Recovery correction for quantitation in emission tomography: a feasibility study

In emission tomography, the spread of regional tracer uptake to surrounding areas caused by limited spatial resolution of the tomograph must be taken into account when quantitating activity concentrations in vivo. Assuming linearity and stationarity, the relationship between imaged activity concentration and true activity concentration is only dependent on the geometric relationship between the limited spatial resolution of the tomograph in all three dimensions and the three-dimensional size and shape of the object. In particular it is independent of the type of object studied. This concept is characterized by the term ”recovery coefficient”. Recovery effects can be corrected for by recovery coefficients determined in a calibration measurement for lesions of simple geometrical shape. This method works on anatomical structures that can be approximated to simple geometrical objects. The aim of this study was to investigate whether recovery correction of appropriate structures is feasible in a clinical setting. Measurements were done on a positron emission tomography (PET) scanner in the 2D and 3D acquisition mode and on an analogue and digital single-photon emission tomography (SPET) system using commercially available software for image reconstruction and correction of absorption and scatter effects. The results of hot spot and cold spot phantom measurements were compared to validate the assumed conditions of linearity and stationarity. It can be concluded that a recovery correction is feasible for PET scanners down to lesions measuring about 1.5×FWHM in size, whereas with simple correction schemes, which are widely available, an object-independent recovery correction for SPET cannot be performed. This result can be attributed to imperfections in the commercially available methods for attenuation and scatter correction in SPET, which are only approximate. Received 22 June and in revised form 30 September 1999     

55Co-EDTA for renal imaging using positron emission tomography (PET): a feasibility study

The feasibility of imaging renal function with 55Co-ethylene diamine tetraacetic acid (EDTA) and dynamic positron emission tomography was investigated. A group of normal Wistar rats was injected intravenously with 55Co-EDTA and underwent dynamic positron emission tomography (PET) imaging in order to study the biodistribution. The time-activity curves of the heart (blood pool), both kidneys, liver, and bladder were observed. In two animals, blood and urinary clearances of 55Co-EDTA were compared with those for 51Cr-EDTA. In one animal, unilateral reduction in kidney function was induced and the right/left ratio for the kidneys was determined. The time-activity curves showed that 55Co-EDTA cleared rapidly from the blood pool (heart), whereas prompt and high target-to-background ratios for both kidneys were obtained. The entire tracer was cleared from the renal parenchyma by urinary excretion and collection of the activity in the bladder. No specific activity uptake was noticed in any other organ or tissue. The clearances of 55Co-EDTA and 51Cr-EDTA in blood were not significantly different, showing that the nature of the M++ has no influence on the in vivo behavior of EDTA. 55Co can be produced easily by cyclotron irradiation and 55Co-EDTA is a promising physiological tracer for nephrological research using PET.     

Attenuation correction in cardiac positron emission tomography and single-photon emission computed tomography

Quantitation in cardiac positron emission tomography (PET) and single-photon emission computed tomography (SPECT) depends on being able to correct for several physical factors that tend to distort the data. One of the most important of these corrections is the correction for attenuation. For PET, cardiac attenuation correction is a reality, although certain problems remain to be solved. For SPECT, recent developments in gamma camera hardware and reconstruction methods have finally made it possible to attempt attenuation correction in a clinical setting. This article reviews the methods available to perform attenuation correction in both PET and SPECT, with emphasis on the commonality between the problems encountered and solutions proposed for each modality.     

Attenuation correction in hybrid positron emission tomography

Attenuation effects are more severe for coincidence imaging than for single-photon imaging. The capability to measure and correct attenuation now exists with dedicated positron emission tomography (PET) scanners. Attenuation correction may or may not improve lesion detection in various situations, but it definitely produces a more realistic radioactivity distribution and is essential for quantitation, which is an important PET capability. For hybrid PET systems, though, which are relatively new and in which neither the performance nor the cost of the scanner can be compromised much compared with the conventional nuclear medicine device alone, attenuation correction is still novel. Just as the entire modality of PET imaging on hybrid gamma cameras has expanded very rapidly, the capability to achieve attenuation correction has quickly followed. Both radioactive source-based and x-ray-based systems exist that provide adequate maps for attenuation correction, and the x-ray systems go even further to provide anatomic detail to aid in image interpretation.     

