at any desired time point in the respiratory cycle. Digital radiographic images were acquired of anaesthetized, free-breathing rats with a digital radiographic system to correlate the respiratory wave form with respiration-induced organ motion. The respiratory wave form was monitored and recorded simultaneously with the x-ray radiation pulses, and an imaging window was defined, beginning at end expiration. Phantom experiments were performed to verify that the respiratory gating apparatus was triggering the micro-CT system. Attached to the distensible phantom were 100 microm diameter copper wires and the measured full width at half maximum was used to assess differences in image quality between respiratory-gated and ungated imaging protocols. This experiment allowed us to quantify the improvement in the spatial resolution, and the reduction of motion artifacts caused by moving structures, in the images resulting from respiratory-gated image acquisitions. The measured wire diameters were 0.135 mm for the stationary phantom image, 0.137 mm for the image gated at end deflation, 0.213 mm for the image gated at peak inflation, and 0.406 mm for the ungated image. Micro-CT images of anaesthetized, free-breathing rats were acquired with a General Electric Healthcare eXplore RS in vivo micro-CT system. Images of the thorax were acquired using the respiratory cycle-based trigger for the respiratory-gated mode. Respiratory gated-images were acquired at inspiration and end expiration, during a period of minimal respiration-induced organ motion. Gated images were acquired with a nominal isotropic voxel spacing of 44 microm in 20-25 min (80 kVp, 113 mAs, 300 ms imaging window per projection). The equivalent ungated acquisitions were 11 min in length. We observed improved definition of the diaphragm boundary and increased conspicuity of small structures within the lungs in the gated images, when compared to the ungated acquisitions. In this work, we have characterized the externally monitored respiratory wave form of free-breathing, anaesthetized rats and correlated the respiration-induced organ motion to the respiratory cycle. We have shown that the respiratory pressure wave form is an excellent surrogate for the radiographic organ motion. This information facilitates the definition of an imaging window at any phase of the breathing cycle. This approach for prospectively gated micro-CT can provide high quality images of anaesthetized free-breathing rodents.

Comparison of contrast-enhanced breath-hold and free-breathing respiratory-gated imaging in three-dimensional magnetic resonance coronary angiography

Suppression of respiratory motion is one of the major challenges of magnetic resonance (MR) coronary angiography. Two approaches to compensate for respiratory motion have often been proposed: breath-hold (BH) and free-breathing respiratory-gated (FBRG) imaging. So far, however, these approaches have never been directly compared. MR coronary angiography was performed in 32 patients with suspected coronary artery disease. MR data were acquired using contrast-enhanced BH and FBRG 3-dimensional MR coronary angiographic techniques. MR images were compared with regard to image quality using quantitative parameters and with regard to accuracy for stenosis detection in the proximal and mid-coronary segments in comparison to x-ray angiography. With regard to image quality, BH was superior to FBRG. Signal-to-noise ratio was 29.1 ± 10.7 for BH versus 18.8 ± 9.7 for FBRG (p <0.05) and contrast-to-noise was 18.0 ± 7.4 for BH versus 11.3 ± 7.9 for FBRG (p ≤0.05). One hundered seventy-one of 224 coronary artery segments (76%) were evaluable in BH compared with 155 of 224 in FBRG (69%). In the evaluable segments, BH demonstrated a sensitivity of 87% (26 of 30 stenoses detected) and specificity of 92% (129 of 141 nonstenotic segments correctly identified), whereas FBRG showed a sensitivity of 60% (15 of 25) and specificity of 89% (115 of 130). Overall accuracy was 91% (155 of 171) for BH and 84% (130 of 155) for FBRG. Sensitivity was significantly higher for BH (p = 0.0320), whereas specificity and overall accuracy were not significantly different. Thus, contrast-enhanced BH MR coronary angiography compares favorably to FBRG imaging with regard to image quality and detection of coronary stenoses.

Technical and analytical advances in pulmonary ventilation SPECT with xenon-133 gas and Tc-99m-Technegas.

This paper describes the recent advances in technical and analytical methods in pulmonary ventilation SPECT studies, including a respiratory-gated image acquisition of Technetium-99m (99mTc)-labeled Technegas SPECT, a fusion image between Technegas SPECT and chest CT images created by a fully automatic image registration algorithm, and a three-dimensional (3D). display of xenon-133 (133Xe) gas SPECT data, and new analytical approaches by means of fractal analysis or the coefficient of variations of the pixel counts for Technegas SPECT data. The respiratory-gated image acquisition can partly eliminate problematic effects of the SPECT images obtained during non-breath-hold. The fusion image is available for routine clinical use, and provides complementary information on function and anatomy. The 3D displays of dynamic 133Xe SPECT data are helpful for accurate perception of the anatomic extent and locations of impaired ventilation, and the assessment of the severity of ventilation abnormalities. The new analytical approaches facilitate the objective assessment of the degrees of ventilation abnormalities.