1
|
Overbeck N, Andersen TL, Rodell AB, Cabello J, Birge N, Schleyer P, Conti M, Korsholm K, Fischer BM, Andersen FL, Lindberg U. Device-Less Data-Driven Cardiac and Respiratory Gating Using LAFOV PET Histo Images. Diagnostics (Basel) 2024; 14:2055. [PMID: 39335734 PMCID: PMC11431545 DOI: 10.3390/diagnostics14182055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
Background: The outstanding capabilities of modern Positron Emission Tomography (PET) to highlight small tumor lesions and provide pathological function assessment are at peril from image quality degradation caused by respiratory and cardiac motion. However, the advent of the long axial field-of-view (LAFOV) scanners with increased sensitivity, alongside the precise time-of-flight (TOF) of modern PET systems, enables the acquisition of ultrafast time resolution images, which can be used for estimating and correcting the cyclic motion. Methods: 0.25 s so-called [18F]FDG PET histo image series were generated in the scope of for detecting respiratory and cardiac frequency estimates applicable for performing device-less data-driven gated image reconstructions. The frequencies of the cardiac and respiratory motion were estimated for 18 patients using Short Time Fourier Transform (STFT) with 20 s and 30 s window segments, respectively. Results: The Fourier analysis provided time points usable as input to the gated reconstruction based on eight equally spaced time gates. The cardiac investigations showed estimates in accordance with the measured pulse oximeter references (p = 0.97) and a mean absolute difference of 0.4 ± 0.3 beats per minute (bpm). The respiratory frequencies were within the expected range of 10-20 respirations per minute (rpm) in 16 out of 18 patients. Using this setup, the analysis of three patients with visible lung tumors showed an increase in tumor SUVmax and a decrease in tumor volume compared to the non-gated reconstructed image. Conclusions: The method can provide signals that were applicable for gated reconstruction of both cardiac and respiratory motion, providing a potential increased diagnostic accuracy.
Collapse
Affiliation(s)
- Nanna Overbeck
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Thomas Lund Andersen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, 2100 Copenhagen, Denmark
| | | | - Jorge Cabello
- Siemens Medical Solutions USA, Inc., Knoxville, TN 37932, USA
| | - Noah Birge
- Siemens Medical Solutions USA, Inc., Knoxville, TN 37932, USA
| | - Paul Schleyer
- Siemens Medical Solutions USA, Inc., Knoxville, TN 37932, USA
| | - Maurizio Conti
- Siemens Medical Solutions USA, Inc., Knoxville, TN 37932, USA
| | - Kirsten Korsholm
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Barbara Malene Fischer
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, 2100 Copenhagen, Denmark
| | - Flemming Littrup Andersen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, 2100 Copenhagen, Denmark
| | - Ulrich Lindberg
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| |
Collapse
|
2
|
Virili F, Obermair A, Sanjida S, Nicklin JL, Garrett A, Land R, Tang A, Campbell L, Gebski V, Thomas P. Impact of gated FDG PET/CT on the staging of patients with suspected or proven newly diagnosed advanced epithelial ovarian, fallopian tube, and primary peritoneal cancer: results from a non-randomized, phase II clinical trial. Int J Gynecol Cancer 2024:ijgc-2024-005633. [PMID: 39237158 DOI: 10.1136/ijgc-2024-005633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE Imaging for staging ovarian cancer is important to determine the extent of disease. The primary objective of this study was to compare gated 18F-fluorodeoxyglucose positron emission tomography coupled with computed tomography (FDG PET/CT) and standard CT scan with intravenous contrast to diagnose thoracic involvement in patients with advanced ovarian cancer prior to treatment. The secondary objective was to estimate changes in the International Federation of Gynecology and Obstetrics (FIGO) stage and clinical management resulting from gated PET/CT. METHODS The IMAGE trial is a non-randomized phase II clinical trial comparing standard CT scanning with gated PET/CT in diagnosing thoracic involvement in a non-selected group of patients with suspected ovarian cancer on a contrast CT scan. Three sets of PET images were obtained comprising an ungated 2 min whole body image, a static 7.5 min image of the upper abdomen and thorax, and a gated end-expiratory image over the upper abdomen and thorax. Images were evaluated for specificity, sensitivity, diagnostic accuracy, and the proportion of patients with changes in FIGO stage and subsequent clinical management was compared between imaging techniques. RESULTS A total of 84 patients were enrolled based on a standard CT scan, 67 of whom were eligible for gated PET/CT scans. Diagnostic accuracy with gated PET/CT was more than 80% for lesions in lung, liver, extra-abdominal sites, and pleura, but less than 50% for extra-abdominal lymph nodes. Compared with CT scan at baseline, 46% of patients who had 7.5 min gated PET/CT had disease upstaged from stage III to IV, and 8% had disease downstaged from stage IV to III. However, this led to a change of management in only 5% of patients. CONCLUSIONS Gated PET/CT enables upstaging; however, in our institution it altered clinical management only in a minority of patients. TRIAL REGISTRATION NUMBER NCT02258165.
Collapse
Affiliation(s)
- Florencia Virili
- Sanatorio de la Trinidad San Isidro, San Isidro, Argentina
- Sanatorio Anchorena, Buenos Aires, Argentina
| | - Andreas Obermair
- Queensland Centre for Gynaecological Cancer Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
| | - Saira Sanjida
- The University of Queensland, Brisbane, Queensland, Australia
| | - James L Nicklin
- Faculty of Medicine, The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
| | - Andrea Garrett
- Queensland Centre for Gynaecological Cancer Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Russell Land
- Queensland Centre for Gynaecological Cancer Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Amy Tang
- Queensland Centre for Gynaecological Cancer Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | | | - Val Gebski
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Paul Thomas
- Department of Nuclear Medicine, RBWH, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
3
|
Zhang H, Liu M, Shi X, Ma J, Ren C, Huang Z, Wang Y, Jing H, Huo L. Feasibility of a deep-inspiration breath-hold [ 18F]AlF-NOTA-LM3 PET/CT imaging on upper-abdominal lesions in NET patients: in comparison with respiratory-gated PET/CT. EJNMMI Phys 2024; 11:75. [PMID: 39207609 PMCID: PMC11362407 DOI: 10.1186/s40658-024-00677-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSES To explore the clinical feasibility and efficacy of a deep inspiration breath-hold (BH) PET/CT using [18F]AlF-NOTA-LM3 on upper abdominal lesions in patients with neuroendocrine tumors (NETs). METHODS Twenty-three patients underwent a free-breath (FB) whole-body PET/CT, including a 10 min/bed scan for the upper abdomen with a vital signal monitoring for respiratory gating (RG) followed by a 20-second BH PET/CT covering the same axial range. For the upper abdomen bed, the following PET series was reconstructed: a 2-min FB PET; RG PET (6 bins); a 20-second and 15-second BH PET (BH_15 and BH_20). Semi-quantitative analysis was performed to compare liver SUVmean, lesion SUVmax, MTV, its percentage difference and target-to-background ratio (TBR) between both BH PET and RG PET images. Subgroup analysis considered lesion location, MTV and SUVmax. A 5-point Likert scale was used to perform visual analysis and any missed or additional lesions were identified compared with RG PET. RESULTS Quantitative analysis on overall lesions (n = 78) revealed higher SUVmax and TBR, and smaller MTV for both BH PET compared to FB and RG PET, with lesion location-specific variations. Neither significant difference was observed in all metrics between RG and FB PET in larger lesions, nor in MTV in lower-uptake lesions. However, both BH PET significantly enhanced these measurements. In the visual analysis, both BH PET showed noninferior performance to RG PET, and were evaluated clinically acceptable. Additional and missed lesions were observed in FB and both BH PET compared with RG PET, but didn't alter the clinical management. The BH_15 PET showed comparable performance to BH_20 PET in any comparison. CONCLUSION The BH PET/CT using [18F]AlF-NOTA-LM3 is effective in detecting upper abdominal lesions, offering more accurate quantitative measurements. Using a novel PET/CT scanner, a 15-second BH PET can provide comparable and superior performance to RG PET, indicating potential feasibility in clinical routines.
Collapse
Affiliation(s)
- Haiqiong Zhang
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Meixi Liu
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ximin Shi
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jiangyu Ma
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chao Ren
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Zhenghai Huang
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ying Wang
- Central Research Institute, United Imaging Healthcare, Shanghai, 201815, China
| | - Hongli Jing
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Li Huo
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| |
Collapse
|
4
|
Huang S, Cao C, Guo L, Li C, Zhang F, Li Y, Liang Y, Mu W. Comparison of the variability and diagnostic efficacy of respiratory-gated PET/CT based radiomics features with ungated PET/CT in lung lesions. Lung Cancer 2024; 194:107889. [PMID: 39029358 DOI: 10.1016/j.lungcan.2024.107889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 06/12/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVES To investigate the variability and diagnostic efficacy of respiratory-gated (RG) PET/CT based radiomics features compared to ungated (UG) PET/CT in the differentiation of non-small cell lung cancer (NSCLC) and benign lesions. METHODS 117 patients with suspected lung lesions from March 2020 to May 2021 and consent to undergo UG PET/CT and chest RG PET/CT (including phase-based quiescent period gating, pQPG and phase-matched 4D PET/CT, 4DRG) were prospectively included. 377 radiomics features were extracted from PET images of each scan. Paired t test was used to compare UG and RG features for inter-scan variability analysis. We developed three radiomics models with UG and RG features (i.e. UGModel, pQPGModel and 4DRGModel). ROC curves were used to compare diagnostic efficiencies, and the model-level comparison of diagnostic value was performed by five-fold cross-validation. A P value < 0.05 was considered as statistically significant. RESULTS A total of 111 patients (average age ± standard deviation was 59.1 ± 11.6 y, range, 29 - 88 y, and 63 were males) with 209 lung lesions were analyzed for features variability and the subgroup of 126 non-metastasis lesions in 91 patients without treatment before PET/CT were included for diagnosis analysis. 101/377 (26.8 %) 4DRG features and 82/377 (21.8 %) pQPG features showed significant difference compared to UG features (both P<0.05). 61/377 (16.2 %) and 59/377 (15.6 %) of them showed significantly better discriminant ability (ΔAUC% (i.e. (AUCRG - AUCUG) / AUCUG×100 %) > 0 and P<0.05) in malignant recognition, respectively. For the model-level comparison, 4DRGModel achieved the highest diagnostic efficacy (sen 73.2 %, spe 87.3 %) compared with UGModel (sen 57.7 %, spe 76.4 %) and pQPGModel (sen 63.4 %, spe 81.8 %). CONCLUSION RG PET/CT performs better in the quantitative assessment of metabolic heterogeneity for lung lesions and the subsequent diagnosis in patients with NSCLC compared with UG PET/CT.