X-ray-based attenuation correction for positron emission tomography/computed tomography scanners

A synergy of positron emission tomography (PET)/computed tomography (CT) scanners is the use of the CT data for x-ray-based attenuation correction of the PET emission data. Current methods of measuring transmission use positron sources, gamma-ray sources, or x-ray sources. Each of the types of transmission scans involves different trade-offs of noise versus bias, with positron transmission scans having the highest noise but lowest bias, whereas x-ray scans have negligible noise but the potential for increased quantitative errors. The use of x-ray-based attenuation correction, however, has other advantages, including a lack of bias introduced from post-injection transmission scanning, which is an important practical consideration for clinical scanners, as well as reduced scan times. The sensitivity of x-ray-based attenuation correction to artifacts and quantitative errors depends on the method of translating the CT image from the effective x-ray energy of approximately 70 keV to attenuation coefficients at the PET energy of 511 keV. These translation methods are usually based on segmentation and/or scaling techniques. Errors in the PET emission image arise from positional mismatches caused by patient motion or respiration differences between the PET and CT scans; incorrect calculation of attenuation coefficients for CT contrast agents or metallic implants; or keeping the patient's arms in the field of view, which leads to truncation and/or beam-hardening (or x-ray scatter) artifacts. Proper interpretation of PET emission images corrected for attenuation by using the CT image relies on an understanding of the potential artifacts. In cases where an artifact or bias is suspected, careful inspection of all three available images (CT and PET emission with and without attenuation correction) is recommended.     

An automatic classification technique for attenuation correction in positron emission tomography

In this paper a clustering technique is proposed for attenuation correction (AC) in positron emission tomography (PET). The method is unsupervised and adaptive with respect to counting statistics in the transmission (TR) images. The technique allows the classification of pre- or post-injection TR images into main tissue components in terms of attenuation coefficients. The classified TR images are then forward projected to generate new TR sinograms to be used for AC in the reconstruction of the corresponding emission (EM) data. The technique has been tested on phantoms and clinical data of brain, heart and whole-body PET studies. The method allows: (a) reduction of noise propagation from TR into EM images, (b) reduction of TR scanning to a few minutes (3 min) with maintenance of the quantitative accuracy (within 6%) of longer acquisition scans (15–20 min), (c) reduction of the radiation dose to the patient, (d) performance of quantitative whole-body studies. Received 8 August and in revised form 29 December 1998     

Automated quantitation of three-dimensional cardiac positron emission tomography for routine clinical use

Visual comparison of rest/stress cardiac positron emission tomography indicates coronary flow reserve for diagnosing and assessing severity of coronary artery disease. An accurate, rapid, automated method for comparison and quantitation of paired cardiac PET studies has been developed to analyze size, intensity, statistical significance of and changes in perfusion or metabolism. The method utilizes polar coordinate maps derived from circumferential profiles of true short axis slices; from the short axis data algorithms determine mean and minimum activity levels in the anterior, septal, lateral, inferior and apical regions of the myocardium, percent of the cardiac image in specific ranges of activity levels or their changes and the percent of myocardium beyond 1.5, 2.0, and 2.5 standard deviations from the normal range with blackout display of the areas beyond these statistical limits for rest, stress, and stress/rest ratio polar maps. Additional applications include comparing stress-stress images to evaluate progression/regression of stenoses, early and late resting rubidium images for determining myocardial viability based on rubidium washout kinetics, and perfusion-metabolic comparisons for quantifying ischemia, viability and necrosis after acute myocardial infarction.     

An automatic classification technique for attenuation correction in positron emission tomography.

In this paper a clustering technique is proposed for attenuation correction (AC) in positron emission tomography (PET). The method is unsupervised and adaptive with respect to counting statistics in the transmission (TR) images. The technique allows the classification of pre- or post-injection TR images into main tissue components in terms of attenuation coefficients. The classified TR images are then forward projected to generate new TR sinograms to be used for AC in the reconstruction of the corresponding emission (EM) data. The technique has been tested on phantoms and clinical data of brain, heart and whole-body PET studies. The method allows: (a) reduction of noise propagation from TR into EM images, (b) reduction of TR scanning to a few minutes (3 min) with maintenance of the quantitative accuracy (within 6%) of longer acquisition scans (15-20 min), (c) reduction of the radiation dose to the patient, (d) performance of quantitative whole-body studies.     

