Optimized contrast-enhanced CT protocols for diagnostic whole-body 18F-FDG PET/CT: technical aspects of single-phase versus multiphase CT imaging.

The purpose of this study was to compare various PET/CT examination protocols that use contrast-enhanced single-phase or contrast-enhanced multiphase CT scans under different breathing conditions. METHODS: Sixty patients with different malignant tumors were randomized into 4 different PET/CT protocols. Single-phase protocols included an intravenous contrast-enhanced (Ultravist 370; iodine at 370 mg/mL) single-phase whole-body CT scan (90 mL at 1.8 mL/min; delay, 90 s) during shallow breathing (protocol A) or during normal expiration (NormExp; protocol B). Multiphase protocols included 2 separate CT scans in the arterial contrast enhancement phase (90 mL at 2.5-2.8 mL/min; bolus tracking; scan range, base of the skull to the kidneys) and the portal-venous contrast enhancement phase (delay, 90 s; scan range, base of the lungs to the proximal thighs) during shallow breathing (protocol C) or during NormExp (protocol D) followed by a low-dose CT scan during shallow breathing for attenuation correction and whole-body PET. Feasibility was assessed by comparing the misalignment of the upper abdominal organs quantitatively by means of the craniocaudal, lateral, and anterior-posterior differences on coregistered PET/CT images. For image quality, the occurrence of CT artifacts and mismatching of rigid body points were evaluated qualitatively. RESULTS: Misalignment was significantly lower for protocol B in almost all organs and represented the best coregistration quality. Surprisingly, protocol A showed significantly better alignment than the multiphase CT scans during NormExp. Misalignment values between the multiphase protocols were not significantly different, with a trend toward lower values for protocol D. The best CT image quality, with a significantly lower occurrence of artifacts, was found for protocols B and D (NormExp). The levels of mismatching of rigid body points because of patient movement in between the transmission and emission scans were similar for all protocols. CONCLUSION: Multiphase CT protocols presented a technical disadvantage represented by suboptimal image coregistration compared with single-phase protocols. Nevertheless, multiphase protocols are technically feasible and should be considered for patients who will benefit from a contrast-enhanced multiphase CT examination for diagnosis.     

Semiautomated analysis of small-animal PET data.

The objective of the work reported here was to develop and test automated methods to calculate biodistribution of PET tracers using small-animal PET images. METHODS: After developing software that uses visually distinguishable organs and other landmarks on a scan to semiautomatically coregister a digital mouse phantom with a small-animal PET scan, we elastically transformed the phantom to conform to those landmarks in 9 simulated scans and in 18 actual PET scans acquired of 9 mice. Tracer concentrations were automatically calculated in 22 regions of interest (ROIs) reflecting the whole body and 21 individual organs. To assess the accuracy of this approach, we compared the software-measured activities in the ROIs of simulated PET scans with the known activities, and we compared the software-measured activities in the ROIs of real PET scans both with manually established ROI activities in original scan data and with actual radioactivity content in immediately harvested tissues of imaged animals. RESULTS: PET/atlas coregistrations were successfully generated with minimal end-user input, allowing rapid quantification of 22 separate tissue ROIs. The simulated scan analysis found the method to be robust with respect to the overall size and shape of individual animal scans, with average activity values for all organs tested falling within the range of 98% +/- 3% of the organ activity measured in the unstretched phantom scan. Standardized uptake values (SUVs) measured from actual PET scans using this semiautomated method correlated reasonably well with radioactivity content measured in harvested organs (median r = 0.94) and compared favorably with conventional SUV correlations with harvested organ data (median r = 0.825). CONCLUSION: A semiautomated analytic approach involving coregistration of scan-derived images with atlas-type images can be used in small-animal whole-body radiotracer studies to estimate radioactivity concentrations in organs. This approach is rapid and less labor intensive than are traditional methods, without diminishing overall accuracy. Such techniques have the possibility of saving time, effort, and the number of animals needed for such assessments.     

Evaluation of primary brain tumors using 11C-methionine PET with reference to a normal methionine uptake map.

