Dataset Information

Accuracy of CT-based attenuation correction in PET/CT bone imaging.

ABSTRACT: We evaluate the accuracy of scaling CT images for attenuation correction of PET data measured for bone. While the standard tri-linear approach has been well tested for soft tissues, the impact of CT-based attenuation correction on the accuracy of tracer uptake in bone has not been reported in detail. We measured the accuracy of attenuation coefficients of bovine femur segments and patient data using a tri-linear method applied to CT images obtained at different kVp settings. Attenuation values at 511 keV obtained with a (68)Ga/(68)Ge transmission scan were used as a reference standard. The impact of inaccurate attenuation images on PET standardized uptake values (SUVs) was then evaluated using simulated emission images and emission images from five patients with elevated levels of FDG uptake in bone at disease sites. The CT-based linear attenuation images of the bovine femur segments underestimated the true values by 2.9 ± 0.3% for cancellous bone regardless of kVp. For compact bone the underestimation ranged from 1.3% at 140 kVp to 14.1% at 80 kVp. In the patient scans at 140 kVp the underestimation was approximately 2% averaged over all bony regions. The sensitivity analysis indicated that errors in PET SUVs in bone are approximately proportional to errors in the estimated attenuation coefficients for the same regions. The variability in SUV bias also increased approximately linearly with the error in linear attenuation coefficients. These results suggest that bias in bone uptake SUVs of PET tracers ranges from 2.4% to 5.9% when using CT scans at 140 and 120 kVp for attenuation correction. Lower kVp scans have the potential for considerably more error in dense bone. This bias is present in any PET tracer with bone uptake but may be clinically insignificant for many imaging tasks. However, errors from CT-based attenuation correction methods should be carefully evaluated if quantitation of tracer uptake in bone is important.

SUBMITTER: Abella M

PROVIDER: S-EPMC3353415 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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Accuracy of CT-based attenuation correction in PET/CT bone imaging.

Abella Monica M Alessio Adam M AM Mankoff David A DA MacDonald Lawrence R LR Vaquero Juan Jose JJ Desco Manuel M Kinahan Paul E PE

Physics in medicine and biology 20120405 9

We evaluate the accuracy of scaling CT images for attenuation correction of PET data measured for bone. While the standard tri-linear approach has been well tested for soft tissues, the impact of CT-based attenuation correction on the accuracy of tracer uptake in bone has not been reported in detail. We measured the accuracy of attenuation coefficients of bovine femur segments and patient data using a tri-linear method applied to CT images obtained at different kVp settings. Attenuation values a ...[more]

PMID: 22481547

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Project description:The authors evaluate the energy dependent noise and bias properties of monoenergetic images synthesized from dual-energy CT (DECT) acquisitions. These monoenergetic images can be used to estimate attenuation coefficients at energies suitable for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging. This is becoming more relevant with the increased use of quantitative imaging by PET/CT and SPECT/CT scanners. There are, however, potential variations in the noise and bias of synthesized monoenergetic images as a function of energy.The authors used analytic approximations and simulations to estimate the noise and bias of synthesized monoenergetic images of water-filled cylinders with different shapes and the NURBS-based cardiac-torso (NCAT) phantom from 40 to 520 keV, the range of SPECT and PET energies. The dual-kVp spectra were based on the GE Lightspeed VCT scanner at 80 and 140 kVp with added filtration of 0.5 mm Cu. The authors evaluated strategies of noise suppression with sinogram smoothing and dose minimization with reduction of tube currents at the two kVp settings. The authors compared the impact of DECT-based attenuation correction with single-kVp CT-based attenuation correction on PET quantitation for the NCAT phantom for soft tissue and high-Z materials of bone and iodine contrast enhancement.Both analytic calculations and simulations displayed the expected minimum noise value for a synthesized monoenergetic image at an energy between the mean energies of the two spectra. In addition the authors found that the normalized coefficient of variation in the synthesized attenuation map increased with energy but reached a plateau near 160 keV, and then remained constant with increasing energy up to 511 keV and beyond. The bias was minimal, as the linear attenuation coefficients of the synthesized monoenergetic images were within 2.4% of the known true values across the entire energy range. Compared with no sinogram smoothing, sinogram smoothing can dramatically reduce noise in the DECT-derived attenuation map. Through appropriate selection of tube currents for high and low kVp scans, DECT can deliver roughly the same amount of radiation dose as that of a single kVp CT scan, but could be used for PET attenuation correction with reduced bias in contrast agent regions by a factor of ≈ 2.6 and slightly reduced RMSE for the total image.When DECT is used for attenuation correction at higher energies, there is a noise amplification that is dependent on the energy of the synthesized monoenergetic image of linear attenuation coefficients. Sinogram smoothing reduces the noise amplification in DECT-derived attenuation maps without increasing bias. With an appropriate selection of CT techniques, a DECT scan with the same radiation dose as a single CT scan can result in a PET image with improved quantitative accuracy.

Project description:Whole-body attenuation correction (AC) is still challenging in combined PET/MR scanners. We describe Dixon-VIBE Deep Learning (DIVIDE), a deep-learning network that allows synthesizing pelvis pseudo-CT maps based only on the standard Dixon volumetric interpolated breath-hold examination (Dixon-VIBE) images currently acquired for AC in some commercial scanners. Methods: We propose a network that maps between the four 2-dimensional (2D) Dixon MR images (water, fat, in-phase, and out-of-phase) and their corresponding 2D CT image. In contrast to previous methods, we used transposed convolutions to learn the up-sampling parameters, we used whole 2D slices to provide context information, and we pretrained the network with brain images. Twenty-eight datasets obtained from 19 patients who underwent PET/CT and PET/MR examinations were used to evaluate the proposed method. We assessed the accuracy of the μ-maps and reconstructed PET images by performing voxel- and region-based analysis comparing the SUVs (in g/mL) obtained after AC using the Dixon-VIBE (PETDixon), DIVIDE (PETDIVIDE), and CT-based (PETCT) methods. Additionally, the bias in quantification was estimated in synthetic lesions defined in the prostate, rectum, pelvis, and spine. Results: Absolute mean relative change values relative to CT AC were lower than 2% on average for the DIVIDE method in every region of interest except for bone tissue, where it was lower than 4% and 6.75 times smaller than the relative change of the Dixon method. There was an excellent voxel-by-voxel correlation between PETCT and PETDIVIDE (R 2 = 0.9998, P < 0.01). The Bland-Altman plot between PETCT and PETDIVIDE showed that the average of the differences and the variability were lower (mean PETCT-PETDIVIDE SUV, 0.0003; PETCT-PETDIVIDE SD, 0.0094; 95% confidence interval, [-0.0180,0.0188]) than the average of differences between PETCT and PETDixon (mean PETCT-PETDixon SUV, 0.0006; PETCT-PETDixon SD, 0.0264; 95% confidence interval, [-0.0510,0.0524]). Statistically significant changes in PET data quantification were observed between the 2 methods in the synthetic lesions, with the largest improvement in femur and spine lesions. Conclusion: The DIVIDE method can accurately synthesize a pelvis pseudo-CT scan from standard Dixon-VIBE images, allowing for accurate AC in combined PET/MR scanners. Additionally, our implementation allows rapid pseudo-CT synthesis, making it suitable for routine applications and even allowing retrospective processing of Dixon-VIBE data.

Dataset Information

Accuracy of CT-based attenuation correction in PET/CT bone imaging.

Publications

Accuracy of CT-based attenuation correction in PET/CT bone imaging.

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