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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 12/2007

01-12-2007 | Original Article

Attenuation correction in cardiac PET/CT with three different CT protocols: a comparison with conventional PET

Authors: Michael Souvatzoglou, Frank Bengel, Raymonde Busch, Coletta Kruschke, Helga Fernolendt, Denise Lee, Markus Schwaiger, Stephan G. Nekolla

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2007

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Abstract

Purpose

CT-based attenuation correction may influence cardiac PET owing to its higher susceptibility to misalignment compared with conventional 68Ge transmission scans. The aims of this study were to evaluate whether CT attenuation correction leads to changes in tracer distribution compared with conventional cardiac PET and to determine a suitable CT protocol.

Methods

A total of 27 patients underwent PET/CT and subsequently a PET scan. Twenty patients received a low-dose CT (LDCT group; 120 kV, 26 mA, 8-s scan time), seven patients a slow CT (SCT group; 120 kV, 99 mA, 46-s scan time) and ten patients an ultra-low-dose CT (ULDCT group; 80 kV, 13 mA, 5-s scan time) as the transmission scan in PET/CT. Polar maps were divided into 17 segments and regression analysis was computed in every scan pair (CT attenuation corrected–68Ge attenuation corrected). Correlation coefficient (r), the slope (s) and the offset (os) of the regression line were determined. Visual assessment of misalignment between the transmission and emission data was performed. The effective dose of the different transmission scans was calculated.

Results

Overall, there was a moderate correlation between the mean values measured in all segments on PET/CT and on PET when using LDCT (r=0.78, p<0.0001), SCT (r=0.79, p<0.0001) and ULDCT (r=0.82, p<0.0001). No differences were observed when comparing the scores assigned in the visual misalignment assessment in the three groups (p=0.12). The differences between the results from the regression analysis observed in the respective groups were not statistically significant (Kruskal-Wallis p=0.11 for r, p=0.67 for s and p=0.27 for os). The effective dose was lowest for the ULDCT.