(11)C-Methionine PET is a well-established technique for evaluating tumor extent for diagnosis and treatment planning in neurooncology. Image interpretation is typically performed using the ratio of uptake within the tumor to a reference region. The precise location of this reference region is important as local variations in methionine uptake may significantly alter the result, particularly for lesions at the border of gray and white matter. Selection of a reference region can be highly user dependant, and identifying a representative normal region may be complicated by midline or multifocal tumors. We hypothesized that current coregistration methods would enable interpretation of methionine PET images with reference to an averaged normal uptake map, allowing better standardization of scan analysis and increasing the sensitivity to tumor infiltration, particularly of white matter regions. METHODS: A normal methionine uptake map was prepared from the normal hemispheres of 20 scans performed on patients with benign or low-grade lesions. Affine and nonlinear coregistration algorithms were evaluated for spatial normalization of the images to a previously developed PET template. A standardized method for applying the normal uptake map in brain tumors was developed and evaluated in a sample of 18 scans (6 grade II, 6 grade III, and 6 grade IV gliomas). Tumor extent was compared with that derived from a mirrored contralateral reference region method. Correlation coefficients were calculated between the uptake ratios for tumor to normal uptake map versus tumor to mirrored reference region. RESULTS: "RatioMap" images depicting voxel-by-voxel ratios of a patient scan to the normal uptake map revealed increased methionine uptake in white matter regions that could not be identified using the standard method. Uptake ratios within the tumor varied slightly with the normalization methods used but correlated closely with the ratio to a single reference value. Nonlinear coregistration with median ratio intensity normalization gave the strongest correlation (r = 0.97, P < 0.001, n = 17). CONCLUSION: Evaluation of methionine PET data with reference to normal uptake data may improve sensitivity to white matter infiltration. The tumor uptake ratios obtained correlated closely with a standard reference value technique, whereas the described method allowed for better standardization of the image analysis.     

Retrospective coregistration of functional magnetic resonance imaging data using external monitoring.

Coregistration is essential for correcting head motion artifacts in functional magnetic resonance imaging (fMRI). Coregistration algorithms typically realign images through optimization of a similarity measure based on voxel signal intensities. However, coregistration can also be performed through external monitoring, whereby a tracking device measures head motion directly and independently of the imaging data. This paper describes development of external monitoring using fMRI-compatible infrared cameras. Three subjects participated in block-design fMRI experiments consisting of bilateral finger tapping alone and tapping combined with visuomotor tracking to produce controlled task-correlated head motion. Functional MRI time-series were coregistered using the external monitoring technique and a known image-based algorithm for comparison. Over various performance characteristics, external monitoring and image-based coregistration exhibited good agreement, in particular reducing signals correlated with millimeter task-correlated motions by 50-100%, with a 5% difference between the two techniques. These results promise future applications and refinements of external monitoring in patient populations where head motion is especially problematic. Possibilities include 3D prospective coregistration during real-time fMRI, coregistration of individual slices, and motion correction in anatomic MRI.     

Volume tracking cardiac 31P spectroscopy.

The limited reliability and accuracy of cardiac spectroscopy have been partly attributed to effects from respiratory motion. In this work, we developed a prospective volume tracking method for respiratory motion compensation based on multiple navigator echoes and demonstrated its application in cardiac (31)P spectroscopy. The sequence consists of two 2D selective excitation pulses preceding the spectroscopic experiment to sample respiratory motion components. The navigator information is evaluated in real-time to calculate the shift of the heart from respiration. Based on the displacement information, the spectroscopic volume and/or grid position is prospectively corrected to track the volume of interest. The method was validated with a moving compartment phantom simulating in vivo respiratory motion. With volume tracking, no signal contamination was apparent. Spectra obtained in 14 healthy volunteers were evaluated using time-domain fitting procedures. The fitting accuracy improved consistently with volume tracking compared to data from non-navigated reference acquisitions. Compared to other gating approaches available for spectroscopy, the current technique does not degrade the scan efficiency, thus allowing effective use of scan time.     

