Characterisation and correction of respiratory-motion artefacts in cardiac PET-CT

Respiratory motion during cardiac Positron Emission Tomography (PET) Computed Tomography (CT) imaging results in blurring of the PET data and can induce mismatches between the PET and CT datasets, leading to attenuation-correction artefacts. The aim of this project was to develop a method of motion-correction to overcome both of these problems. The approach implemented was to transform a single CT to match the frames of a gated PET study, to facilitate respiratory-matched attenuation-correction, without the need for a gated CT. This is benecial for lowering the radiation dose to the patient and in reducing PETCT mismatches, which can arise even in gated studies. The heart and diaphragm were identied through phantom studies as the structures responsible for generating attenuation-correction artefacts in the heart and their motions therefore needed to be considered in transforming the CT. Estimating heart motion was straight-forward, due to its high contrast in PET, however the poor diaphragm contrast meant that additional information was required to track its position. Therefore a diaphragm shape model was constructed using segmented diaphragm surfaces, enabling complete diaphragm surfaces to be produced from incomplete and noisy initial estimates. These complete surfaces, in combination with the estimated heart motions were used to transform the CT. The PET frames were then attenuation-corrected with the transformed CT, reconstructed, aligned and summed, to produce motion-free images. It was found that motion-blurring was reduced through alignment, although benets were marginal in the presence of small respiratory motions. Quantitative accuracy was improved from use of the transformed CT for attenuation-correction (compared with no CT transformation), which was attributed to both the heart and the diaphragm transformations. In comparison to a gated CT, a substantial dose saving and a reduced dependence on gating techniques were achieved, indicating the potential value of the technique in routine clinical procedures

Computers in Diagnostic Nuclear Medicine Imaging - A Review

Digital computers are becoming increasingly popular for a variety of purposes in nuclear medicine. They are particuiarly useful in the areas of nuclear imaging and gamma camera image processing,radionuclide inventory and patient record keeping. By far the most important use of the digital computer is in array processors which are commonly available with emission computed systems for fast reconstruction of images in transverse, coronal and sagittal views, particularly when the data to be handled is enormous and involves filtration and correction processes. The addition of array processors to computer systems has helped the clinicians in improving diagnostic nuclear medicine imaging capability. This paper reviews briefly therole of computers in the field of nuclear medicine imaging

Post-Acquisition Small-Animal Respiratory Gated Imaging Using Micro Cone-Beam CT

On many occasions, it is desirable to image lungs in vivo to perform a pulmonary physiology study. Since the lungs are moving, gating with respect to the ventilatory phase has to be performed in order to minimize motion artifacts. Gating can be done in real time, similar to cardiac imaging in clinical applications, however, there are technical problems that have lead us to investigate different approaches. The problems include breath-to-breath inconsistencies in tidal volume, which makes the precise detection of ventilatory phase difficult, and the relatively high ventilation rates seen in small animals (rats and mice have ventilation rates in the range of a hundred cycles per minute), which challenges the capture rate of many imaging systems (this is particularly true of our system which utilizes cone-beam geometry and a 2 dimensional detector). Instead of pre-capture ventilation gating we implemented a method of post-acquisition gating. We acquire a sequence of projections images at 30 frames per second for each of 360 viewing angles. During each capture sequence the rat undergoes multiple ventilation cycles. Using the sequence of projection images, an automated region of interest algorithm, based on integrated grayscale intensity, tracts the ventilatory phase of the lungs. In the processing of an image sequence, multiple projection images are identified at a particular phase and averaged to improve the signal-to-ratio. The resulting averaged projection images are input to a Feldkamp cone-beam algorithm reconstruction algorithm in order to obtain isotropic image volumes. Minimal motion artifact data sets improve qualitative and quantitative analysis techniques useful in physiologic studies of pulmonary structure and function

Image processing techniques in nuclear medicine

The application of image processing techniques to radionuclide images acquired on a gamma camera - computer system has been investigated. Hepatic perfusion imaging studies with 99Tcm-tin colloid were performed in patients with primary colorectal carcimma. The hepatic perfusion index performed poorly in the detection of those patients with occult or overt hepatic metastastes, as did mean transit times of liver colloid flow derived from deconvolution analysis. A discriminant function was developed which separated those patients with occult metastases from those without liver disease. A fully automatic algorithm to derive a left ventricular edge from each frame of an ECG gated cardiac blood pool study was developed and validated in patient studies. Left ventricular ejection fractions calculated from count rates within the edge were reproducible and correlated well with ejection fractions derived from the same images by a manual technique, and with ejection fractions derived from left ventricular cineangiography. Studies were performed in patients to evaluate the effectiveness of tomographic imaging of the myocardial perfusion imaging agent 99Tcm-tBIN for detection of ischaemic heart disease. Tomographic reconstructions in the planes of the axes of the left ventricle gave better results than transaxial reconstructions or planar imaging. Choice of the optimum reconstruction filter for use in tomography using 99Tcm-tBIN was examined by means of patient am phantom studies. These showed that more accurate diagnoses and better reconstructions were obtained with smoothing filters than by the use of sharp reconstruction filters. This work shows that optimum image processing techniques must be established to attain the best possible results with new radiopharmaceuticals for nuclear medicine investigations

Comparison of estimates of left ventricular ejection fraction using gated blood imagining

Serial measurement of left ventricular ejection fraction (L VEF) using GBP imaging is an established technique for monitoring L VEF in patients undergoing chemotherapy with cardio-toxic medication and in patients after heart transplants. Oncologists at our institution decide that cardio-toxic chemotherapy should be discontinued if the L VEF decreases by 10%, or if a value of 50% is reached. In patients with baseline L VEFs of less than 50% but greater than 30% therapy will be discontinued if the L VEF decreases by 10% or if a value of less than 30% is reached. This is in accordance with the guidelines set out by the Oxford Textbook ofOncology.3 In patients who have had heart transplants, GBP studies are used to monitor L VEF. If there is a decrease in L VEF, cardiologists may decide to start glucocoricosteroids for rejection. It is therefore imperative that serial studies on an individual patient are comparable. There are two software systems used in our nuclear medicine department; the Siemens system and the Hermes system. In a pilot study we found large differences between the L VEFs calculated by the two systems. This is consistent with the consensus in the literature that different software programs for processing GBP studies cannot be used interchangeably