Collapse
Affiliation(s)
- Shengyun Huang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Caifang Cao
- School of Engineering Medicine, Beihang University, Beijing, China; Key Laboratory of Big Data-Based Precision Medicine, Ministry of Industry and Information Technology of the People's Republic of China, Beijing, China
| | - Linna Guo
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Chengze Li
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Feng Zhang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yiluo Li
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Ying Liang
- Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China; National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Wei Mu
- School of Engineering Medicine, Beihang University, Beijing, China; Key Laboratory of Big Data-Based Precision Medicine, Ministry of Industry and Information Technology of the People's Republic of China, Beijing, China.
| |
Collapse
|
5
|
Lee CW, Son HJ, Woo JY, Lee SH. Is Prone Position [ 18F]FDG PET/CT Useful in Reducing Respiratory Motion Artifacts in Evaluating Hepatic Lesions? Diagnostics (Basel) 2023; 13:2539. [PMID: 37568906 PMCID: PMC10417611 DOI: 10.3390/diagnostics13152539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Prone position is useful in reducing respiratory motion artifacts in lung nodules on 2-Deoxy-2-[18F] fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT). However, whether prone position PET/CT is useful in evaluating hepatic lesions is unknown. Thirty-five hepatic lesions from 20 consecutive patients were evaluated. The maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of both standard supine position PET/CT and additional prone position PET/CT were evaluated. No significant difference in SUVmax (4.41 ± 2.0 vs. 4.23 ± 1.83; p = 0.240) and MTV (5.83 ± 6.69 vs. 5.95 ± 6.24; p = 0.672) was observed between supine position PET/CT and prone position PET/CT. However, SUVmax changes in prone position PET/CT varied compared with those in supine position PET/CT (median, -4%; range: -30-71%). Prone position PET/CT was helpful when [18F]FDG uptake of the hepatic lesions was located outside the liver on supine position PET/CT (n = 4, SUVmax change: median 15%; range: 7-71%) and there was more severe blurring on supine position PET/CT (n = 6, SUVmax change: median 11%; range: -3-32%). Unlike in lung nodules, prone position PET/CT is not always useful in evaluating hepatic lesions, but it may be helpful in individual cases such as hepatic dome lesions.
Collapse
Affiliation(s)
- Chung Won Lee
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
| | - Hye Joo Son
- Department of Nuclear Medicine, Dankook University Medical Center, Cheonan 31116, Republic of Korea;
| | - Ji Young Woo
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
| | - Suk Hyun Lee
- Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea;
| |
Collapse
|
6
|
Liu G, Chen S, Hu Y, Cao S, Yang X, Zhou Y, Shi H. Respiratory-gated PET imaging with reduced acquisition time for suspect malignancies: the first experience in application of total-body PET/CT. Eur Radiol 2022; 33:3366-3376. [PMID: 36565352 DOI: 10.1007/s00330-022-09369-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/08/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES This study aimed to investigate the performance of respiratory-gating imaging with reduced acquisition time using the total-body positron emission tomography/computed tomography (PET/CT) scanner. METHODS Imaging data of 71 patients with suspect malignancies who underwent total-body 2-[18F]-fluoro-2-deoxy-D-glucose PET/CT for 15 min with respiration recorded were analyzed. For each examination, four reconstructions were performed: Ungated-15, using all coincidences; Ungated-5, using data of the first 5 min; Gated-15 using all coincidences but with respiratory gating; and Gated-6 using data of the first 6 min with respiratory gating. Lesions were quantified and image quality was evaluated; both were compared between the four image sets. RESULTS A total of 390 lesions were found in the thorax and upper abdomen. Lesion detectability was significantly higher in gated-15 (97.2%) than in ungated-15 (93.6%, p = 0.001) and ungated-5 (92.3%, p = 0.001), but comparable to Gated-6 (95.9%, p = 0.993). A total of 131 lesions were selected for quantitative analyses. Lesions in Gated-15 presented significantly larger standardized uptake values, tumor-to-liver ratio, and tumor-to-blood ratio, but smaller metabolic tumor volume, compared to those in Ungated-15 and Ungated-5 (all p < 0.001). These differences were more obvious in small lesions and in lesions from sites other than mediastinum/retroperitoneum. However, these indices were not significantly different between Gated-15 and Gated-6. Higher, but acceptable, image noise was identified in gated images than in ungated images. CONCLUSIONS Respiratory-gating imaging with reduced scanning time using the total-body PET/CT scanner is superior to ungated imaging and can be used in the clinic. KEY POINTS • In PET imaging, respiratory gating can improve lesion presentation and detectability but requires longer imaging time. • This single-center study showed that the total-body PET scanner allows respiratory-gated imaging with reduced and clinically acceptable scanning time.
Collapse
Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yan Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shuangliang Cao
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Xinlan Yang
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China. .,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. .,Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
7
|
Noto B, Roll W, Zinken L, Rischen R, Kerschke L, Evers G, Heindel W, Schäfers M, Büther F. Respiratory motion correction in F-18-FDG PET/CT impacts lymph node assessment in lung cancer patients. EJNMMI Res 2022; 12:61. [PMID: 36107357 PMCID: PMC9478021 DOI: 10.1186/s13550-022-00926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUNDS Elastic motion correction in PET has been shown to increase image quality and quantitative measurements of PET datasets affected by respiratory motion. However, little is known on the impact of respiratory motion correction on clinical image evaluation in oncologic PET. This study evaluated the impact of motion correction on expert readers' lymph node assessment of lung cancer patients. METHODS Forty-three patients undergoing F-18-FDG PET/CT for the staging of suspected lung cancer were included. Three different PET reconstructions were investigated: non-motion-corrected ("static"), belt gating-based motion-corrected ("BG-MC") and data-driven gating-based motion-corrected ("DDG-MC"). Assessment was conducted independently by two nuclear medicine specialists blinded to the reconstruction method on a six-point scale [Formula: see text] ranging from "certainly negative" (1) to "certainly positive" (6). Differences in [Formula: see text] between reconstruction methods, accounting for variation caused by readers, were assessed by nonparametric regression analysis of longitudinal data. From [Formula: see text], a dichotomous score for N1, N2, and N3 ("negative," "positive") and a subjective certainty score were derived. SUV and metabolic tumor volumes (MTV) were compared between reconstruction methods. RESULTS BG-MC resulted in higher scores for N1 compared to static (p = 0.001), whereas DDG-MC resulted in higher scores for N2 compared to static (p = 0.016). Motion correction resulted in the migration of N1 from tumor free to metastatic on the dichotomized score, consensually for both readers, in 3/43 cases and in 2 cases for N2. SUV was significantly higher for motion-corrected PET, while MTV was significantly lower (all p < 0.003). No significant differences in the certainty scores were noted. CONCLUSIONS PET motion correction resulted in significantly higher lymph node assessment scores of expert readers. Significant effects on quantitative PET parameters were seen; however, subjective reader certainty was not improved.
Collapse
Affiliation(s)
- Benjamin Noto
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Wolfgang Roll
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Laura Zinken
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Robert Rischen
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
| | - Laura Kerschke
- grid.5949.10000 0001 2172 9288Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Georg Evers
- grid.16149.3b0000 0004 0551 4246Department of Medicine A, Hematology, Oncology and Pulmonary Medicine, University Hospital Münster, Münster, Germany
| | - Walter Heindel
- grid.16149.3b0000 0004 0551 4246Clinical for Radiology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Michael Schäfers
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany ,West German Cancer Centre (WTZ), Münster, Germany
| | - Florian Büther
- grid.16149.3b0000 0004 0551 4246Department of Nuclear Medicine, University Hospital Münster, Münster, Germany ,grid.5949.10000 0001 2172 9288European Institute for Molecular Imaging, University of Münster, Münster, Germany
| |
Collapse
|
8
|
Grootjans W, Rietbergen DDD, van Velden FHP. Added Value of Respiratory Gating in Positron Emission Tomography for the Clinical Management of Lung Cancer Patients. Semin Nucl Med 2022; 52:745-758. [DOI: 10.1053/j.semnuclmed.2022.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
|
9
|
Cheung AHY, Wu VWC, Cheung ALY, Cai J. Respiratory 4D-Gating F-18 FDG PET/CT Scan for Liver Malignancies: Feasibility in Liver Cancer Patient and Tumor Quantitative Analysis. Front Oncol 2022; 12:789506. [PMID: 35223472 PMCID: PMC8864173 DOI: 10.3389/fonc.2022.789506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the potential clinical role and effectiveness of respiratory 4D-gating F-18 FDG PET/CT scan for liver malignancies, relative to routine (3D) F-18 FDG PET/CT scan. Materials and Methods This study presented a prospective clinical study of 16 patients who received F-18 FDG PET/CT scan for known or suspected malignant liver lesions. Ethics approvals were obtained from the ethics committees of the Hong Kong Baptist Hospital and The Hong Kong Polytechnic University. Liver lesions were compared between the gated and ungated image sets, in terms of 1) volume measurement of PET image, 2) accuracy of maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and 3) accuracy of total lesion glycoses (TLG). Statistical analysis was performed by using a two-tailed paired Student t-test and Pearson correlation test. Results The study population consisted of 16 patients (9 males and 7 females; mean age of 65) with a total number of 89 lesions. The SUVmax and SUVmean measurement of the gated PET images was more accurate than that of the ungated PET images, compared to the static reference images. An average of 21.48% (p < 0.001) reduction of the tumor volume was also observed. The SUVmax and SUVmean of the gated PET images were improved by 19.81% (p < 0.001) and 25.53% (p < 0.001), compared to the ungated PET images. Conclusions We have demonstrated the feasibility of implementing 4D PET/CT scan for liver malignancies in a prospective clinical study. The 4D PET/CT scan for liver malignancies could improve the quality of PET image by improving the SUV accuracy of the lesions and reducing image blurring. The improved accuracy in the classification and identification of liver tumors with 4D PET image would potentially lead to its increased utilization in target delineation of GTV, ITV, and PTV for liver radiotherapy treatment planning in the future.