Echo‐planar imaging with prospective slice‐by‐slice motion correction using active markers

Head motion is a fundamental problem in functional magnetic resonance imaging and is often a limiting factor in its clinical implementation. This work presents a rigid‐body motion correction strategy for echo‐planar imaging sequences that uses micro radiofrequency coil “active markers” for real‐time, slice‐by‐slice prospective correction. Before the acquisition of each echo‐planar imaging‐slice, a short tracking pulse‐sequence measures the positions of three active markers integrated into a headband worn by the subject; the rigid‐body transformation that realigns these markers to their initial positions is then fed back to dynamically update the scan‐plane, maintaining it at a fixed orientation relative to the head. Using this method, prospectively‐corrected echo‐planar imaging time series are acquired on volunteers performing in‐plane and through‐plane head motions, with results demonstrating increased image stability over conventional retrospective image‐realignment. The benefit of this improved image stability is assessed in a blood oxygenation level dependent functional magnetic resonance imaging application. Finally, a non‐rigid‐body distortion‐correction algorithm is introduced to reduce the remaining signal variation. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

The effects of geometric distortion correction on motion realignment in fMRI

RATIONALE AND OBJECTIVES: Subject motion is well recognized as a significant impediment to resolution and sensitivity in functional magnetic resonance imaging (fMRI). A parallel confounder to fMRI data quality is geometric image distortion, particularly at high field strengths, due to susceptibility-induced magnetic field inhomogeneity. Consequently, many high-field echo-planar imaging methods incorporate a post-processing distortion correction by acquiring a field map of the sample prior to the fMRI measurement. However, field mapping methods impose a spatial mask on the data, since field information is only obtainable from regions with adequate signal-to-noise ratio (SNR). This masking, when applied to subsequent images in the fMRI time series, can clip the effects of motion, resulting in inaccurate estimation and correction of motion-based changes in the images. MATERIALS AND METHODS: The effects of geometric distortion correction on automated realignment (motion correction) of fMRI data are investigated from data acquired at 4 T. The results of image realignment with and without prior application of distortion correction are compared, using the estimated motion parameters and overall image realignment as metrics. RESULTS: The application of field-map-based distortion correction prior to image realignment reduces the amount of motion detected by a standard motion correction algorithm. Moreover, motion correction applied before distortion correction is shown to result in superior realignment of motion-correction images. CONCLUSION: It is preferable to perform motion realignment prior to correcting for geometric distortion.     

Artifacts from misaligned CT in cardiac perfusion PET/CT studies: frequency, effects, and potential solutions.

CT-based attenuation correction is a widely used option in commercial PET/CT scanners. However, as a result of a nonsimultaneous acquisition and differences in temporal resolution between both modalities, a potential misregistration between the PET and CT, especially in the thorax and the upper abdomen, can be found. We observed a substantial number of apparent perfusion defects in spatial coincidence with the misregistered segments of the heart and assumed these defects were related to an incorrect attenuation correction. The purpose of this work was to assess the clinical impact of emission-transmission misalignment in myocardial perfusion imaging with PET/CT and to investigate potential solutions. METHODS: Twenty-eight coronary artery disease patients underwent PET/CT (13)NH3 rest/stress examinations. The emission-transmission misalignment was corrected by manual registration and the PET studies were reconstructed again using the realigned CT images for attenuation correction. The effects of the registration were evaluated by quantitative analysis of the local tracer uptake on a polar map basis. In addition to manual registration, 2 alternative realignment methods were evaluated: mutual information-based image registration and emission-driven correction based on the outline of the heart in the PET image. RESULTS: Manual realignment resulted in a change in the defect size of >10% of the left ventricle in 6 of 28 studies (21.4%); in 5 of the studies, this resulted in the disappearance of large apparent perfusion defects (15%-46% of the left ventricle), which were fully due to emission-transmission misregistration. Automatic image registration was unable to realign the datasets, whereas the emission-driven correction showed a good agreement with manual registration. CONCLUSION: Misregistration of PET and CT images is common in cardiac PET/CT studies and results in artifacts on the attenuation-corrected PET images, which appear to be corrected by repeating the PET reconstruction after manual realignment of the CT image data. In contrast to manual realignment, an automated emission-driven correction appears to be a promising approach.     

Reducing radiation dose in rest-stress cardiac PET/CT by single poststress cine CT for attenuation correction: quantitative validation.

