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Wang J, Bermudez D, Chen W, Durgavarjhula D, Randell C, Uyanik M, McMillan A. Motion-correction strategies for enhancing whole-body PET imaging. FRONTIERS IN NUCLEAR MEDICINE (LAUSANNE, SWITZERLAND) 2024; 4:1257880. [PMID: 39118964 PMCID: PMC11308502 DOI: 10.3389/fnume.2024.1257880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Positron Emission Tomography (PET) is a powerful medical imaging technique widely used for detection and monitoring of disease. However, PET imaging can be adversely affected by patient motion, leading to degraded image quality and diagnostic capability. Hence, motion gating schemes have been developed to monitor various motion sources including head motion, respiratory motion, and cardiac motion. The approaches for these techniques have commonly come in the form of hardware-driven gating and data-driven gating, where the distinguishing aspect is the use of external hardware to make motion measurements vs. deriving these measures from the data itself. The implementation of these techniques helps correct for motion artifacts and improves tracer uptake measurements. With the great impact that these methods have on the diagnostic and quantitative quality of PET images, much research has been performed in this area, and this paper outlines the various approaches that have been developed as applied to whole-body PET imaging.
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Affiliation(s)
- James Wang
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States
| | - Dalton Bermudez
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States
| | - Weijie Chen
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Electrical and Computer Engineering, University of Wisconsin Madison, Madison, WI, United States
| | - Divya Durgavarjhula
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Computer Science, University of Wisconsin Madison, Madison, WI, United States
| | - Caitlin Randell
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Biomedical Engineering, University of Wisconsin Madison, Madison, WI, United States
| | - Meltem Uyanik
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States
| | - Alan McMillan
- Department of Radiology, University of Wisconsin Madison, Madison, WI, United States
- Department of Medical Physics, University of Wisconsin Madison, Madison, WI, United States
- Department of Electrical and Computer Engineering, University of Wisconsin Madison, Madison, WI, United States
- Department of Biomedical Engineering, University of Wisconsin Madison, Madison, WI, United States
- Data Science Institute, University of Wisconsin Madison, Madison, WI, United States
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Nammas W, Paunonen C, Teuho J, Siekkinen R, Luoto P, Käkelä M, Hietanen A, Viljanen T, Dietz M, Prior JO, Li XG, Roivainen A, Knuuti J, Saraste A. Imaging of Myocardial α vβ 3 Integrin Expression for Evaluation of Myocardial Injury After Acute Myocardial Infarction. J Nucl Med 2024; 65:132-138. [PMID: 37973184 DOI: 10.2967/jnumed.123.266148] [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: 06/08/2023] [Revised: 09/27/2023] [Indexed: 11/19/2023] Open
Abstract
[68Ga]Ga-NODAGA-Arg-Gly-Asp (RGD) is a PET tracer targeting αvβ3 integrin, which is upregulated during angiogenesis soon after acute myocardial infarction (AMI). We prospectively evaluated determinants of myocardial uptake of [68Ga]Ga-NODAGA-RGD and its associations with left ventricular (LV) function in patients after AMI. Methods: Myocardial blood flow and [68Ga]Ga-NODAGA-RGD uptake (60 min after injection) were evaluated by PET in 31 patients 7.7 ± 3.8 d after primary percutaneous coronary intervention for ST-elevation AMI. Transthoracic echocardiography of LV function was performed on the day of PET and at the 6-mo follow-up. Results: PET images showed increased uptake of [68Ga]Ga-NODAGA-RGD in the ischemic area at risk (AAR), predominantly in injured myocardial segments. The SUV in the segment with the highest uptake (SUVmax) in the ischemic AAR was higher than the SUVmean of the remote myocardium (0.73 ± 0.16 vs. 0.51 ± 0.11, P < 0.001). Multivariable predictors of [68Ga]Ga-NODAGA-RGD uptake in the AAR included high peak N-terminal pro-B-type natriuretic peptide (P < 0.001), low LV ejection fraction, low global longitudinal strain (P = 0.01), and low longitudinal strain in the AAR (P = 0.01). [68Ga]Ga-NODAGA-RGD uptake corrected for myocardial blood flow and perfusable tissue fraction in the AAR predicted improvement in global longitudinal strain at follow-up (P = 0.002), independent of peak troponin, N-terminal pro-B-type natriuretic peptide, and LV ejection fraction. Conclusion: [68Ga]Ga-NODAGA-RGD uptake shows increased αvβ3 integrin expression in the ischemic AAR early after AMI that is associated with regional and global systolic dysfunction, as well as increased LV filling pressure. Increased [68Ga]Ga-NODAGA-RGD uptake predicts improvement of global LV function 6 mo after AMI.