Absolute quantitation of iodine-123 epidepride kinetics using single-photon emission tomography: comparison with carbon-11 epidepride and positron emission tomography

Epidepride labelled with iodine-123 is a suitable probe for the in vivo imaging of striatal and extrastriatal dopamine D2 receptors using single-photon emission tomography (SPET). Recently, this molecule has also been labelled with carbon-11. The goal of this work was to develop a method allowing the in vivo quantification of radioactivity uptake in baboon brain using SPET and to validate it using positron emission tomography (PET). SPET studies were performed in Papio anubis baboons using 123I-epidepride. Emission and transmission measurements were acquired on a dual-headed system with variable head angulation and low-energy ultra-high resolution (LEUHR) collimation. The imaging protocol consisted of one transmission measurement (24 min, heads at 90 degrees), obtained with two sliding line sources of gadolinium-153 prior to injection of 0.21-0.46 GBq of 123I-epidepride, and 12 emission measurements starting 5 min post injection. For scatter correction (SC) we used a dual-window method adapted to 123I. Collimator blurring correction (CBC) was done by deconvolution in Fourier space and attenuation correction (AT) was applied on a preliminary (CBC) filtered back-projection reconstruction using 12 iterations of a preconditioned, regularized minimal residual algorithm. For each reconstruction, a calibration factor was derived from a uniform cylinder filled with a 123I solution of a known radioactivity concentration. Calibration and baboon images were systematically built with the same reconstruction parameters. Uncorrected (UNC) and (AT), (SC + AT) and (SC + CBC + AT) corrected images were compared. PET acquisitions using 0.11-0.44 GBq of 11C-epidepride were performed on the same baboons and used as a reference. The radioactive concentrations expressed in percent of the injected dose per 100 ml (% ID/100 ml) obtained after (SC + CBC + AT) in SPET are in good agreement with those obtained with PET and 11C-epidepride. A method for the in vivo absolute quantitation of 123I-epidepride uptake using SPET has been developed which can be directly applied to other 123I-labelled molecules used in the study of the dopamine system. Further work will consist in using PET to model the radioligand-receptor interactions and to derive a simplified model applicable in SPET.     

Absolute quantitation of iodine-123 epidepride kinetics using single-photon emission tomography: comparison with carbon-11 epidepride and positron emission tomography

Epidepride labelled with iodine-123 is a suitable probe for the in vivo imaging of striatal and extrastriatal dopamine D₂ receptors using single-photon emission tomography (SPET). Recently, this molecule has also been labelled with carbon-11. The goal of this work was to develop a method allowing the in vivo quantification of radioactivity uptake in baboon brain using SPET and to validate it using positron emission tomography (PET). SPET studies were performed in Papio anubis baboons using ¹²³I-epidepride. Emission and transmission measurements were acquired on a dual-headed system with variable head angulation and low-energy ultra-high resolution (LEUHR) collimation. The imaging protocol consisted of one transmission measurement (24 min, heads at 90°), obtained with two sliding line sources of gadolinium-153 prior to injection of 0.21–0.46 GBq of ¹²³I-epidepride, and 12 emission measurements starting 5 min post injection. For scatter correction (SC) we used a dual-window method adapted to ¹²³I. Collimator blurring correction (CBC) was done by deconvolution in Fourier space and attenuation correction (AT) was applied on a preliminary (CBC) filtered back-projection reconstruction using 12 iterations of a preconditioned, regularized minimal residual algorithm. For each reconstruction, a calibration factor was derived from a uniform cylinder filled with a ¹²³I solution of a known radioactivity concentration. Calibration and baboon images were systematically built with the same reconstruction parameters. Uncorrected (UNC) and (AT), (SC+AT) and (SC+CBC+AT) corrected images were compared. PET acquisitions using 0.11–0.44 GBq of ¹¹C-epidepride were performed on the same baboons and used as a reference. The radioactive concentrations expressed in percent of the injected dose per 100 ml (%ID/100 ml) obtained after (SC+CBC+AT) in SPET are in good agreement with those obtained with PET and ¹¹C-epidepride. A method for the in vivo absolute quantitation of ¹²³I-epidepride uptake using SPET has been developed which can be directly applied to other ¹²³I-labelled molecules used in the study of the dopamine system. Further work will consist in using PET to model the radioligand-receptor interactions and to derive a simplified model applicable in SPET.     

