Dataset Information

Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI.

ABSTRACT: OBJECTIVE:To evaluate the frequency of artifacts in MR-based attenuation correction (AC) maps and their impact on the quantitative accuracy of PET-based flow and metabolism measurements in a cohort of consecutive heart failure patients undergoing combined PET/MR imaging. METHODS:Myocardial viability studies were performed in 20 patients following a dual-tracer protocol involving the assessment of myocardial perfusion (13N-NH3: 813 ± 86 MBq) and metabolism (18F-FDG: 335 ± 38 MBq). All acquisitions were performed using a fully-integrated PET/MR system, with standard DIXON-attenuation correction (DIXON-AC) mapping for each PET scan. All AC maps were examined for spatial misalignment with the emission data, total lung volume, susceptibility artifacts, and tissue inversion (TI). Misalignment and susceptibility artifacts were corrected using rigid co-registration and retrospective filling of the susceptibility-induced gaps, respectively. The effects of the AC artifacts were evaluated by relative difference measures and perceived changes in clinical interpretations. RESULTS:Average respiratory misalignment of (7 ± 4) mm of the PET-emission data and the AC maps was observed in 18 (90%) patients. Substantial changes in the lung volumes of the AC maps were observed in the test-retest analysis (ratio: 1.0 ± 0.2, range: 0.8-1.4). Susceptibility artifacts were observed in 10 (50%) patients, while six (30%) patients had TI artifacts. Average differences of 14 ± 10% were observed for PET images reconstructed with the artifactual AC maps. The combined artifact effects caused false-positive findings in three (15%) patients. CONCLUSION:Standard DIXON-AC maps must be examined carefully for artifacts and misalignment effects prior to AC correction of cardiac PET/MRI studies in order to avoid misinterpretation of biased perfusion and metabolism readings from the PET data.

SUBMITTER: Lassen ML

PROVIDER: S-EPMC6660490 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI.

Lassen Martin Lyngby ML Rasul Sazan S Beitzke Dietrich D Stelzmüller Marie-Elisabeth ME Cal-Gonzalez Jacobo J Hacker Marcus M Beyer Thomas T

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20171122 4

<h4>Objective</h4>To evaluate the frequency of artifacts in MR-based attenuation correction (AC) maps and their impact on the quantitative accuracy of PET-based flow and metabolism measurements in a cohort of consecutive heart failure patients undergoing combined PET/MR imaging.<h4>Methods</h4>Myocardial viability studies were performed in 20 patients following a dual-tracer protocol involving the assessment of myocardial perfusion (<sup>13</sup>N-NH<sub>3</sub>: 813 ± 86 MBq) and metabolism (<s ...[more]

PMID: 29168158

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Project description:Respiratory motion causes misalignments between positron emission tomography (PET) and magnetic resonance (MR)-derived attenuation maps (µ-maps) in addition to artifacts on both PET and MR images in simultaneous PET/MRI for organs such as liver that can experience motion of several centimeters. To address this problem, we developed an efficient MR-based attenuation correction (MRAC) method to generate phase-matched µ-maps for quiescent period PET (PETQ) in abdominal PET/MRI. MRAC data was acquired with CIRcular Cartesian UnderSampling (CIRCUS) sampling during 100?s in free-breathing as an accelerated data acquisition strategy for phase-matched MRAC (MRACPM-CIRCUS). For comparison, MRAC data with raster (Default) k-space sampling was also acquired during 100?s in free-breathing (MRACPM-Default), and used to evaluate MRACPM-CIRCUS as well as un-matched MRAC (MRACUM) that was un-gated. We purposefully oversampled the MRACPM data to ensure we had enough information to capture all respiratory phases to make this comparison as robust as possible. The proposed MRACPM-CIRCUS was evaluated in 17 patients with 68Ga-DOTA-TOC PET/MRI exams, suspected of having neuroendocrine tumors or liver metastases. Effects of CIRCUS sampling for accelerating a data acquisition were evaluated by simulating the data acquisition time retrospectively in increments of 5?s. Effects of MRACPM-CIRCUS on PETQ were evaluated using uptake differences in the liver lesions (n??=??35), compared to PETQ with MRACPM-Default and MRACUM. A Wilcoxon signed-rank test was performed to compare lesion uptakes between the MRAC methods. MRACPM-CIRCUS showed higher image quality compared to MRACPM-Default for the same acquisition times, demonstrating that a data acquisition time of 30?s was reasonable to achieve phase-matched µ-maps. Lesion update differences between MRACPM-CIRCUS (30?s) versus MRACPM-Default (reference, 100?s) were 0.1%??±??1.4% (range of??-2.7% to 3.2%) and not significant (P??>??.05); while, the differences between MRACUM versus MRACPM-Default were 0.6%??±??11.4% with a large variation (range of??-37% to 20%) and significant (P??<??.05). In conclusion, we demonstrated that a data acquisition of 30?s achieved phase-matched µ-maps when using specialized CIRCUS data sampling and phase-matched µ-maps improved PETQ quantification significantly.