Collapse
Affiliation(s)
- Anson H Y Cheung
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.,Radiotherapy and Oncology Department, Hong Kong Baptist Hospital, Hong Kong, Hong Kong SAR, China
| | - Vincent W C Wu
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Andy L Y Cheung
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.,Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Jing Cai
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
10
|
Achievements of true whole-body imaging using a faster acquisition of the lower extremities in variable-speed continuous bed motion. Radiol Phys Technol 2021; 14:373-380. [PMID: 34697782 DOI: 10.1007/s12194-021-00640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
Variable-speed continuous bed motion 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT), a reliable imaging technique, allows setting the bed motion speed for arbitrary sections of the body. The purpose of this study was to evaluate the relationship between the PET image quality and the bed speed following shortening of the scanning time for the lower extremities to achieve whole-body acquisition optimization of the examination time. Four sets of images were created by editing four-phase dynamic whole-body PET/CT images acquired at a bed speed of 6 and 14 mm/s in the trunk and lower extremities, respectively. The signal-to-noise ratio (SNR) was calculated using regions of interest in the liver, gluteus muscles, thigh, and lower legs, and the relationship between the bed speed and the SNR was assessed. The number of patients with findings in the lower extremities among 967 cases was evaluated. Based on this relationship between the SNR and bed motion speed, it is reasonable to increase the speed of the lower extremities by up to three times that of the trunk. The findings from whole-body FDG-PET imaging revealed that the number of patients with detected lesions in the lower extremities was 6.6% (64/967), bone metastases were found in 2.6%, soft lesions in 1.8%, and inflammation in 2.3%. Images of the lower extremities, which have a better SNR than the trunk, can be acquired at a faster bed speed using the variable-speed continuous bed motion PET.
Collapse
|
11
|
Messerli M, Liberini V, Grünig H, Maurer A, Skawran S, Lohaus N, Husmann L, Orita E, Trinckauf J, Kaufmann PA, Huellner MW. Clinical evaluation of data-driven respiratory gating for PET/CT in an oncological cohort of 149 patients: impact on image quality and patient management. Br J Radiol 2021; 94:20201350. [PMID: 34520673 DOI: 10.1259/bjr.20201350] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the impact of fully automatic motion correction by data-driven respiratory gating (DDG) on positron emission tomography (PET) image quality, lesion detection and patient management. MATERIALS AND METHODS A total of 149 patients undergoing PET/CT for cancer (re-)staging were retrospectively included. Patients underwent a PET/CT on a digital detector scanner and for every patient a PET data set where DDG was enabled (PETDDG) and as well as where DDG was not enabled (PETnonDDG) was reconstructed. All PET data sets were evaluated by two readers which rated the general image quality, motion effects and organ contours. Further, both readers reviewed all scans on a case-by-case basis and evaluated the impact of PETDDG on additional apparent lesion, change of report, and change of management. RESULTS In 85% (n = 126) of the patients, at least one bed position was acquired using DDG, resulting in mean scan time increase of 4:37 min per patient in the whole study cohort (n = 149). General image quality was not rated differently for PETnonDDG and PETDDG images (p = 1.000) while motion effects (i.e. indicating general blurring) was rated significantly lower in PETDDG images and organ contours, including liver and spleen, were rated significantly sharper using PETDDG as compared to PETnonDDG (all p < 0.001). In 27% of patients, PETDDG resulted in a change of the report and in a total of 12 cases (8%), PETDDG resulted in a change of further clinical management. CONCLUSION Deviceless DDG provided reliable fully automatic motion correction in clinical routine and increased lesion detectability and changed management in a considerable number of patients. ADVANCES IN KNOWLEDGE DDG enables PET/CT with respiratory gating to be used routinely in clinical practice without external gating equipment needed.
Collapse
Affiliation(s)
- Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Virginia Liberini
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Hannes Grünig
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niklas Lohaus
- University of Zurich, Zurich, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Lars Husmann
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Erika Orita
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Josephine Trinckauf
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| |
Collapse
|
12
|
Crivellaro C, Guerra L. Respiratory Gating and the Performance of PET/CT in Pulmonary Lesions. Curr Radiopharm 2021; 13:218-227. [PMID: 32183685 PMCID: PMC8206192 DOI: 10.2174/1874471013666200317144629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/29/2019] [Accepted: 07/17/2019] [Indexed: 12/15/2022]
Abstract
Background Motion artifacts related to the patient’s breathing can be the cause of underestimation of the lesion uptake and can lead to missing of small lung lesions. The respiratory gating (RG) technology has demonstrated a significant increase in image quality. Objective The aim of this paper was to evaluate the advantages of RG technique on PET/CT performance in lung lesions. The impact of 4D-PET/CT on diagnosis (metabolic characterization), staging and re-staging lung cancer was also assessed, including its application for radiotherapy planning. Finally, new technologies for respiratory motion management were also discussed. Methods A comprehensive electronic search of the literature was performed by using Medline database (PubMed) searching “PET/CT”, “gated” and “lung”. Original articles, review articles, and editorials published in the last 10 years were selected, included and critically reviewed in order to select relevant articles. Results Many papers compared Standardized Uptake Value (SUV) in gated and ungated PET studies showing an increase in SUV of gated images, particularly for the small lesions located in medium and lower lung. In addition, other features as Metabolic Tumor Volume (MTV), Total Lesion Glycolysis (TLG) and textural-features presented differences when obtained from gated and ungated PET acquisitions. Besides the increase in quantification, gating techniques can determine an increase in the diagnostic accuracy of PET/CT. Gated PET/CT was evaluated for lung cancer staging, therapy response assessment and for radiation therapy planning. Conclusion New technologies able to track the motion of organs lesion directly from raw PET data, can reduce or definitively solve problems (i.e.: extended acquisition time, radiation exposure) currently limiting the use of gated PET/CT in clinical routine.
Collapse
Affiliation(s)
- Cinzia Crivellaro
- School of Medicine and Surgery - University of Milan - Bicocca, Milan, Italy
| | - Luca Guerra
- School of Medicine and Surgery - University of Milan - Bicocca, Milan, Italy,Nuclear Medicine Department, ASST- Monza, San Gerardo Hospital, Monza, Italy
| |
Collapse
|
13
|
Black DG, Yazdi YO, Wong J, Fedrigo R, Uribe C, Kadrmas DJ, Rahmim A, Klyuzhin IS. Design of an anthropomorphic PET phantom with elastic lungs and respiration modeling. Med Phys 2021; 48:4205-4217. [PMID: 34031896 DOI: 10.1002/mp.14998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 05/06/2021] [Accepted: 05/10/2021] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Respiratory motion during positron emission tomography (PET) scans can be a major detriment to image quality in oncological imaging. The impact of motion on lesion quantification and detectability can be assessed using phantoms with realistic anatomy representation and motion modeling. In this work, we develop an anthropomorphic phantom for PET imaging that combines anatomic fidelity and a realistic breathing mechanism with deformable lungs. METHODS We start from a previously developed anatomically accurate but static phantom of a human torso, and add elastic lungs with a highly controllable actuation mechanism which replicates the physics of breathing. The space outside the lungs is filled with a radioactive water solution. To maintain anatomical accuracy and realistic gamma ray attenuation in the torso, all motion mechanisms and actuators are positioned outside of the phantom compartment. The actuation mechanism can produce custom respiratory waveforms with breathing rates up to 25 breaths per minute and tidal volumes up to 1200 mL. RESULTS Several tests were performed to validate the performance of the phantom assembly, in which the phantom was filled with water and given respiratory waveforms to execute. All parts demonstrated expected performance. Force requirements were not exceeded and no leaks were detected, although continued use of the phantom is required to evaluate wear. The motion of the lungs was determined to be within a reasonable realistic range. CONCLUSIONS The full mechanical design is described in this paper, as well as a software application with graphical user interface which was developed to plan and visualize respiratory patterns. Both are available online as open source files. The developed phantom will facilitate future work in evaluating the impact of respiratory motion on lesion quantification and detectability in clinical practice.
Collapse
Affiliation(s)
- David G Black
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Yas Oloumi Yazdi
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Jeremy Wong
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Roberto Fedrigo
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,BC Cancer Research Institute, Vancouver, BC, Canada
| | - Carlos Uribe
- Department of Functional Imaging, BC Cancer, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Dan J Kadrmas
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - Arman Rahmim
- Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada.,BC Cancer Research Institute, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Ivan S Klyuzhin
- BC Cancer Research Institute, Vancouver, BC, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
14
|
Driscoll B, Vines D, Shek T, Publicover J, Yeung I, Breen S, Jaffray D. 4D-CT Attenuation Correction in Respiratory-Gated PET for Hypoxia Imaging: Is It Really Beneficial? ACTA ACUST UNITED AC 2021; 6:241-249. [PMID: 32548302 PMCID: PMC7289254 DOI: 10.18383/j.tom.2019.00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous literature has shown that 4D respiratory-gated positron emission tomography (PET) is beneficial for quantitative analysis and defining targets for boosting therapy. However the case for addition of a phase-matched 4D-computed tomography (CT) for attenuation correction (AC) is less clear. We seek to validate the use of 4D-CT for AC and investigate the impact of motion correction for low signal-to-background PET imaging of hypoxia using radiotracers such as FAZA and FMISO. A new insert for the Modus Medicals' QUASAR™ Programmable Respiratory Motion Phantom was developed in which a 3D-printed sphere was placed within the "lung" compartment while an additional compartment is added to simulate muscle/blood compartment required for hypoxia quantification. Experiments are performed at 4:1 or 2:1 signal-to-background ratio consistent with clinical FAZA and FMISO imaging. Motion blur was significant in terms of SUVmax, mean, and peak for motion ≥1 cm and could be significantly reduced (from 20% to 8% at 2-cm motion) for all 4D-PET-gated reconstructions. The effect of attenuation method on precision was significant (σ2 hCT-AC = 5.5%/4.7%/2.7% vs σ2 4D-CT-AC = 0.5%/0.6%/0.7% [max%/peak%/mean% variance]). The simulated hypoxic fraction also significantly decreased under conditions of 2-cm amplitude motion from 55% to 20% and was almost fully recovered (HF = 0.52 for phase-matched 4D-CT) using gated PET. 4D-gated PET is valuable under conditions of low radiotracer uptake found in hypoxia imaging. This work demonstrates the importance of using 4D-CT for AC when performing gated PET based on its significantly improved precision over helical CT.