Cardiac PET/CT is optimized by cine CT with dedicated shift software for manual correction of attenuation-emission misregistration. Separate rest and stress CT scans incur greater radiation dose to patients than does standard helical PET/CT or "pure" PET using rotating rod attenuation sources. To reduce radiation dose, we tested quantitative accuracy of using a single poststress cine CT attenuation scan for reconstructing rest perfusion images to eliminate resting CT attenuation scans. METHODS: A total of 250 consecutive patients underwent diagnostic rest-dipyridamole myocardial perfusion PET/CT with (82)Rb and a 16-slice PET/CT scanner using averaged cine CT attenuation data during breathing at rest and stress. After correcting for any attenuation-emission misregistration, we quantitatively compared resting perfusion images reconstructed using rest cine CT attenuation data with the same resting emission data reconstructed with poststress cine CT attenuation data. Automated software quantifying average regional quadrant activity, severity, size, and combined size and severity of perfusion defects was used for this comparison. RESULTS: Resting perfusion images reconstructed using rest cine CT attenuation data were quantitatively comparable to resting images reconstructed with poststress cine CT attenuation data with no clinically significant differences. Twenty-five (10%) of 250 cases required shifting of stress cine CT attenuation data to achieve optimal attenuation-emission coregistration with resting perfusion data. Eliminating rest CT attenuation scans reduced CT radiation dose by 50% below rest-plus-stress cine CT protocols. CONCLUSION: Resting perfusion images reconstructed using poststress cine CT attenuation data are quantitatively comparable to resting images reconstructed with resting cine CT attenuation data. Eliminating the rest CT scan reduces CT radiation dose by 50%.     

Real‐time correction by optical tracking with integrated geometric distortion correction for reducing motion artifacts in functional MRI

Head motion artifacts are a major problem in functional MRI that limit its use in neuroscience research and clinical settings. Real‐time scan‐plane correction by optical tracking has been shown to correct slice misalignment and nonlinear spin‐history artifacts; however, residual artifacts due to dynamic magnetic field nonuniformity may remain in the data. A recently developed correction technique, Phase Labeling for Additional Coordinate Encoding, can correct for absolute geometric distortion using only the complex image data from two echo planar images with slightly shifted k‐space trajectories. An approach is presented that integrates Phase Labeling for Additional Coordinate Encoding into a real‐time scan‐plane update system by optical tracking, applied to a tissue‐equivalent phantom undergoing complex motion and an functional MRI finger tapping experiment with overt head motion to induce dynamic field nonuniformity. Experiments suggest that such integrated volume‐by‐volume corrections are very effective at artifact suppression, with potential to expand functional MRI applications. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

External radioactive markers for PET data-driven respiratory gating in positron emission tomography

Purpose

Respiratory gating is an established approach to overcoming respiration-induced image artefacts in PET. Of special interest in this respect are raw PET data-driven gating methods which do not require additional hardware to acquire respiratory signals during the scan. However, these methods rely heavily on the quality of the acquired PET data (statistical properties, data contrast, etc.). We therefore combined external radioactive markers with data-driven respiratory gating in PET/CT. The feasibility and accuracy of this approach was studied for [¹⁸F]FDG PET/CT imaging in patients with malignant liver and lung lesions.

Methods

PET data from 30 patients with abdominal or thoracic [¹⁸F]FDG-positive lesions (primary tumours or metastases) were included in this prospective study. The patients underwent a 10-min list-mode PET scan with a single bed position following a standard clinical whole-body [¹⁸F]FDG PET/CT scan. During this scan, one to three radioactive point sources (either ²²Na or ¹⁸F, 50–100 kBq) in a dedicated holder were attached the patient’s abdomen. The list mode data acquired were retrospectively analysed for respiratory signals using established data-driven gating approaches and additionally by tracking the motion of the point sources in sinogram space. Gated reconstructions were examined qualitatively, in terms of the amount of respiratory displacement and in respect of changes in local image intensity in the gated images.

Results

The presence of the external markers did not affect whole-body PET/CT image quality. Tracking of the markers led to characteristic respiratory curves in all patients. Applying these curves for gated reconstructions resulted in images in which motion was well resolved. Quantitatively, the performance of the external marker-based approach was similar to that of the best intrinsic data-driven methods. Overall, the gain in measured tumour uptake from the nongated to the gated images indicating successful removal of respiratory motion was correlated with the magnitude of the respiratory displacement of the respective tumour lesion, but not with lesion size.

Conclusion

Respiratory information can be assessed from list-mode PET/CT through PET data-derived tracking of external radioactive markers. This information can be successfully applied to respiratory gating to reduce motion-related image blurring. In contrast to other previously described PET data-driven approaches, the external marker approach is independent of tumour uptake and thereby applicable even in patients with poor uptake and small tumours.     