A method for calibrating three-dimensional positron emission tomography without scatter correction

Calibration for three-dimensional positron emission tomography (3D PET) using a uniform cylinder and cross-calibration with aliquots requires correction for scatter and attenuation. Thus the accuracy of thecalibration is dependent on the scatter correction method, and on the applicability of the scatter correction for different regions of the body. A method has been developed which provides a calibration which does not require correction for scatter or attenuation, making it generally applicable and independent of the scatter correction. The method has been previously described for measurement of the absolute sensitivity of tomography devices. This approach has been extended to give a calibration of the PET camera in air in units of kBq/pixel. The reconstructed images are multiplied by this factor to, give accurate activity concentrations, after attenuation and scatter correction. The method has been used with a fully 3D filtered back-projection (reprojection) algorithm and iterative convolution-subtraction scatter correction on data from an ECAT 953B. Using this method 3D PET images have been calibrated te, within ±5% accuracy, but this is highly dependent on the accuracy of the scatter correction. The method described here is practical and provides a means of calibrating a 3D PET system without the need for correction for scatter or attenuation of the calibration data.     

A new iterative reconstruction technique for attenuation correction in high-resolution positron emission tomography

A new iterative reconstruction technique (NIRT) for positron emission computed tomography (PET), which uses transmission data for nonuniform attenuation correction, is described. Utilizing the general inverse problem theory, a cost functional which includes a noise term was derived. The cost functional was minimized using a weighted-least-square maximum a posteriori conjugate gradient (CG) method. The procedure involves a change in the Hessian of the cost function by adding an additional term. Two phantoms were used in a real data acquisition. The first was a cylinder phantom filled with uniformly distributed activity of 74 MBq of fluorine-18. Two different inserts were placed in the phantom. The second was a Hoffman brain phantom filled with uniformly distributed activity of 7.4 MBq of¹⁸F. Resulting reconstructed images were used to test and compare a new iterative reconstruction technique with a standard filtered backprojection (FBP) method. The results confirmed that NIRT, based on the conjugate gradient method, converges rapidly and provides good reconstructed images. In comparison with standard results obtained by the FBP method, the images reconstructed by NIRT showed better noise properties. The noise was measured as rms% noise and was less, by a factor of 1.75, in images reconstructed by NIRT than in the same images reconstructed by FBP. The distance between the Hoffman brain slice reconstructed by FBP and the perfect PET Hoffman brain slice created from the MRI image was 0.526, while the same distance for the Hoffman brain slice reconstructed by NIRT was 0.328. The NIRT method suppressed the propagation of the noise without visible loss of resolution in the reconstructed PET images.     

Comparison of dedicated breast positron emission tomography and whole-body positron emission tomography/computed tomography images: a common phantom study

Annals of Nuclear Medicine - High-resolution dedicated breast positron emission tomography (dbPET) can visualize breast cancer more clearly than whole-body PET/computed tomography (CT). In Japan,...     

Attenuation correction single-photon emission computed tomography myocardial perfusion imaging

Clinicians now rely heavily on the results of single-photon emission computed tomography (SPECT) myocardial perfusion imaging for diagnosing coronary disease and for planning therapy. However, the technique is imperfect for these purposes, mainly because of technical limitations, the most prominent of which is the effect of soft-tissue attenuation on apparent tracer distribution. Providers have attempted to compensate for this by a number of indirect approaches. Recently, validated hardware and software solutions for directly correcting image data for soft-tissue attenuation have become widely available commercially. Optimal application requires an understanding of the technical details that differ somewhat from system to system, the quality control prerequisites, knowledge of the importance of the transmission map quality, and how dedicated SPECT and SPECT-computed tomography systems present different challenges. In addition, the clinical literature is expanding rapidly, including studies on diagnostic accuracy, image appearances, quantitative analysis, appropriate patients for attenuation correction, clinical utility, incremental value in relation to ECG-gating, and risk stratification.     

Scattering and attenuation correction in emission tomography in the nuclear industry

A multi-energetic γ-ray source has been used in conjunction with titanium and water-bath phantoms to simulate the scattering and attenuation effects encountered in nuclear industrial applications. The effect of scattered photons on the image reconstructions has been investigated by the subtraction of varying fractions of the scattered counts from the photopeak counts. A dual energy attenuation correction has also been applied to the data. In order to evaluate the effects of these corrections a “fidelity” factor has been calculated.