Collapse
Affiliation(s)
- Brandon Driscoll
- Quantitative Imaging for Personalized Cancer Medicine Program-Techna Institute, University Health Network, Toronto, ON, Canada
| | - Douglass Vines
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; and.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Tina Shek
- Quantitative Imaging for Personalized Cancer Medicine Program-Techna Institute, University Health Network, Toronto, ON, Canada
| | - Julia Publicover
- Quantitative Imaging for Personalized Cancer Medicine Program-Techna Institute, University Health Network, Toronto, ON, Canada
| | - Ivan Yeung
- Quantitative Imaging for Personalized Cancer Medicine Program-Techna Institute, University Health Network, Toronto, ON, Canada.,Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; and.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Stephen Breen
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; and.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - David Jaffray
- Quantitative Imaging for Personalized Cancer Medicine Program-Techna Institute, University Health Network, Toronto, ON, Canada.,Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; and.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
15
|
Kyme AZ, Fulton RR. Motion estimation and correction in SPECT, PET and CT. Phys Med Biol 2021; 66. [PMID: 34102630 DOI: 10.1088/1361-6560/ac093b] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/08/2021] [Indexed: 11/11/2022]
Abstract
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.
Collapse
Affiliation(s)
- Andre Z Kyme
- School of Biomedical Engineering, The University of Sydney, Sydney, New South Wales, AUSTRALIA
| | - Roger R Fulton
- Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, AUSTRALIA
| |
Collapse
|
16
|
Prone position [ 18F]FDG PET/CT to reduce respiratory motion artefacts in the evaluation of lung nodules. Eur Radiol 2021; 31:4606-4614. [PMID: 33852046 DOI: 10.1007/s00330-021-07894-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/09/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES 2-Deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron-emission tomography/computed tomography (PET/CT) is widely used to evaluate lung nodules, although respiratory motion artefacts may occur. We investigated the value of prone position PET/CT (pPET/CT) in lung nodule evaluation compared with standard supine position PET/CT (sPET/CT). METHODS We retrospectively reviewed 28 consecutive patients (20 men; age, 65.6 ± 12.1 years) with a lung nodule (size, 16.8 ± 5.5 mm) located below the sub-carinal level who underwent [18F]FDG PET/CT in a standard supine position and additional prone position. The maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), difference of diaphragm position between PET and CT (DDP), Dice's similarity coefficient (DSC) and occurrence of mis-registration were analysed. The [18F]FDG uptake of 20 biopsy-confirmed (15 malignant) nodules was evaluated visually. RESULTS pPET/CT yielded a significantly higher SUVmax, lower MTV and shorter DDP than with sPET/CT (p = 0.043, 0.007 and 0.021, respectively). Mis-registration occurred in 53.6% of cases in sPET/CT and in 28.6% of cases in pPET/CT (p = 0.092). Among the 15 patients with mis-registration in sPET/CT, 10 patients (66.7%) did not show mis-registration in pPET/CT. DSC was higher in pPET/CT than in sPET/CT in 18 out of 28 patients (64.3%). In visual analysis, malignant nodules exhibited a higher [18F]FDG uptake positivity than benign nodules in pPET/CT (93.3% vs. 40.0%, p = 0.032) but not in sPET/CT (80.0% vs. 40.0%, p = 0.131). CONCLUSIONS pPET/CT reduces respiratory motion artefact and enables more-precise measurements of PET parameters. KEY POINTS • In prone position PET/CT, the decrease in the blurring effect caused by reduced respiratory motion resulted in a higher SUVmax and lower MTV in lung nodules than that with supine position PET/CT. • Prone position PET/CT was useful to interpret correctly malignant lung nodules as being positive in individual cases that had a negative result in supine position PET/CT.
Collapse
|
17
|
Pre-Processing Method for Contouring the Uptake Levels of [18F] FDG for Enhanced Specificity of PET Imaging of Solitary Hypermetabolic Pulmonary Nodules. J Clin Med 2021; 10:jcm10071430. [PMID: 33916035 PMCID: PMC8036284 DOI: 10.3390/jcm10071430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The paper presents a pre-processing method which, based on positron-emission tomography (PET) images of 18F-fluorodeoxyglucose ([18F] FDG) hypermetabolic pulmonary nodules, makes it possible to obtain additional visual characteristics and use them to enhance the specificity of imaging. MATERIAL AND METHODS A retrospective analysis of 69 FDG-PET/CT scans of solitary hypermetabolic pulmonary nodules (40 cases of lung cancer and 29 benign tumours), where in each case, the standardised uptake value of the hottest voxel within the defined volume of interest was greater than 2.5 (SUVmax > 2.5). No diagnosis could be made based on these SUVmax values. All of the PET DICOM images were transformed by means of the pre-processing method for contouring the uptake levels of [18F] FDG (PCUL-FDG). Next, a multidimensional comparative analysis was conducted using a synthetic variable obtained by calculating the similarities based on the generalised distance measure for non-metric scaling (GDM2) from the pattern object. The calculations were performed with the use of the R language. RESULTS The PCUL-FDG method revealed 73.9% hypermetabolic nodules definitively diagnosed as either benign or malignant lesions. As for the other 26.1% of the nodules, there was uncertainty regarding their classification (some had features suggesting malignancy, while the characteristics of others made it impossible to confirm malignancy with a high degree of certainty). CONCLUSIONS Application of the PCUL-FDG method enhances the specificity of PET in imaging solitary hypermetabolic pulmonary nodules. Images obtained using the PCUL-FDG method can serve as point of departure for automatic analysis of PET data based on convolutional neural networks.
Collapse
|
18
|
Alongi P, Laudicella R, Desideri I, Chiaravalloti A, Borghetti P, Quartuccio N, Fiore M, Evangelista L, Marino L, Caobelli F, Tuscano C, Mapelli P, Lancellotta V, Annunziata S, Ricci M, Ciurlia E, Fiorentino A. Positron emission tomography with computed tomography imaging (PET/CT) for the radiotherapy planning definition of the biological target volume: PART 1. Crit Rev Oncol Hematol 2019; 140:74-79. [PMID: 30795884 DOI: 10.1016/j.critrevonc.2019.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/11/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023] Open
Abstract
AIM Functional and molecular imaging, including positron emission tomography with computed tomography imaging (PET/CT) is increasing for radiotherapy (RT) definition of the target volume. This expert review summarizes existing data of functional imaging modalities and RT management, in terms of target volume delineation, for the following anatomical districts: brain (for primary and secondary tumors), head/neck and lung. MATERIALS AND METHODS A collection of available published data was made, by PubMed a search. Only original articles were carefully and critically revised. RESULTS For primary and secondary brain tumors, amino acid PET radiotracers could be useful to identify microscopic residual areas and to differ between recurrence and treatment-related alterations in case of re-irradiation. As for head and neck neoplasms may benefit from precise PET/CT-based target delineation, due to the major capability to identify high-risk RT areas. In primary and secondary lung cancer, PET/CT could be useful both to delimit a tumor and collapsed lungs and as a predictive parameter of treatment response. CONCLUSION Taken together, molecular and functional imaging approaches offer a major step to individualize radiotherapeutic care going forward. Nevertheless, several uncertainties remain on the standard method to properly assess the target volume definition including PET information for primary and secondary brain tumors.
Collapse
Affiliation(s)
- Pierpaolo Alongi
- Department of Radiological Sciences, Nuclear Medicine Service, Fondazione Istituto G. Giglio, Cefalu. Italy
| | - Riccardo Laudicella
- Department of Biomedical and Dental Sciences and of Morphofunctional Imaging, University of Messina. Italy
| | - Isacco Desideri
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", Section of Radiation Oncology, University of Florence, Italy
| | - Agostino Chiaravalloti
- IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Paolo Borghetti
- Radiation Oncology Department University and Spedali Civili, Brescia, Italy
| | | | - Michele Fiore
- Radiation Oncology, Campus Bio-Medico University, Rome, Italy
| | - Laura Evangelista
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Lorenza Marino
- Radiotherapy Oncology Department, REM, Viagrande, Catania, Italy
| | - Federico Caobelli
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Carmelo Tuscano
- Radiotherapy Oncology Department, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - Paola Mapelli
- Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Salvatore Annunziata
- Fondazione Policlinico A. Gemelli IRCCS-Università Cattolica Sacro Cuore, Roma, Italy
| | - Maria Ricci
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Elisa Ciurlia
- Radiotherapy Oncology Department, Vito Fazzi Hospital, Lecce, Italy
| | - Alba Fiorentino
- Radiotherapy Oncology Department, General Regional Hospital "F. Miulli", Strada Prov. 127 Km 4, 70021, Acquaviva delle Fonti, Bari, Italy.
| |
Collapse
|
19
|
Mitsumoto T, Minamimoto R, Sunaoka F, Kishimoto S, Inoue K, Fukushi M. The clinical utility of phase-based respiratory gated PET imaging based on visual feedback with a head-mounted display system. Br J Radiol 2019; 92:20180233. [PMID: 31017455 DOI: 10.1259/bjr.20180233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE We developed a new respiratory-gated positron emission tomography (PET) imaging method (RGV-PET) that phase-based respiratory gated PET imaging (RG-PET) combine with head-mounted display (HMD)-guided "visual feedback." The purpose of this study was to investigate whether RGV-PET is effective at improving the quantitative measurement of tracer uptake in tumors using the phase-based respiratory gating method. METHODS Of the 41 enrolled patients with hepatobiliary or pancreatic cancer, 20 patients underwent RGV-PET and the remaining 21 patients underwent RG-PET. We measured the peak standardized uptake value (SUVpeak) of the primary lesion in each five bins obtained from both RG-PET and RGV-PET. The SUVpeak change rate calculated based on the ungated PET imaging. To evaluate the quantitative variation, the coefficient of variation of the SUVpeak change rate was compared between RG-PET and RGV-PET. In addition, we performed qualitative evaluation using visual score for the incidence of artifacts on four-dimensional-CT. RESULTS The coefficient of variation of the average SUVpeak change rate in RGV-PET was 7.01 ± 4.43, which was significantly lower than the values in RG-PET (10.72 ± 5.74, p < 0.05). A significant improvement in the SUVpeak change rate of RGV-PET was obtained in bins 1 and 2 compared to RG-PET ( p < 0.05). The visual score of RGV-PET was significantly lower than RG-PET ( p < 0.05). CONCLUSION RGV-PET was effective for respiratory stabilization and improved respiratory gating imaging quality. ADVANCES IN KNOWLEDGE The RGV-PET is applicable to various PET/CT respiratory gating imaging and may improve the quantitativeness of PET images.