Hybrid ultrasound MRI for improved cardiac imaging and real‐time respiration control

A hybridized dual‐imaging system combining real‐time ultrasound imaging and MRI was utilized for cardiac imaging at 1.5 T and 3 T. The ultrasound scanner with a programmable software interface was connected via computer to the MRI scanner. Electronic noise was eliminated with electromagnetic shielding and grounding to the screen room. At 3 T, real‐time prospective motion compensation in dynamic cine cardiac imaging was implemented using B‐mode ultrasound imaging. The ultrasound technique avoided drawbacks such as signal saturation or steady‐state interruption of the MR navigator gating. At 1.5 T, a low‐latency real‐time feedback to balanced steady state free precision MR imaging was performed in three normal volunteers. Results showed active tracking of the heart during respiratory motion and improvement in time‐averaged cardiovascular images. Future studies can fully exploit the potential of the high‐frequency position information provided by the ultrasound system for more advanced applications in real‐time organ tracking. Magn Reson Med, 2010. © 2009 Wiley‐Liss, Inc.     

Human PET studies of metabotropic glutamate receptor subtype 5 with 11C-ABP688.

3-(6-Methyl-pyridin-2-ylethynyl)-cyclohex-2-enone-O-11C-methyl-oxime (11C-ABP688), a noncompetitive and highly selective antagonist for the metabotropic glutamate receptor subtype 5 (mGluR5), was evaluated for its potential as a PET agent. METHODS: Six healthy male volunteers (mean age, 25 y; range, 21-33 y) were studied. Brain perfusion (15O-H2O) was measured immediately before each 11C-ABP688 PET scan. For anatomic coregistration, T1-weighted MRI was performed on each subject. Arterial blood samples for the determination of the arterial input curve were obtained at predefined time points, and 11C-ABP688 uptake was assessed quantitatively using a 2-tissue-compartment model. RESULTS: An initial rapid uptake of radioactivity followed by a gradual clearance from all examined brain regions was observed. Relatively high radioactivity concentrations were observed in mGluR5-rich brain regions such as the anterior cingulate, medial temporal lobe, amygdala, caudate, and putamen, whereas radioactivity uptake in the cerebellum and white matter, regions known to contain low densities of mGluR5, was low. Specific distribution volume as an outcome measure of mGluR5 density in the various brain regions ranged from 5.45 +/- 1.47 (anterior cingulate) to 1.91 +/- 0.32 (cerebellum), and the rank order of the corresponding specific distribution volumes of 11C-ABP688 in cortical regions was temporal > frontal > occipital > parietal. The metabolism of 11C-ABP688 in plasma was rapid; at 60 min after injection, 25% +/- 0.03% of radioactivity measured in the plasma of healthy volunteers was intact parent compound. CONCLUSION: The results of these studies indicate that 11C-ABP688 has suitable characteristics and is a promising PET ligand for imaging mGluR5 distribution in humans. Furthermore, it could be of great value for the selection of appropriate doses of clinically relevant candidate drugs that bind to mGluR5 and for PET studies of patients with psychiatric and neurologic disorders.     

Motion artifact reduction on parametric PET images of neuroreceptor binding.

PET studies of cerebral neuroreceptors are often recorded over periods ranging from 1 to 2 h, and head movements during the studies not only lead to blurred images but also may seriously disturb the kinetic analysis. We report the effect of motion on parametric images of the distribution volume ratio (DVR), as well as possible improvements if the dynamic PET data are corrected for head movements. METHODS: The study was performed with the 5-hydroxytryptamine 2A receptor ligand (18)F-altanserin. During PET scanning, which was performed in list mode for 1 h, the position of the head was monitored by an infrared motion-tracking system. The list mode data were sorted into time frames of between 10 s and 2 min. Motion was corrected using the multiple-acquisition-frame (MAF) approach, which calculates individual attenuation files for each emission frame and its corresponding head position to avoid misalignment of transmission and emission data. After reconstruction of attenuation-corrected emission frames, each image frame was realigned to match the head position of the first frame of the emission scan. The resulting motion-corrected dynamic images were evaluated using the noninvasive Logan plot to obtain parametric images of DVR. RESULTS: DVR images of motion-affected (18)F-altanserin scans showed artifacts whose extent depended on the amount of movement. The artifacts were mainly at the border between gray matter and white matter and at the outer border of gray matter. They were seen as discontinuities and small spots whose values exceeded the expected DVR values or were even negative and that disappeared when motion correction was applied. These effects in human data were also seen on simulated (18)F-altanserin images that contained no statistical noise. CONCLUSION: Whereas the native PET images looked just blurred if the patient moved during the PET scan, parametric images of the Logan DVR, which are calculated by pixelwise linear regression, contained severe discontinuities primarily at the cortical edge. MAF-based motion correction was able to avoid these errors.     