Project description:BackgroundThis study aims to compare proton density weighted magnetic resonance imaging (MRI) zero echo time (ZTE) and head atlas attenuation correction (AC) to the reference standard computed tomography (CT) based AC for 11C-methionine positron emission tomography (PET)/MRI.MethodsA retrospective cohort of 14 patients with suspected or confirmed brain tumour and 11C-Methionine PET/MRI was included in the study. For each scan, three AC maps were generated: ZTE-AC, atlas-AC and reference standard CT-AC. Maximum and mean standardised uptake values (SUV) were measured in the hotspot, mirror region and frontal cortex. In postoperative patients (n?=?8), SUV values were additionally obtained adjacent to the metal implant and mirror region. Standardised uptake ratios (SUR) hotspot/mirror, hotspot/cortex and metal/mirror were then calculated and analysed with Bland-Altman, Pearson correlation and intraclass correlation reliability in the overall group and subgroups.ResultsZTE-AC demonstrated narrower SD and 95% CI (Bland-Altman) than atlas-AC in the hotspot analysis for all groups (ZTE overall???2.84, - 1.41 to 1.70; metal???1.67, - 3.00 to 2.20; non-metal???3.04, - 0.96 to 3.38; Atlas overall???4.56, - 1.05 to 3.83; metal???3.87, - 3.81 to 4.64; non-metal???4.90, - 1.68 to 5.86). The mean bias for both ZTE-AC and atlas-AC was???2.4% compared to CT-AC. In the metal region analysis, ZTE-AC demonstrated a narrower mean bias range-closer to zero-and narrower SD and 95% CI (ZTE 0.21-0.48,???2.50, - 1.70 to 2.57; Atlas 0.56-1.54,???4.01, - 1.81 to 4.89). The mean bias for both ZTE-AC and atlas-AC was within 1.6%. A perfect correlation (Pearson correlation) was found for both ZTE-AC and atlas-AC compared to CT-AC in the hotspot and metal analysis (ZTE ? 1.00, p?<?0.0001; atlas ? 1.00, p?<?0.0001). An almost perfect intraclass correlation coefficient for absolute agreement was found between Atlas-, ZTE and CT maps for maxSUR and meanSUR values in all the analyses (ICC?>?0.99).ConclusionsBoth ZTE and atlas-AC showed a good performance against CT-AC in patients with brain tumour.

Project description:Several factors have to be considered for implementing an accurate attenuation-correction (AC) method in a combined MR-PET scanner. In this work, some of these challenges were investigated, and an AC method based entirely on the MRI data obtained with a single dedicated sequence was developed and used for neurologic studies performed with the MR-PET human brain scanner prototype.The focus was on the problem of bone-air segmentation, selection of the linear attenuation coefficient for bone, and positioning of the radiofrequency coil. The impact of these factors on PET data quantification was studied in simulations and experimental measurements performed on the combined MR-PET scanner. A novel dual-echo ultrashort echo time (DUTE) MRI sequence was proposed for head imaging. Simultaneous MR-PET data were acquired, and the PET images reconstructed using the proposed DUTE MRI-based AC method were compared with the PET images that had been reconstructed using a CT-based AC method.Our data suggest that incorrectly accounting for the bone tissue attenuation can lead to large underestimations (>20%) of the radiotracer concentration in the cortex. Assigning a linear attenuation coefficient of 0.143 or 0.151 cm(-1) to bone tissue appears to give the best trade-off between bias and variability in the resulting images. Not identifying the internal air cavities introduces large overestimations (>20%) in adjacent structures. On the basis of these results, the segmented CT AC method was established as the silver standard for the segmented MRI-based AC method. For an integrated MR-PET scanner, in particular, ignoring the radiofrequency coil attenuation can cause large underestimations (i.e., <or=50%) in the reconstructed images. Furthermore, the coil location in the PET field of view has to be accurately known. High-quality bone-air segmentation can be performed using the DUTE data. The PET images obtained using the DUTE MRI- and CT-based AC methods compare favorably in most of the brain structures.A DUTE MRI-based AC method considering all these factors was implemented. Preliminary results suggest that this method could potentially be as accurate as the segmented CT method and could be used for quantitative neurologic MR-PET studies.

Dataset Information

Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI.

Publications

Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI.

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