Evaluation of a direct motion estimation/correction method in respiratory-gated PET/MRI with motion-adjusted attenuation

PET respiratory motion correction: quo vadis?

Positron emission tomography (PET) respiratory motion correction has been a subject of great interest for the last twenty years, prompted mainly by the development of multimodality imaging devices such as PET/computed tomography (CT) and PET/magnetic resonance imaging (MRI). PET respiratory motion correction involves a number of steps including acquisition synchronization, motion estimation and finally motion correction. The synchronization steps include the use of different external device systems or data driven approaches which have been gaining ground over the last few years. Patient specific or generic motion models using the respiratory synchronized datasets can be subsequently derived and used for correction either in the image space or within the image reconstruction process. Similar overall approaches can be considered and have been proposed for both PET/CT and PET/MRI devices. Certain variations in the case of PET/MRI include the use of MRI specific sequences for the registration of respiratory motion information. The proposed review includes a comprehensive coverage of all these areas of development in field of PET respiratory motion for different multimodality imaging devices and approaches in terms of synchronization, estimation and subsequent motion correction. Finally, a section on perspectives including the potential clinical usage of these approaches is included.

The effect of magnetic field strength on the positron range and projected annihilation artifact in integrated PET/MR systems: A GATE Monte Carlo study

PURPOSE

With improvements in positron emission tomography/magnetic resonance imaging (PET/MRI) over the last decade, there is a need to investigate the projected annihilation (shine-through) artifact and resolution impact for different PET radiopharmaceuticals, magnetic field (MF) strengths, and tissues.

METHODS

The GATE Monte Carlo (MC) simulation was used to simulate the annihilation distribution of positrons in different tissues and MFs. The positron distribution was studied in magnetic field (MF) intensities up to 15 T for ¹¹ C, ¹³ N, ¹⁵ O, ¹⁸ F, ⁶⁸ Ga, and ⁸² Rb. Moreover, the image quality in terms of the occurrence of projected annihilation artifacts was investigated using the 4D anthropomorphic digital extended cardiac-torso (XCAT) phantom.

RESULTS

Positron ranges were restricted across the directions perpendicular to the MF, but no change along the direction of the MF was detected. The projected annihilation artifacts were observed with the presence of MF in the sagittal and coronal view of PET images prepared from the XCAT phantom. The intensity of artifact was constant in MFs higher than 3 T. The significant effect of the MF on resolution improvement was observed in soft tissue for ⁶⁸ Ga in 7 T and ⁸² Rb in 3 and 7 T, while higher MFs have no impact on resolution. The improvement of resolution in the lung tissue was observed for the medium- and high-energy radionuclides in 7 T MF.

CONCLUSION

The MF can create the projected annihilation artifact in the boundary of air cavities and other tissues for medium- and high-energy radionuclides especially for ⁶⁸ Ga in clinical studies. In addition, the strength of the MFs more than 3 T was ineffective on the intensity of the projected annihilation artifact. In a clinical PET/MR scanner, MF has remarkable spatial resolution improvement in lung tissue, especially for medium- and high-energy radionuclides, and negligible effect in bone and soft tissue for most radionuclides.

Motion estimation and correction in SPECT, PET and CT

Patient motion impacts single photon emission computed tomography (SPECT), positron emission tomography (PET) and X-ray computed tomography (CT) by giving rise to projection data inconsistencies that can manifest as reconstruction artifacts, thereby degrading image quality and compromising accurate image interpretation and quantification. Methods to estimate and correct for patient motion in SPECT, PET and CT have attracted considerable research effort over several decades. The aims of this effort have been two-fold: to estimate relevant motion fields characterizing the various forms of voluntary and involuntary motion; and to apply these motion fields within a modified reconstruction framework to obtain motion-corrected images. The aims of this review are to outline the motion problem in medical imaging and to critically review published methods for estimating and correcting for the relevant motion fields in clinical and preclinical SPECT, PET and CT. Despite many similarities in how motion is handled between these modalities, utility and applications vary based on differences in temporal and spatial resolution. Technical feasibility has been demonstrated in each modality for both rigid and non-rigid motion, but clinical feasibility remains an important target. There is considerable scope for further developments in motion estimation and correction, and particularly in data-driven methods that will aid clinical utility. State-of-the-art machine learning methods may have a unique role to play in this context.