Frequent diagnostic errors in cardiac PET/CT due to misregistration of CT attenuation and emission PET images: a definitive analysis of causes, consequences, and corrections.

Cardiac PET combined with CT is rapidly expanding despite artifactual defects and false-positive results due to misregistration of PET and CT attenuation correction data-the frequency, cause, and correction of which remain undetermined. METHODS: Two hundred fifty-nine consecutive patients underwent diagnostic rest-dipyridamole myocardial perfusion PET/CT using (82)Rb, a 16-slice PET/CT scanner, helical CT attenuation correction with breathing and also at end-expiratory breath-hold, and averaged cine CT data during breathing. Misregistration on superimposed PET/CT fusion images was objectively measured in millimeters and correlated with associated quantitative size and severity of PET defects. Misregistration artifacts were defined as PET defects with corresponding misregistration on helical CT-PET fusion images that resolved after correct coregistration using a repeat CT scan, cine CT averaged attenuation during normal breathing, or shifted cine CT data that coregistered with PET data. RESULTS: Misregistration of standard helical CT PET images caused artifactual PET defects in 103 of 259 (40%) patients that were moderate to severe in 59 (23%) (P = 0.0000) and quantitatively normalized on cine or shifted cine CT PET (P = 0.0000). Quantitative misregistration was a powerful predictor of artifact size and severity (P = 0.0000), particularly for transaxial misregistration >6 mm occurring in anterior or lateral areas in 76%, in inferior areas in 16%, and at the apex in 8% of 103 artifactual defects. CONCLUSION: Misregistration of helical CT attenuation and PET emission images causes artifactual defects with false-positive results in 40% of patients that normalize on cine CT PET using averaged CT attenuation data during normal breathing comparable to normal breathing during PET emission scanning and shifting cine CT images to coregister visually with PET.     

Non-model-based correction of respiratory motion using beat-to-beat 3D spiral fat-selective imaging

PURPOSE: To demonstrate the feasibility of retrospective beat-to-beat correction of respiratory motion, without the need for a respiratory motion model. MATERIALS AND METHODS: A high-resolution three-dimensional (3D) spiral black-blood scan of the right coronary artery (RCA) of six healthy volunteers was acquired over 160 cardiac cycles without respiratory gating. One spiral interleaf was acquired per cardiac cycle, prior to each of which a complete low-resolution fat-selective 3D spiral dataset was acquired. The respiratory motion (3D translation) on each cardiac cycle was determined by cross-correlating a region of interest (ROI) in the fat around the artery in the low-resolution datasets with that on a reference end-expiratory dataset. The measured translations were used to correct the raw data of the high-resolution spiral interleaves. RESULTS: Beat-to-beat correction provided consistently good results, with the image quality being better than that obtained with a fixed superior-inferior tracking factor of 0.6 and better than (N = 5) or equal to (N = 1) that achieved using a subject-specific retrospective 3D translation motion model. CONCLUSION: Non-model-based correction of respiratory motion using 3D spiral fat-selective imaging is feasible, and in this small group of volunteers produced better-quality images than a subject-specific retrospective 3D translation motion model.     