Collapse
Affiliation(s)
- Takuya Mitsumoto
- 1 Department of Radioisotope Research Center, Teikyo university , Tokyo.,2 Department of Radiology, National Center for Global Health and Medicine , Tokyo
| | - Ryogo Minamimoto
- 2 Department of Radiology, National Center for Global Health and Medicine , Tokyo
| | - Fumio Sunaoka
- 2 Department of Radiology, National Center for Global Health and Medicine , Tokyo
| | - Seishi Kishimoto
- 1 Department of Radioisotope Research Center, Teikyo university , Tokyo
| | - Kazumasa Inoue
- 3 Department of Radiological Sciences, Graduate School of Medicine, Tokyo Metropolitan University , Tokyo
| | - Masahiro Fukushi
- 3 Department of Radiological Sciences, Graduate School of Medicine, Tokyo Metropolitan University , Tokyo
| |
Collapse
|
20
|
Abstract
BACKGROUND Fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) is a reliable imaging modality for the diagnosis of malignant lung nodules and to assess the latter's prognosis. However, physiological respiratory motion deteriorates PET images and thus decreases the technique's diagnostic and prognostic values. This issue can be overcome by applying respiratory gating to the F-FDG PET/CT acquisitions. PURPOSE The aim of this study was to evaluate the ability of respiratory-gated F-FDG PET/CT to diagnose malignant lung nodules and to predict recurrence and patient survival. PATIENTS AND METHODS A total of 103 prospectively enrolled patients with solid lung nodules underwent both ungated and gated F-FDG PET/CT acquisitions. The maximum standardized uptake value (SUVmax) was used to differentiate benign from malignant nodules. Patients have been followed up for at least 36 months to confirm imaging results and assess survival. RESULTS Gated F-FDG PET/CT was significantly more sensitive than ungated PET/CT for the diagnosis of malignant lung nodules located in the lower lobes (92 vs. 58%; P<0.001) and in patients aged older than 60 years (73 vs. 48%; P<0.001). The same gain was observed for stage I cancers with tumors from 10 to 20 mm. When considering patients aged older than 60 years, those with a low SUVmax on gated PET images had a significantly higher 3-year disease-free survival rate than those with a high SUVmax (76 vs. 47%; P=0.03). CONCLUSION F-FDG PET/CT is advisable for the assessment of lung nodules in patients aged older than 60 years and/or in the lower lobes.
Collapse
|
21
|
Walker MD, Bradley KM, McGowan DR. Evaluation of principal component analysis-based data-driven respiratory gating for positron emission tomography. Br J Radiol 2018; 91:20170793. [PMID: 29419327 PMCID: PMC5911393 DOI: 10.1259/bjr.20170793] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Respiratory motion can degrade PET image quality and lead to inaccurate quantification of lesion uptake. Such motion can be mitigated via respiratory gating. Our objective was to evaluate a data-driven gating (DDG) technique that is being developed commercially for clinical PET/CT. Methods: A data-driven respiratory gating algorithm based on principal component analysis (PCA) was applied to phantom and FDG patient data. An anthropomorphic phantom and a NEMA IEC Body phantom were filled with 18F, placed on a respiratory motion platform, and imaged using a PET/CT scanner. Motion waveforms were measured using an infrared camera [the Real-time Position Management™ system (RPM)] and also extracted from the PET data using the DDG algorithm. The waveforms were compared via calculation of Pearson’s correlation coefficients. PET data were reconstructed using quiescent period gating (QPG) and compared via measurement of recovery percentage and background variability. Results: Data-driven gating had similar performance to the external gating system, with correlation coefficients in excess of 0.97. Phantom and patient images were visually clearer with improved contrast when QPG was applied as compared to no motion compensation. Recovery coefficients in the phantoms were not significantly different between DDG- and RPM-based QPG, but were significantly higher than those found for no motion compensation (p < 0.05). Conclusion: A PCA-based DDG algorithm was evaluated and found to provide a reliable respiratory gating signal in anthropomorphic phantom studies and in example patients. Advances in knowledge: The prototype commercial DDG algorithm may enable reliable respiratory gating in routine clinical PET-CT.
Collapse
Affiliation(s)
- Matthew D Walker
- 1 Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust , Oxford , UK
| | - Kevin M Bradley
- 2 Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust , Oxford , UK
| | - Daniel R McGowan
- 1 Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust , Oxford , UK.,3 Department of Oncology, University of Oxford , Oxford , UK
| |
Collapse
|
22
|
Frood R, McDermott G, Scarsbrook A. Respiratory-gated PET/CT for pulmonary lesion characterisation-promises and problems. Br J Radiol 2018; 91:20170640. [PMID: 29338327 DOI: 10.1259/bjr.20170640] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
2-deoxy-2-(18Fluorine)-fluoro-D-glucose (FDG) PET/CT is an integral part of lung carcinoma staging and frequently used in the assessment of solitary pulmonary nodules. However, a limitation of conventional three-dimensional PET/CT when imaging the thorax is its susceptibility to motion artefact, which blurs the signal from the lesion resulting in inaccurate representation of size and metabolic activity. Respiratory gated (four-dimensional) PET/CT aims to negate the effects of motion artefact and provide a more accurate interpretation of pulmonary nodules and lymphadenopathy. There have been recent advances in technology and a shift from traditional hardware to more streamlined software methods for respiratory gating which should allow more widespread use of respiratory-gating in the future. The purpose of this article is to review the evidence surrounding four-dimensional PET/CT in pulmonary lesion characterisation.
Collapse
Affiliation(s)
- Russell Frood
- 1 Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Garry McDermott
- 2 Department of Medical Physics & Engineering, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom
| | - Andrew Scarsbrook
- 1 Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust , Leeds , United Kingdom.,3 Leeds Institute of Cancer and Pathology, University of Leeds , Leeds , United Kingdom
| |
Collapse
|
23
|
Grassi E, Fioroni F, Berenato S, Patterson N, Ferri V, Braglia L, Filice A, Versari A, Iori M, Spezi E. Effect of image registration on 3D absorbed dose calculations in 177 Lu-DOTATOC peptide receptor radionuclide therapy. Phys Med 2018; 45:177-185. [DOI: 10.1016/j.ejmp.2017.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 10/18/2017] [Accepted: 11/26/2017] [Indexed: 11/29/2022] Open
|
24
|
Kesner AL, Meier JG, Burckhardt DD, Schwartz J, Lynch DA. Data-driven optimal binning for respiratory motion management in PET. Med Phys 2017; 45:277-286. [DOI: 10.1002/mp.12651] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- Adam L. Kesner
- Department of Medical Physics; Memorial Sloan Kettering Cancer Center; New York NY USA
| | - Joseph G. Meier
- Department of Imaging Physics; University of Texas MD Anderson Cancer Center; Houston TX USA
| | | | - Jazmin Schwartz
- Department of Medical Physics; Memorial Sloan Kettering Cancer Center; New York NY USA
| | - David A. Lynch
- Department of Radiology; National Jewish Health; Denver CO USA
| |
Collapse
|
25
|
Crivellaro C, De Ponti E, Elisei F, Morzenti S, Picchio M, Bettinardi V, Versari A, Fioroni F, Dziuk M, Tkaczewski K, Ahond-Vionnet R, Nodari G, Todde S, Landoni C, Guerra L. Added diagnostic value of respiratory-gated 4D 18F-FDG PET/CT in the detection of liver lesions: a multicenter study. Eur J Nucl Med Mol Imaging 2017; 45:102-109. [PMID: 28825125 DOI: 10.1007/s00259-017-3795-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/26/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the added diagnostic value of respiratory-gated 4D18F-FDG PET/CT in liver lesion detection and characterization in a European multicenter retrospective study. METHODS Fifty-six oncological patients (29 males and 27 females, mean age, 61.2 ± 11.2 years) from five European centers, submitted to standard 3D-PET/CT and liver 4D-PET/CT were retrospectively evaluated. Based on visual analysis, liver PET/CT findings were scored as positive, negative, or equivocal both in 3D and 4D PET/CT. The impact of 4D-PET/CT on the confidence in classifying liver lesions was assessed. PET/CT findings were compared to histology and clinical follow-up as standard reference and diagnostic accuracy was calculated for both techniques. At semi-quantitative analysis, SUVmax was calculated for each detected lesion in 3D and 4D-PET/CT. RESULTS Overall, 72 liver lesions were considered for the analysis. Based on visual analysis in 3D-PET/CT, 32/72 (44.4%) lesions were considered positive, 21/72 (29.2%) negative, and 19/72 (26.4%) equivocal, while in 4D-PET/CT 48/72 (66.7%) lesions were defined positive, 23/72 (31.9%) negative, and 1/72 (1.4%) equivocal. 4D-PET/CT findings increased the confidence in lesion definition in 37/72 lesions (51.4%). Considering 3D equivocal lesions as positive, sensitivity, specificity, and accuracy were 88.9, 70.0, and 83.1%, respectively, while the same figures were 67.7, 90.0, and 73.8% if 3D equivocal findings were included as negative. 4D-PET/CT sensitivity, specificity, and accuracy were 97.8, 90.0, and 95.4%, respectively, considering equivocal lesions as positive and 95.6, 90.0, and 93.8% considering equivocal lesions as negative. The SUVmax of the liver lesions in 4D-PET (mean ± SD, 6.9 ± 3.2) was significantly higher (p < 0.001) than SUVmax in 3D-PET (mean ± SD, 5.2 ± 2.3). CONCLUSIONS Respiratory-gated PET/CT technique is a valuable clinical tool in diagnosing liver lesions, reducing 3D undetermined findings, improving diagnostic accuracy, and confidence in reporting. 4D-PET/CT also improved the quantification of SUVmax of liver lesions.