Attenuation correction for human PET/MRI studies

Attenuation correction has been one of the main methodological challenges in the integrated positron emission tomography and magnetic resonance imaging (PET/MRI) field. As standard transmission or computed tomography approaches are not available in integrated PET/MRI scanners, MR-based attenuation correction approaches had to be developed. Aspects that have to be considered for implementing accurate methods include the need to account for attenuation in bone tissue, normal and pathological lung and the MR hardware present in the PET field-of-view, to reduce the impact of subject motion, to minimize truncation and susceptibility artifacts, and to address issues related to the data acquisition and processing both on the PET and MRI sides. The standard MR-based attenuation correction techniques implemented by the PET/MRI equipment manufacturers and their impact on clinical and research PET data interpretation and quantification are first discussed. Next, the more advanced methods, including the latest generation deep learning-based approaches that have been proposed for further minimizing the attenuation correction related bias are described. Finally, a future perspective focused on the needed developments in the field is given.

Effect of attenuation mismatches in time of flight PET reconstruction

While the pursuit of better time resolution in positron emission tomography (PET) is rapidly evolving, little work has been performed on time of flight (TOF) image quality at high time resolution in the presence of modelling inconsistencies. This works focuses on the effect of using the wrong attenuation map in the system model, causing perturbations in the reconstructed radioactivity image. Previous work has usually considered the effects to be local to the area where there is attenuation mismatch, and has shown that the quantification errors in this area tend to reduce with improved time resolution. This publication shows however that errors in the PET image at a distance from the mismatch increase with time resolution. The errors depend on the reconstruction algorithm used. We quantify the errors in the hypothetical case of perfect time resolution for maximum likelihood reconstructions. In addition, we perform reconstructions on simulated and patient data. In particular, for respiratory-gated reconstructions from a wrong attenuation map, increased errors are observed with improved time resolutions in areas close to the lungs (e.g. from 13.3% in non-TOF to up to 20.9% at 200 ps in the left ventricle).

Non-Rigid Event-by-Event Continuous Respiratory Motion Compensated List-Mode Reconstruction for PET

Respiratory motion during positron emission tomography (PET)/computed tomography (CT) imaging can cause significant image blurring and underestimation of tracer concentration for both static and dynamic studies. In this paper, with the aim to eliminate both intra-cycle and inter-cycle motions, and apply to dynamic imaging, we developed a non-rigid event-by-event (NR-EBE) respiratory motion-compensated list-mode reconstruction algorithm. The proposed method consists of two components: the first component estimates a continuous non-rigid motion field of the internal organs using the internal-external motion correlation. This continuous motion field is then incorporated into the second component, non-rigid MOLAR (NR-MOLAR) reconstruction algorithm to deform the system matrix to the reference location where the attenuation CT is acquired. The point spread function (PSF) and time-of-flight (TOF) kernels in NR-MOLAR are incorporated in the system matrix calculation, and therefore are also deformed according to motion. We first validated NR-MOLAR using a XCAT phantom with a simulated respiratory motion. NR-EBE motion-compensated image reconstruction using both the components was then validated on three human studies injected with ¹⁸F-FPDTBZ and one with ¹⁸F-fluorodeoxyglucose (FDG) tracers. The human results were compared with conventional non-rigid motion correction using discrete motion field (NR-discrete, one motion field per gate) and a previously proposed rigid EBE motion-compensated image reconstruction (R-EBE) that was designed to correct for rigid motion on a target lesion/organ. The XCAT results demonstrated that NR-MOLAR incorporating both PSF and TOF kernels effectively corrected for non-rigid motion. The ¹⁸F-FPDTBZ studies showed that NR-EBE out-performed NR-Discrete, and yielded comparable results with R-EBE on target organs while yielding superior image quality in other regions. The FDG study showed that NR-EBE clearly improved the visibility of multiple moving lesions in the liver where some of them could not be discerned in other reconstructions, in addition to improving quantification. These results show that NR-EBE motion-compensated image reconstruction appears to be a promising tool for lesion detection and quantification when imaging thoracic and abdominal regions using PET.