Whole-body MRI in children: current status and future applications

Whole-body MRI (WBMRI) is a novel technique that makes imaging of the whole patient in a manner similar to scintigraphy or positron emission tomography (PET) possible. Unlike the latter two methods, it is without exposure to radiation and thus gaining increasing importance and application in pediatrics. With the introduction of a moving tabletop, sequential movement of the patient through the magnet has become possible with automatic direct realignment of the images after acquisition. The common scan plane is coronal with additional planes being added depending on the indication. WBMRI is targeted for maximum coverage of the body within the shortest possible time using the minimum number of sequences. The evaluation of the bone marrow has been the primary indication thus inversion recovery sequences like STIR or TIRM are mostly used with the T1-weighted sequence being added variably. For correct evaluation of the bone marrow in the pediatric age group understanding normal pattern of marrow transformation is essential. The primary role of WBMRI has been in oncology for the detection of tumor spread and also for the follow-up and evaluation of complications. The initial comparative studies of WBMRI with scintigraphy and PET in children have shown the high diagnostic potential of WBMRI. Emerging potential applications of WBMRI include the evaluation for osteonecrosis, chronic multifocal recurrent osteomyelitis, myopathies, and generalized vascular malformations. Future use of WBMRI may incorporate non-accidental trauma, virtual autopsy, body fat mapping and diffusion-weighted imaging.     

Transmission scanning in emission tomography

Attenuation correction in single-photon (SPET) and positron emission (PET) tomography is now accepted as a vital component for the production of artefact-free, quantitative data. The most accurate attenuation correction methods are based on measured transmission scans acquired before, during, or after the emission scan. Alternative methods use segmented images, assumed attenuation coefficients or consistency criteria to compensate for photon attenuation in reconstructed images. This review examines the methods of acquiring transmission scans in both SPET and PET and the manner in which these data are used. While attenuation correction gives an exact correction in PET, as opposed to an approximate one in SPET, the magnitude of the correction factors required in PET is far greater than in SPET. Transmission scans also have a number of other potential applications in emission tomography apart from attenuation correction, such as scatter correction, inter-study spatial co-registration and alignment, and motion detection and correction. The ability to acquire high-quality transmission data in a practical clinical protocol is now an essential part of the practice of nuclear medicine. Received: 19 February 1998 / Accepted: 19 March 1998     

Effects of Head Motion on the Evaluation of Age-related Brain Network Changes Using Resting State Functional MRI

Purpose:The estimation of functional connectivity (FC) measures using resting state functional MRI (fMRI) is often affected by head motion during functional imaging scans. Head motion is more common in the elderly than in young participants and could therefore affect the evaluation of age-related changes in brain networks. Thus, this study aimed to investigate the influence of head motion in FC estimation when evaluating age-related changes in brain networks.Methods:This study involved 132 healthy volunteers divided into 3 groups: elderly participants with high motion (OldHM, mean age (±SD) = 69.6 (±5.31), N = 44), elderly participants with low motion (OldLM, mean age (±SD) = 68.7 (±4.59), N = 43), and young adult participants with low motion (YugLM, mean age (±SD) = 27.6 (±5.26), N = 45). Head motion was quantified using the mean of the framewise displacement of resting state fMRI data. After preprocessing all resting state fMRI datasets, several resting state networks (RSNs) were extracted using independent component analysis (ICA). In addition, several network metrics were also calculated using network analysis. These FC measures were then compared among the 3 groups.Results:In ICA, the number of voxels with significant differences in RSNs was higher in YugLM vs. OldLM comparison than in YugLM vs. OldHM. In network analysis, all network metrics showed significant (P < 0.05) differences in comparisons involving low vs. high motion groups (OldHM vs. OldLM and OldHM vs. YugLM). However, there was no significant (P > 0.05) difference in the comparison involving the low motion groups (OldLM vs. YugLM).Conclusion:Our findings showed that head motion during functional imaging could significantly affect the evaluation of age-related brain network changes using resting state fMRI data.     

Prospective motion correction for single‐voxel 1H MR spectroscopy

Head motion during ¹H MR spectroscopy acquisitions may compromise the quality and reliability of in vivo metabolite measurements. Therefore, a three‐plane image‐based motion‐tracking module was integrated into a single‐voxel ¹H MR spectroscopy (point‐resolved spectroscopy) sequence. A series of three orthogonal spiral navigator images was acquired immediately prior to the MR spectroscopy water suppression module in order to estimate head motion. By applying the appropriate rotations and translations, the MR spectroscopy voxel position can be updated such that it remains stationary with respect to the brain. Frequency and phase corrections were applied during postprocessing to reduce line width and restore coherent averaging. Spectra acquired during intentional head motion in 11 volunteers demonstrate reduced lipid contamination and increased spectral reproducibility when motion correction is applied. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.