Collapse
Affiliation(s)
- Cinzia Crivellaro
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy. .,University of Milan-Bicocca, Milan, Italy.
| | | | | | | | - Maria Picchio
- Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Annibale Versari
- Nuclear Medicine, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | - Federica Fioroni
- Medical Physics, Santa Maria Nuova Hospital IRCCS, Reggio Emilia, Italy
| | | | | | - Renée Ahond-Vionnet
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Guillaume Nodari
- Service de Médecine Nucléaire, Hôpital Pierre Beregovoy, Cedex, Nevers, France
| | - Sergio Todde
- Tecnomed Foundation, University of Milan-Bicocca, Monza, Italy
| | - Claudio Landoni
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
| | - Luca Guerra
- Nuclear Medicine, San Gerardo Hospital, Monza, Italy.,University of Milan-Bicocca, Milan, Italy
| |
Collapse
|
26
|
The relevance of data driven motion correction in diagnostic PET. Eur J Nucl Med Mol Imaging 2017; 44:2326-2327. [DOI: 10.1007/s00259-017-3794-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 12/28/2022]
|
27
|
Yang J, Khalighi M, Hope TA, Ordovas K, Seo Y. Technical Note: Fast respiratory motion estimation using sorted singles without unlist processing: A feasibility study. Med Phys 2017; 44:1632-1637. [PMID: 28099995 DOI: 10.1002/mp.12115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The study aims to demonstrate the feasibility of fast respiratory motion estimation using singles data available as a sorted format in list-mode files acquired in an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) system for a proof-of-concept. METHODS The derivation of singles-driven respiratory motion (SDRM) is enabled by singles recorded and binned by second for each detector crystal in PET list-mode data acquired in a SIGNA PET/MR. The proposed method is to derive a SDRM trace by summing up all singles from all detectors through the PET data acquisition. To assess the feasibility of SDRM for data-driven gating (DDG), SDRM traces were derived from the list-mode data acquired in five liver-focused 68 Ga-DOTA-TOC PET/MRI scans, and compared with the traces derived from bellows (pressure belt). Pearson's correlation coefficients and trigger time differences at peak-inhalation phases between SDRM and bellows traces were measured for quantitative evaluation. RESULTS The method presented the average processing time of 4.2 ± 0.42 s (range: 3.9 ~ 4.7 s) for the derivation of SDRM traces. The majority of the time was spent for reading singles data from a list-mode file (3.1 ± 0.40 s, range: 2.7 ~ 3.7s). On average, the correlation coefficient of SDRM and bellows traces was 0.69 ± 0.16 (range: 0.41 ~ 0.80) and the time offset of SDRM-driven triggers from bellows-driven triggers was 0.25 ± 0.39 s (range: -0.85 ~ 2.69 s later than bellows triggers), demonstrating the similar patterns and phases of SDRM and bellows traces. CONCLUSIONS We introduced PET singles-driven respiratory motion (SDRM) estimation as a proof-of-principle, using sorted singles ready for immediate processing in list-mode data. The results demonstrated the feasibility of SDRM and its potential use for gated PET with fast processing time.
Collapse
Affiliation(s)
- Jaewon Yang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.,Department of Radiology, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Karen Ordovas
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Youngho Seo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.,Joint Graduate Group in Bioengineering, University of California, San Francisco and Berkeley, CA, USA.,Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
28
|
Alternative imaging strategy of solitary pulmonary nodule by FDG PET/CT: Can be imagined a tailored PET? Eur J Radiol 2017; 90:188-191. [PMID: 28583632 DOI: 10.1016/j.ejrad.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/20/2017] [Accepted: 03/03/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Patients with solitary pulmonary nodule (SPN) are usually sent to total-body positron emission tomography/computed tomography (PET/CT) examination with 18F-fluorodeoxyglucose (FDG). However, a segmental scan strategy may improve cost/effectiveness in this category of patients. CONCLUSION A segmental PET/CT scan only at the chest level could be performed in patients with indeterminate SPN. Limiting the PET/CT field to the thoracic region would greatly affect on radiobiology, department organization and health-care costs.
Collapse
|
29
|
Spadafora M, Pace L, Mansi L. Segmental 18F-FDG-PET/CT in a single pulmonary nodule: a better cost/effectiveness strategy. Eur J Nucl Med Mol Imaging 2017; 44:1-4. [PMID: 27695909 DOI: 10.1007/s00259-016-3532-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Marco Spadafora
- Department of Imaging, S.G. Moscati Hospital, Avellino, Italy
| | - Leonardo Pace
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Luigi Mansi
- Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale, Second University of Naples, Napoli, Italy.
| |
Collapse
|
30
|
Ahn IJ, Kim JH, Chang Y, Nam WH, Ra JB. Super-Resolution Reconstruction of 3D PET Images Using Two Respiratory-Phase Low-Dose CT Images. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2017. [DOI: 10.1109/tns.2016.2611624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
31
|
Minamimoto R, Mitsumoto T, Miyata Y, Sunaoka F, Morooka M, Okasaki M, Iagaru A, Kubota K. Evaluation of a new motion correction algorithm in PET/CT: combining the entire acquired PET data to create a single three-dimensional motion-corrected PET/CT image. Nucl Med Commun 2016; 37:162-70. [PMID: 26513056 DOI: 10.1097/mnm.0000000000000423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study evaluated the potential of Q.Freeze algorithm for reducing motion artifacts, in comparison with ungated imaging (UG) and respiratory-gated imaging (RG). PATIENTS AND METHODS Twenty-nine patients with 53 lesions who had undergone RG F-FDG PET/CT were included in this study. Using PET list mode data, five series of PET images [UG, RG, and QF images with an acquisition duration of 3 min (QF3), 5 min (QF5), and 10 min (QF10)] were reconstructed retrospectively. The image quality was evaluated first. Next, quantitative metrics [maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), SD, metabolic tumor volume, signal to noise ratio, or lesion to background ratio] were calculated for the liver, background, and each lesion, and the results were compared across the series. RESULTS QF10 and QF5 showed better image quality compared with all other images. SUVmax in the liver, background, and lesions was lower with QF10 and QF5 than with the others, but there were no statistically significant differences in SUVmean and the lesion to background ratios. The SD with UG and RG was significantly higher than that with QF5 and QF10. The metabolic tumor volume in QF3 and QF5 was significantly lower than that in UG. CONCLUSION The Q.Freeze algorithm can improve the quality of PET imaging compared with RG and UG.
Collapse
Affiliation(s)
- Ryogo Minamimoto
- aDepartment of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo bDepartment of Radiology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan cDepartment of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, California, USA
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Respiratory-gated time-of-flight PET/CT during whole-body scan for lung lesions: feasibility in a routine clinical setting and quantitative analysis. Ann Nucl Med 2016; 30:722-730. [PMID: 27566685 DOI: 10.1007/s12149-016-1118-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/18/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To demonstrate the feasibility of respiratory gating during whole-body scan for lung lesions in routine 18F-FDG PET/CT examinations using a time-of-flight (TOF)-capable scanner to determine the effect of respiratory gating on reduction of both misregistration (between CT and PET) and image blurring, and on improvement of the maximum standardized uptake value (SUVmax). MATERIALS AND METHODS Patients with lung lesions who received FDG PET/CT were prospectively studied. Misregistration, volume of PET (Vp), and SUVmax were compared between ungated and gated images. The difference in respiratory gating effects was compared between lesions located in the upper or middle lobes (UML) and the lower lobe (LL). The correlation between three parameters (% change in misregistration, % change in Vp, and lesion size) and % change in SUVmax was analyzed. RESULTS The study population consisted of 60 patients (37 males, 23 females; age 68 ± 12 years) with lung lesions (2.5 ± 1.7 cm). Fifty-eight out of sixty respiratory gating studies were successfully completed with a total scan time of 20.9 ± 1.9 min. Eight patients' data were not suitable for analysis, while the remaining 50 patients' data were analyzed. Respiratory gating reduced both misregistration by 21.4 % (p < 0.001) and Vp by 14.2 % (p < 0.001). The SUVmax of gated images improved by 14.8 % (p < 0.001). The % change in misregistration, Vp, and SUVmax by respiratory gating tended to be larger in LL lesions than in UML lesions. The correlation with % change in SUVmax was stronger in % change in Vp (r = 0.57) than % change in misregistration (r = 0.35). There was no statistically significant correlation between lesion size and % change in SUVmax (r = -0.20). CONCLUSIONS Respiratory gating during whole-body scan in routine TOF PET/CT examinations is feasible and can reduce both misregistration and PET image blurring, and improve the SUVmax of lung lesions located primarily in the LL.
Collapse
|
33
|
Kesner AL, Chung JH, Lind KE, Kwak JJ, Lynch D, Burckhardt D, Koo PJ. Validation of Software Gating: A Practical Technology for Respiratory Motion Correction in PET. Radiology 2016; 281:239-48. [PMID: 27027335 DOI: 10.1148/radiol.2016152105] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To assess the performance of hardware- and software-gating technologies in terms of qualitative and quantitative characteristics of respiratory motion in positron emission tomography (PET) imaging. Materials and Methods Between 2010 and 2013, 219 fluorine 18 fluorodeoxyglucose PET examinations were performed in 116 patients for assessment of pulmonary nodules. All patients provided informed consent in this institutional review board-approved study. Acquisitions were reconstructed as respiratory-gated images by using hardware-derived respiratory triggers and software-derived signal (via an automated postprocessing method). Asymmetry was evaluated in the joint distribution of reader preference, and linear mixed models were used to evaluate differences in outcomes according to gating type. Results In blind reviews of reconstructed gated images, software was selected as superior 16.9% of the time (111 of 657 image sets; 95% confidence interval [CI]: 14.0%, 19.8%), and hardware was selected as superior 6.2% of the time (41 of 657 image sets; 95% CI: 4.4%, 8.1%). Of the image sets, 76.9% (505 of 657; 95% CI: 73.6%, 80.1%) were judged as having indistinguishable motion quality. Quantitative analysis demonstrated that the two gating strategies exhibited similar performance, and the performance of both was significantly different from that of nongated images. The mean increase ± standard deviation in lesion maximum standardized uptake value was 42.2% ± 38.9 between nongated and software-gated images, and lesion full width at half maximum values decreased by 9.9% ± 9.6. Conclusion Compared with vendor-supplied respiratory-gating hardware methods, software gating performed favorably, both qualitatively and quantitatively. Fully automated gating is a feasible approach to motion correction of PET images. (©) RSNA, 2016 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Adam Leon Kesner
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - Jonathan Hero Chung
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - Kimberly Erin Lind
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - Jennifer Jihyang Kwak
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - David Lynch
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - Darrell Burckhardt
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| | - Phillip Jahhyung Koo
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, University of Colorado School of Medicine, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 (A.L.K., K.E.L., J.J.K., P.J.K.); Department of Radiology, National Jewish Health, Denver, Colo (J.H.C., D.L.); and Siemens, Hoffman Estates, Ill (D.B.)