Conclusion

Our study shows that CT-based attenuation correction is feasible for cardiac PET imaging. The results indicate that ultra-low-dose CT is the preferable choice for transmission scanning.
Literature
1.
Marshall RC, Tillisch JH, Phelps ME, Huang SC, Carson R, Henze E, et al. Identification and differentiation of resting myocardial ischemia and infarction in man with positron computed tomography, 18F-labeled fluorodeoxyglucose and N-13 ammonia. Circulation 1983;67(4):766–78.PubMed
2.
Schwaiger M, Brunken R, Grover-McKay M, Krivokapich J, Child J, Tillisch JH, et al. Regional myocardial metabolism in patients with acute myocardial infarction assessed by positron emission tomography. J Am Coll Cardiol 1986;8(4):800–8.PubMedCrossRef
3.
Haas F, Haehnel CJ, Picker W, Nekolla S, Martinoff S, Meisner H, et al. Preoperative positron emission tomographic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. J Am Coll Cardiol 1997;30(7):1693–700.PubMedCrossRef
4.
Tillisch J, Brunken R, Marshall R, Schwaiger M, Mandelkern M, Phelps M, et al. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med 1986;314(14):884–8.PubMedCrossRef
5.
Beanlands RS, Ruddy TD, deKemp RA, Iwanochko RM, Coates G, Freeman M, et al. Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function. J Am Coll Cardiol 2002;40(10):1735–43.PubMedCrossRef
6.
Kaufmann PA, Camici PG. Myocardial blood flow measurement by PET: technical aspects and clinical applications. J Nucl Med 2005;46(1):75–88.PubMed
7.
Matsunari I, Boning G, Ziegler SI, Kosa I, Nekolla SG, Ficaro EP, et al. Effects of misalignment between transmission and emission scans on attenuation-corrected cardiac SPECT. J Nucl Med 1998;39(3):411–6.PubMed
8.
Pitman AG, Kalff V, Van Every B, Risa B, Barnden LR, Kelly MJ. Effect of mechanically simulated diaphragmatic respiratory motion on myocardial SPECT processed with and without attenuation correction. J Nucl Med 2002;43(9):1259–67.PubMed
9.
McCord ME, Bacharach SL, Bonow RO, Dilsizian V, Cuocolo A, Freedman N. Misalignment between PET transmission and emission scans: its effect on myocardial imaging. J Nucl Med 1992;33(6):1209–14; discussion 1214–5.
10.
Kinahan PE, Townsend DW, Beyer T, Sashin D. Attenuation correction for a combined 3D PET/CT scanner. Med Phys 1998;25(10):2046–53.PubMedCrossRef
11.
Beyer T, Townsend DW, Brun T, Kinahan PE, Charron M, Roddy R, et al. A combined PET/CT scanner for clinical oncology. J Nucl Med 2000;41(8):1369–79.PubMed
12.
Beyer T, Antoch G, Blodgett T, Freudenberg LF, Akhurst T, Mueller S. Dual-modality PET/CT imaging: the effect of respiratory motion on combined image quality in clinical oncology. Eur J Nucl Med Mol Imaging 2003;30(4):588–96.PubMedCrossRef
13.
Chin BB, Nakamoto Y, Kraitchman DL, Marshall L, Wahl R. PET-CT evaluation of 2-deoxy-2-[18F]fluoro-D-glucose myocardial uptake: effect of respiratory motion. Mol Imaging Biol 2003;5(2):57–64.PubMedCrossRef
14.
Goerres GW, Kamel E, Heidelberg TN, Schwitter MR, Burger C, von Schulthess GK. PET-CT image co-registration in the thorax: influence of respiration. Eur J Nucl Med Mol Imaging 2002;29(3):351–60.PubMedCrossRef
15.
Wu TH, Huang YH, Lee JJ, Wang SC, Su CT, Chen LK, et al. Radiation exposure during transmission measurements: comparison between CT- and germanium-based techniques with a current PET scanner. Eur J Nucl Med Mol Imaging 2004;31(1):38–43.PubMedCrossRef
16.
Lagerwaard FJ, Van Sornsen de Koste JR, Nijssen-Visser MR, Schuchhard-Schipper RH, Oei SS, Munne A, et al. Multiple “slow” CT scans for incorporating lung tumor mobility in radiotherapy planning. Int J Radiat Oncol Biol Phys 2001;51(4):932–7.PubMed
17.
Pan T, Mawlawi O, Nehmeh SA, Erdi YE, Luo D, Liu HH, et al. Attenuation correction of PET Images with respiration-averaged CT images in PET/CT. J Nucl Med 2005;46(9):1481–7.PubMed
18.
Kalender WA, Schmidt B, Zankl M, Schmidt M. A PC program for estimating organ dose and effective dose values in computed tomography. Eur Radiol 1999;9(3):555–62.PubMedCrossRef
19.
Burger C, Goerres G, Schoenes S, Buck A, Lonn AH, Von Schulthess GK. PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients. Eur J Nucl Med Mol Imaging 2002;29(7):922–7.PubMedCrossRef
20.
Nekolla SG, Miethaner C, Nguyen N, Ziegler SI, Schwaiger M. Reproducibility of polar map generation and assessment of defect severity and extent assessment in myocardial perfusion imaging using positron emission tomography. Eur J Nucl Med 1998;25(9):1313–21.PubMedCrossRef
21.
Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Int J Cardiovasc Imaging 2002;18(1):539–42.PubMed
22.
Koepfli P, Hany TF, Wyss CA, Namdar M, Burger C, Konstantinidis AV, et al. CT attenuation correction for myocardial perfusion quantification using a PET/CT hybrid scanner. J Nucl Med 2004;45(4):537–42.PubMed
23.
Jessen K, Panzer W, Shrimpton P. EUR 16262. European guidelines on quality criteria for computed tomography. Luxemburg: Office for official publications of the European Communities; 2000.
24.
Livieratos L, Rajappan K, Bailey DL, Rimoldi O, Camici PG. Respiratory gating of cardiac PET data [abstract]. Eur J Nucl Med Mol Imaging 2003;30 Supplement 2:174.
25.
Livieratos L, Stegger L, Bloomfield PM, Schafers K, Bailey DL, Camici PG. Rigid-body transformation of list-mode projection data for respiratory motion correction in cardiac PET. Phys Med Biol 2005;50(14):3313–22.PubMedCrossRef
26.
Loghin C, Sdringola S, Gould KL. Common artifacts in PET myocardial perfusion images due to attenuation-emission misregistration: clinical significance, causes, and solutions. J Nucl Med 2004;45(6):1029–39.PubMed
27.
Nehmeh SA, Erdi YE, Pan T, Yorke E, Mageras GS, Rosenzweig KE, et al. Quantitation of respiratory motion during 4D-PET/CT acquisition. Med Phys 2004;31(6):1333–8.PubMedCrossRef
28.
Kamel E, Hany TF, Burger C, Treyer V, Lonn AH, von Schulthess GK, et al. CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current. Eur J Nucl Med Mol Imaging 2002;29(3):346–50.PubMedCrossRef
29.
van der Weerdt AP, Boellaard R, Knaapen P, Visser CA, Lammertsma AA, Visser FC. Postinjection transmission scanning in myocardial 18F-FDG PET studies using both filtered backprojection and iterative reconstruction. J Nucl Med 2004;45(2):169–75.PubMed
30.
Xu EZ, Mullani NA, Gould KL, Anderson WL. A segmented attenuation correction for PET. J Nucl Med 1991;32(1):161–5.PubMed
31.
Meikle SR, Dahlbom M, Cherry SR. Attenuation correction using count-limited transmission data in positron emission tomography. J Nucl Med 1993;34(1):143–50.PubMed
32.
Nehmeh SA, Erdi YE, Mageras GS, Pan T, Yorke E, Mostafawi H, et al. Improved accuracy in image coregistration and tumor quantitation of pulmonary lesions of NSCL patients by respiratory correlated acquistion on PET/CT [abstract]. J Nucl Med 2003;44 Supplement:124.
Metadata
Title
Attenuation correction in cardiac PET/CT with three different CT protocols: a comparison with conventional PET
Authors
Michael Souvatzoglou
Frank Bengel
Raymonde Busch
Coletta Kruschke
Helga Fernolendt
Denise Lee
Markus Schwaiger
Stephan G. Nekolla
Publication date
01-12-2007
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2007
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0492-4

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