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Affiliation(s)
- Wail Nammas
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Christian Paunonen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Jarmo Teuho
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Reetta Siekkinen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Pauliina Luoto
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Meeri Käkelä
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Ari Hietanen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Tapio Viljanen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Matthieu Dietz
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Xiang-Guo Li
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- Department of Chemistry, University of Turku, Turku, Finland; and
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Juhani Knuuti
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
| | - Antti Saraste
- Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland;
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
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Centracchio J, Esposito D, Gargiulo GD, Andreozzi E. Changes in Forcecardiography Heartbeat Morphology Induced by Cardio-Respiratory Interactions. SENSORS (BASEL, SWITZERLAND) 2022; 22:9339. [PMID: 36502041 PMCID: PMC9736082 DOI: 10.3390/s22239339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The cardiac function is influenced by respiration. In particular, various parameters such as cardiac time intervals and the stroke volume are modulated by respiratory activity. It has long been recognized that cardio-respiratory interactions modify the morphology of cardio-mechanical signals, e.g., phonocardiogram, seismocardiogram (SCG), and ballistocardiogram. Forcecardiography (FCG) records the weak forces induced on the chest wall by the mechanical activity of the heart and lungs and relies on specific force sensors that are capable of monitoring respiration, infrasonic cardiac vibrations, and heart sounds, all simultaneously from a single site on the chest. This study addressed the changes in FCG heartbeat morphology caused by respiration. Two respiratory-modulated parameters were considered, namely the left ventricular ejection time (LVET) and a morphological similarity index (MSi) between heartbeats. The time trends of these parameters were extracted from FCG signals and further analyzed to evaluate their consistency within the respiratory cycle in order to assess their relationship with the breathing activity. The respiratory acts were localized in the time trends of the LVET and MSi and compared with a reference respiratory signal by computing the sensitivity and positive predictive value (PPV). In addition, the agreement between the inter-breath intervals estimated from the LVET and MSi and those estimated from the reference respiratory signal was assessed via linear regression and Bland-Altman analyses. The results of this study clearly showed a tight relationship between the respiratory activity and the considered respiratory-modulated parameters. Both the LVET and MSi exhibited cyclic time trends that remarkably matched the reference respiratory signal. In addition, they achieved a very high sensitivity and PPV (LVET: 94.7% and 95.7%, respectively; MSi: 99.3% and 95.3%, respectively). The linear regression analysis reported almost unit slopes for both the LVET (R2 = 0.86) and MSi (R2 = 0.97); the Bland-Altman analysis reported a non-significant bias for both the LVET and MSi as well as limits of agreement of ±1.68 s and ±0.771 s, respectively. In summary, the results obtained were substantially in line with previous findings on SCG signals, adding to the evidence that FCG and SCG signals share a similar information content.
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Affiliation(s)
- Jessica Centracchio
- Department of Electrical Engineering and Information Technologies, University of Naples Federico II, Via Claudio 21, 80125 Napoli, Italy
| | - Daniele Esposito
- Department of Electrical Engineering and Information Technologies, University of Naples Federico II, Via Claudio 21, 80125 Napoli, Italy
| | - Gaetano D. Gargiulo
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia
| | - Emilio Andreozzi
- Department of Electrical Engineering and Information Technologies, University of Naples Federico II, Via Claudio 21, 80125 Napoli, Italy
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Low-Dose PET Imaging of Tumors in Lung and Liver Regions Using Internal Motion Estimation. Diagnostics (Basel) 2021; 11:diagnostics11112138. [PMID: 34829485 PMCID: PMC8625002 DOI: 10.3390/diagnostics11112138] [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: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
Motion estimation and compensation are necessary for improvement of tumor quantification analysis in positron emission tomography (PET) images. The aim of this study was to propose adaptive PET imaging with internal motion estimation and correction using regional artificial evaluation of tumors injected with low-dose and high-dose radiopharmaceuticals. In order to assess internal motion, molecular sieves imitating tumors were loaded with 18F and inserted into the lung and liver regions in rats. All models were classified into two groups, based on the injected radiopharmaceutical activity, to compare the effect of tumor intensity. The PET study was performed with injection of F-18 fluorodeoxyglucose (18F-FDG). Respiratory gating was carried out by external trigger device. Count, signal to noise ratio (SNR), contrast and full width at half maximum (FWHM) were measured in artificial tumors in gated images. Motion correction was executed by affine transformation with estimated internal motion data. Monitoring data were different from estimated motion. Contrast in the low-activity group was 3.57, 4.08 and 6.19, while in the high-activity group it was 10.01, 8.36 and 6.97 for static, 4 bin and 8 bin images, respectively. The results of the lung target in 4 bin and the liver target in 8 bin showed improvement in FWHM and contrast with sufficient SNR. After motion correction, FWHM was improved in both regions (lung: 24.56%, liver: 10.77%). Moreover, with the low dose of radiopharmaceuticals the PET image visualized specific accumulated radiopharmaceutical areas in the liver. Therefore, low activity in PET images should undergo motion correction before quantification analysis using PET data. We could improve quantitative tumor evaluation by considering organ region and tumor intensity.
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