| |
Collapse
|
34
|
Yip S, McCall K, Aristophanous M, Chen AB, Aerts HJWL, Berbeco R. Comparison of texture features derived from static and respiratory-gated PET images in non-small cell lung cancer. PLoS One 2014; 9:e115510. [PMID: 25517987 PMCID: PMC4269460 DOI: 10.1371/journal.pone.0115510] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND PET-based texture features have been used to quantify tumor heterogeneity due to their predictive power in treatment outcome. We investigated the sensitivity of texture features to tumor motion by comparing static (3D) and respiratory-gated (4D) PET imaging. METHODS Twenty-six patients (34 lesions) received 3D and 4D [18F]FDG-PET scans before the chemo-radiotherapy. The acquired 4D data were retrospectively binned into five breathing phases to create the 4D image sequence. Texture features, including Maximal correlation coefficient (MCC), Long run low gray (LRLG), Coarseness, Contrast, and Busyness, were computed within the physician-defined tumor volume. The relative difference (δ3D-4D) in each texture between the 3D- and 4D-PET imaging was calculated. Coefficient of variation (CV) was used to determine the variability in the textures between all 4D-PET phases. Correlations between tumor volume, motion amplitude, and δ3D-4D were also assessed. RESULTS 4D-PET increased LRLG ( = 1%-2%, p < 0.02), Busyness ( = 7%-19%, p < 0.01), and decreased MCC ( = 1%-2%, p < 7.5 × 10(-3)), Coarseness ( = 5%-10%, p < 0.05) and Contrast ( = 4%-6%, p > 0.08) compared to 3D-PET. Nearly negligible variability was found between the 4D phase bins with CV < 5% for MCC, LRLG, and Coarseness. For Contrast and Busyness, moderate variability was found with CV = 9% and 10%, respectively. No strong correlation was found between the tumor volume and δ3D-4D for the texture features. Motion amplitude had moderate impact on δ for MCC and Busyness and no impact for LRLG, Coarseness, and Contrast. CONCLUSIONS Significant differences were found in MCC, LRLG, Coarseness, and Busyness between 3D and 4D PET imaging. The variability between phase bins for MCC, LRLG, and Coarseness was negligible, suggesting that similar quantification can be obtained from all phases. Texture features, blurred out by respiratory motion during 3D-PET acquisition, can be better resolved by 4D-PET imaging. 4D-PET textures may have better prognostic value as they are less susceptible to tumor motion.
Collapse
Affiliation(s)
- Stephen Yip
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Keisha McCall
- Department of Radiology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michalis Aristophanous
- Department of Radiation Physics, Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Aileen B. Chen
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Hugo J. W. L. Aerts
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ross Berbeco
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, United States of America
| |
Collapse
|
35
|
Kesner AL, Schleyer PJ, Büther F, Walter MA, Schäfers KP, Koo PJ. On transcending the impasse of respiratory motion correction applications in routine clinical imaging - a consideration of a fully automated data driven motion control framework. EJNMMI Phys 2014; 1:8. [PMID: 26501450 PMCID: PMC4673082 DOI: 10.1186/2197-7364-1-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/23/2014] [Indexed: 12/21/2022] Open
Abstract
Positron emission tomography (PET) is increasingly used for the detection, characterization, and follow-up of tumors located in the thorax. However, patient respiratory motion presents a unique limitation that hinders the application of high-resolution PET technology for this type of imaging. Efforts to transcend this limitation have been underway for more than a decade, yet PET remains for practical considerations a modality vulnerable to motion-induced image degradation. Respiratory motion control is not employed in routine clinical operations. In this article, we take an opportunity to highlight some of the recent advancements in data-driven motion control strategies and how they may form an underpinning for what we are presenting as a fully automated data-driven motion control framework. This framework represents an alternative direction for future endeavors in motion control and can conceptually connect individual focused studies with a strategy for addressing big picture challenges and goals.
Collapse
Affiliation(s)
- Adam L Kesner
- Division of Nuclear Medicine, Department of Radiology, Anschutz Medical Campus, University of Colorado Denver, 12700 E 19th Ave, Box C-278, Aurora, CO, 80045, USA.
| | - Paul J Schleyer
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, WC2R 2LS, UK.
| | - Florian Büther
- European Institute for Molecular Imaging, University of Münster, Münster, 48149, Germany.
| | - Martin A Walter
- Institute of Nuclear Medicine and Department of Clinical Research, University Hospital Bern, Bern, 3010, Switzerland.
| | - Klaus P Schäfers
- European Institute for Molecular Imaging, University of Münster, Münster, 48149, Germany.
| | - Phillip J Koo
- Division of Nuclear Medicine, Department of Radiology, Anschutz Medical Campus, University of Colorado Denver, 12700 E 19th Ave, Box C-278, Aurora, CO, 80045, USA.
| |
Collapse
|
36
|
Bowen SR, Pierce LA, Alessio AM, Liu C, Wollenweber SD, Stearns CW, Kinahan PE. Assessment of patient selection criteria for quantitative imaging with respiratory-gated positron emission tomography. J Med Imaging (Bellingham) 2014; 1:026001. [PMID: 26158039 DOI: 10.1117/1.jmi.1.2.026001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/03/2014] [Accepted: 09/03/2014] [Indexed: 12/25/2022] Open
Abstract
The objective of this investigation was to propose techniques for determining which patients are likely to benefit from quantitative respiratory-gated imaging by correlating respiratory patterns to changes in positron emission tomography (PET) metrics. Twenty-six lung and liver cancer patients underwent PET/computed tomography exams with recorded chest/abdominal displacements. Static and adaptive amplitude-gated [[Formula: see text]]fluoro-D-glucose (FDG) PET images were generated from list-mode acquisitions. Patients were grouped by respiratory pattern, lesion location, or degree of lesion attachment to anatomical structures. Respiratory pattern metrics were calculated during time intervals corresponding to PET field of views over lesions of interest. FDG PET images were quantified by lesion maximum standardized uptake value ([Formula: see text]). Relative changes in [Formula: see text] between static and gated PET images were tested for association to respiratory pattern metrics. Lower lung lesions and liver lesions had significantly higher changes in [Formula: see text] than upper lung lesions (14 versus 3%, [Formula: see text]). Correlation was highest ([Formula: see text], [Formula: see text], [Formula: see text]) between changes in [Formula: see text] and nonstandard respiratory pattern metrics. Lesion location had a significant impact on changes in PET quantification due to respiratory gating. Respiratory pattern metrics were correlated to changes in [Formula: see text], though sample size limited statistical power. Validation in larger cohorts may enable selection of patients prior to acquisition who would benefit from respiratory-gated PET imaging.
Collapse
Affiliation(s)
- Stephen R Bowen
- University of Washington School of Medicine , Department of Radiation Oncology, 1959 NE Pacific St, Seattle, Washington 98195, United States ; University of Washington School of Medicine , Department of Radiology, 1959 NE Pacific St, Seattle, Washington 98195, United States
| | - Larry A Pierce
- University of Washington School of Medicine , Department of Radiology, 1959 NE Pacific St, Seattle, Washington 98195, United States
| | - Adam M Alessio
- University of Washington School of Medicine , Department of Radiology, 1959 NE Pacific St, Seattle, Washington 98195, United States
| | - Chi Liu
- Yale University School of Medicine , Department of Diagnostic Radiology, New Haven, Connecticut 06510, United States
| | | | | | - Paul E Kinahan
- University of Washington School of Medicine , Department of Radiology, 1959 NE Pacific St, Seattle, Washington 98195, United States
| |
Collapse
|
37
|
Huang TC, Chou KT, Wang YC, Zhang G. Motion freeze for respiration motion correction in PET/CT: a preliminary investigation with lung cancer patient data. BIOMED RESEARCH INTERNATIONAL 2014; 2014:167491. [PMID: 25250313 PMCID: PMC4164623 DOI: 10.1155/2014/167491] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/13/2014] [Accepted: 08/16/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Respiratory motion presents significant challenges for accurate PET/CT. It often introduces apparent increase of lesion size, reduction of measured standardized uptake value (SUV), and the mismatch in PET/CT fusion images. In this study, we developed the motion freeze method to use 100% of the counts collected by recombining the counts acquired from all phases of gated PET data into a single 3D PET data, with correction of respiration by deformable image registration. METHODS Six patients with diagnosis of lung cancer confirmed by oncologists were recruited. PET/CT scans were performed with Discovery STE system. The 4D PET/CT with the Varian real-time position management for respiratory motion tracking was followed by a clinical 3D PET/CT scan procedure in the static mode. Motion freeze applies the deformation matrices calculated by optical flow method to generate a single 3D effective PET image using the data from all the 4D PET phases. RESULTS The increase in SUV and decrease in tumor size with motion freeze for all lesions compared to the results from 3D and 4D was observed in the preliminary data of lung cancer patients. In addition, motion freeze substantially reduced tumor mismatch between the CT image and the corresponding PET images. CONCLUSION Motion freeze integrating 100% of the PET counts has the potential to eliminate the influences induced by respiratory motion in PET data.
Collapse
Affiliation(s)
- Tzung-Chi Huang
- Department of Biomedical Imaging and Radiological Science, China Medical University, 91 Hsueh-Shih Road, Taichung City, Taiwan
- Department of Biomedical Informatics, Asia University, Taichung City, Taiwan
| | - Kuei-Ting Chou
- Department of Biomedical Imaging and Radiological Science, China Medical University, 91 Hsueh-Shih Road, Taichung City, Taiwan
| | - Yao-Ching Wang
- Department of Radiation Oncology, China Medical University Hospital, Taichung City, Taiwan
| | - Geoffrey Zhang
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| |
Collapse
|
38
|
Callahan J, Kron T, Schneider ME, Hicks RJ. A prospective investigation into the clinical impact of 4D-PET/CT in the characterisation of solitary pulmonary nodules. Cancer Imaging 2014; 14:24. [PMID: 25608679 PMCID: PMC4331829 DOI: 10.1186/1470-7330-14-24] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 05/22/2014] [Indexed: 12/26/2022] Open
Abstract
Background While the effects of respiratory motion on measuring metabolic signal in PET/CT scanning are well known, it is still standard practice in most centres to scan patients while breathing freely with no correction for the effects of respiratory motion. The aim of this study was to investigate the impact of 4D-PET/CT in classifying lesions in patients with a radiologically-indeterminate solitary pulmonary nodule. Methods Twenty consecutive patients with a solitary pulmonary nodule for investigation were prospectively recruited and completed a whole-body (WB)-PET/CT and 4D-PET/CT in the same session. The reporting physician initially classified the nodule using a 5-point scale (Definitely Malignant, Probably Malignant, Indeterminate, Probably benign, Definitely Benign) on the WB-PET/CT. The physician was then shown the 4D-PET/CT and asked if they would re-classify the lesion. Frequency, sensitivity, specificity and accuracy values were calculated for WB-PET/CT alone and then with the addition of the 4D-PET/CT. Results There were no changes in the classification for nodules initially classed as either benign or malignant with the addition of a 4D-PET/CT. However changes were observed between WB and 4D-PET/CT scans in lesions initially classified as indeterminate. When indeterminate lesions were defined as malignant there was a minor increase in sensitivity (from 73% to 75%), in specificity (56%-63%) and in accuracy (65%-70%) but these results do not reach statistical significance. When the Indeterminate lesions were defined as benign there was an increase in sensitivity (from 55% to 67%) but there was a reduction in the specificity (100%-75%) and accuracy (75%-70%) with the addition of the 4D-PET/CT but again the results did not reach statistical significance. Conclusion The addition of 4D-PET/CT is most likely to have an impact on those nodules initially classified as indeterminate on standard WB-PET/CT. In lesions classified as benign or malignant on standard WB-PET/CT the addition of a 4D-PET/CT is less likely to impact lesion classification. While 4D-PET/CT does improve the measurement of the metabolic signal, it does not overcome inherent limitations of FDG in differentiating a malignant lesion from inflammatory processes, correct for partial volume effects or compensate for the low intrinsic FDG-avidity of some malignancies.
Collapse
|
39
|
Integrating respiratory-gated PET-based target volume delineation in liver SBRT planning, a pilot study. Radiat Oncol 2014; 9:127. [PMID: 24885897 PMCID: PMC4050417 DOI: 10.1186/1748-717x-9-127] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/18/2014] [Indexed: 12/25/2022] Open
Abstract
Background To assess the feasibility and benefit of integrating four-dimensional (4D) Positron Emission Tomography (PET) – computed tomography (CT) for liver stereotactic body radiation therapy (SBRT) planning. Methods 8 patients with 14 metastases were accrued in the study. They all underwent a non-gated PET and a 4D PET centered on the liver. The same CT scan was used for attenuation correction, registration, and considered the planning CT for SBRT planning. Six PET phases were reconstructed for each 4D PET. By applying an individualized threshold to the 4D PET, a Biological Internal Target Volume (BITV) was generated for each lesion. A gated Planning Target Volume (PTVg) was created by adding 3 mm to account for set-up margins. This volume was compared to a manual Planning Target Volume (PTV) delineated with the help of a semi-automatic Biological Target Volume (BTV) obtained from the non-gated exam. A 5 mm radial and a 10 mm craniocaudal margins were applied to account for tumor motion and set-up margins to create the PTV. Results One undiagnosed liver metastasis was discovered thanks to the 4D PET. The semi-automatic BTV were significantly smaller than the BITV (p = 0.0031). However, after applying adapted margins, 4D PET allowed a statistically significant decrease in the PTVg as compared to the PTV (p = 0.0052). Conclusions In comparison to non-gated PET, 4D PET may better define the respiratory movements of liver targets and improve SBRT planning for liver metastases. Furthermore, non respiratory-gated PET exams can both misdiagnose liver metastases and underestimate the real internal target volumes.
Collapse
|
40
|
|
41
|
Wang S, Bowen SR, Chaovalitwongse WA, Sandison GA, Grabowski TJ, Kinahan PE. Respiratory trace feature analysis for the prediction of respiratory-gated PET quantification. Phys Med Biol 2014; 59:1027-45. [PMID: 24504153 DOI: 10.1088/0031-9155/59/4/1027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The benefits of respiratory gating in quantitative PET/CT vary tremendously between individual patients. Respiratory pattern is among many patient-specific characteristics that are thought to play an important role in gating-induced imaging improvements. However, the quantitative relationship between patient-specific characteristics of respiratory pattern and improvements in quantitative accuracy from respiratory-gated PET/CT has not been well established. If such a relationship could be estimated, then patient-specific respiratory patterns could be used to prospectively select appropriate motion compensation during image acquisition on a per-patient basis. This study was undertaken to develop a novel statistical model that predicts quantitative changes in PET/CT imaging due to respiratory gating. Free-breathing static FDG-PET images without gating and respiratory-gated FDG-PET images were collected from 22 lung and liver cancer patients on a PET/CT scanner. PET imaging quality was quantified with peak standardized uptake value (SUV(peak)) over lesions of interest. Relative differences in SUV(peak) between static and gated PET images were calculated to indicate quantitative imaging changes due to gating. A comprehensive multidimensional extraction of the morphological and statistical characteristics of respiratory patterns was conducted, resulting in 16 features that characterize representative patterns of a single respiratory trace. The six most informative features were subsequently extracted using a stepwise feature selection approach. The multiple-regression model was trained and tested based on a leave-one-subject-out cross-validation. The predicted quantitative improvements in PET imaging achieved an accuracy higher than 90% using a criterion with a dynamic error-tolerance range for SUV(peak) values. The results of this study suggest that our prediction framework could be applied to determine which patients would likely benefit from respiratory motion compensation when clinicians quantitatively assess PET/CT for therapy target definition and response assessment.
Collapse
Affiliation(s)
- Shouyi Wang
- Department of Industrial and Systems Engineering, 3900 Stevens Way, Seattle, WA 98195, USA. Integrated Brain Imaging Center, 1959 NE Pacific St, Seattle, WA 98195, USA
| | | | | | | | | | | |
Collapse
|
42
|
Comparative evaluation of CT-based and respiratory-gated PET/CT-based planning target volume (PTV) in the definition of radiation treatment planning in lung cancer: preliminary results. Eur J Nucl Med Mol Imaging 2013; 41:702-10. [DOI: 10.1007/s00259-013-2594-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 10/01/2013] [Indexed: 12/25/2022]
|
43
|
Respiratory-gated 18F-FDG PET/CT for the diagnosis of liver metastasis. Eur J Radiol 2013; 82:1696-701. [DOI: 10.1016/j.ejrad.2013.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/01/2013] [Accepted: 05/06/2013] [Indexed: 01/18/2023]
|
44
|
Nam WH, Ahn IJ, Kim KM, Kim BI, Ra JB. Motion-compensated PET image reconstruction with respiratory-matched attenuation correction using two low-dose inhale and exhale CT images. Phys Med Biol 2013; 58:7355-74. [DOI: 10.1088/0031-9155/58/20/7355] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
45
|
Skretting A, Revheim ME, Knudtsen IS, Johnsrud K, Bogsrud TV. An implementation of time-efficient respiratory-gated PET acquisition by repeated breath-holds. Acta Radiol 2013; 54:672-5. [PMID: 23463858 DOI: 10.1177/0284185113478007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Respiratory gating in positron emission tomography (PET) is used to improve detection of small tumors in the lower lung regions and in the liver, and to obtain a better estimate of the standardized uptake value (SUV). PURPOSE To develop a time-efficient method for acquisition of respiratory-gated PET/CT that would produce one single high quality image volume corresponding to a breath-hold state. MATERIAL AND METHODS An instrument was developed that displayed to the patient either red or green numbers, counting down from a chosen maximum to one at a rate of one dial per second. The patient was instructed to repeatedly hold the breath in moderate inspiration when red numbers were displayed and to breathe freely during display of green numbers. PET data were acquired in list mode and trigger signals were sent to the scanner and inserted into the list file each time the color of the countdown numbers switched from green to red. Data acquired during breath-holds were used to create one single image volume. RESULTS High quality breath-hold images were obtained from 10 min data acquisition at one bed position. Improved image quality compared to standard whole-body PET was demonstrated by a significant reduction of noise (standard deviation) in regions of normal liver tissues. CONCLUSION The instruction to perform repeated breath-holds was well understood by patients and they cooperated satisfactorily. When the new procedure is used the duration of the data acquisition may typically be reduced by a factor of 4 compared to conventional respiratory-gated protocols where the patient breathes freely.
Collapse
Affiliation(s)
- Arne Skretting
- The Intervention Centre, Oslo University Hospital, Oslo
- Institute of Clinical Medicine, University of Oslo, Oslo
| | - Mona-Elisabeth Revheim
- Institute of Clinical Medicine, University of Oslo, Oslo
- Department of Radiology and Nuclear medicine, Oslo University Hospital, Oslo
| | - Ingerid Skjei Knudtsen
- Department of Physics, University of Oslo, Oslo
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Kjersti Johnsrud
- Department of Radiology and Nuclear medicine, Oslo University Hospital, Oslo
| | - Trond Velde Bogsrud
- Department of Radiology and Nuclear medicine, Oslo University Hospital, Oslo
| |
Collapse
|
46
|
Kesner AL, Abourbeh G, Mishani E, Chisin R, Tshori S, Freedman N. Gating, enhanced gating, and beyond: information utilization strategies for motion management, applied to preclinical PET. EJNMMI Res 2013; 3:29. [PMID: 23618039 PMCID: PMC3648448 DOI: 10.1186/2191-219x-3-29] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 03/05/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Respiratory gating and gate optimization strategies present solutions for overcoming image degradation caused by respiratory motion in PET and traditionally utilize hardware systems and/or employ complex processing algorithms. In this work, we aimed to advance recently emerging data-driven gating methods and introduce a new strategy for optimizing the four-dimensional data based on information contained in that data. These algorithms are combined to form an automated motion correction workflow. METHODS Software-based gating methods were applied to a nonspecific population of 84 small-animal rat PET scans to create respiratory gated images. The gated PET images were then optimized using an algorithm we introduce as 'gating+' to reduce noise and optimize signal; the technique was also tested using simulations. Gating+ is based on a principle of only using gated information if and where it adds a net benefit, as evaluated in temporal frequency space. Motion-corrected images were assessed quantitatively and qualitatively. RESULTS Of the small-animal PET scans, 71% exhibited quantifiable motion after software gating. The mean liver displacement was 3.25 mm for gated and 3.04 mm for gating+ images. The (relative) mean percent standard deviations measured in background ROIs were 1.53, 1.05, and 1.00 for the gated, gating+, and ungated values, respectively. Simulations confirmed that gating+ image voxels had a higher probability of being accurate relative to the corresponding ungated values under varying noise and motion scenarios. Additionally, we found motion mapping and phase decoupling models that readily extend from gating+ processing. CONCLUSIONS Raw PET data contain information about motion that is not currently utilized. In our work, we showed that through automated processing of standard (ungated) PET acquisitions, (motion-) information-rich images can be constructed with minimal risk of noise introduction. Such methods have the potential for implementation with current PET technology in a robust and reproducible way.
Collapse
Affiliation(s)
- Adam Leon Kesner
- Department of Medical Biophysics and Nuclear Medicine, Kiryat Hadassah, P,O, Box 12000, Jerusalem 91120, Israel.
| | | | | | | | | | | |
Collapse
|