Clinical Evaluation of Zero-Echo-Time Attenuation Correction for Brain 18F-FDG PET/MRI: Comparison with Atlas Attenuation Correction.
- Sekine T Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland tetsuro.sekine@gmail.com.
- Ter Voert EE Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Warnock G Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Buck A Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Huellner M Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Veit-Haibach P Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Delso G GE Healthcare Waukesha, Wisconsin.
- 2016-06-25
Published in:
- Journal of nuclear medicine : official publication, Society of Nuclear Medicine. - 2016
18F-FDG
PET/MR
ZTE
atlas-based
attenuation correction
brain
Adult
Aged
Aged, 80 and over
Brain
Feasibility Studies
Female
Fluorodeoxyglucose F18
Humans
Image Processing, Computer-Assisted
Kinetics
Magnetic Resonance Imaging
Male
Middle Aged
Multimodal Imaging
Positron Emission Tomography Computed Tomography
English
Accurate attenuation correction (AC) on PET/MR is still challenging. The purpose of this study was to evaluate the clinical feasibility of AC based on fast zero-echo-time (ZTE) MRI by comparing it with the default atlas-based AC on a clinical PET/MR scanner.
METHODS
We recruited 10 patients with malignant diseases not located on the brain. In all patients, a clinically indicated whole-body 18F-FDG PET/CT scan was acquired. In addition, a head PET/MR scan was obtained voluntarily. For each patient, 2 AC maps were generated from the MR images. One was atlas-AC, derived from T1-weighted liver acquisition with volume acceleration flex images (clinical standard). The other was ZTE-AC, derived from proton-density-weighted ZTE images by applying tissue segmentation and assigning continuous attenuation values to the bone. The AC map generated by PET/CT was used as a silver standard. On the basis of each AC map, PET images were reconstructed from identical raw data on the PET/MR scanner. All PET images were normalized to the SPM5 PET template. After that, these images were qualified visually and quantified in 67 volumes of interest (VOIs; automated anatomic labeling, atlas). Relative differences and absolute relative differences between PET images based on each AC were calculated. 18F-FDG uptake in all 670 VOIs and generalized merged VOIs were compared using a paired t test.
RESULTS
Qualitative analysis shows that ZTE-AC was robust to patient variability. Nevertheless, misclassification of air and bone in mastoid and nasal areas led to the overestimation of PET in the temporal lobe and cerebellum (%diff of ZTE-AC, 2.46% ± 1.19% and 3.31% ± 1.70%, respectively). The |%diff| of all 670 VOIs on ZTE was improved by approximately 25% compared with atlas-AC (ZTE-AC vs. atlas-AC, 1.77% ± 1.41% vs. 2.44% ± 1.63%, P < 0.01). In 2 of 7 generalized VOIs, |%diff| on ZTE-AC was significantly smaller than atlas-AC (ZTE-AC vs. atlas-AC: insula and cingulate, 1.06% ± 0.67% vs. 2.22% ± 1.10%, P < 0.01; central structure, 1.03% ± 0.99% vs. 2.54% ± 1.20%, P < 0.05).
CONCLUSION
The ZTE-AC could provide more accurate AC than clinical atlas-AC by improving the estimation of head-skull attenuation. The misclassification in mastoid and nasal areas must be addressed to prevent the overestimation of PET in regions near the skull base.
METHODS
We recruited 10 patients with malignant diseases not located on the brain. In all patients, a clinically indicated whole-body 18F-FDG PET/CT scan was acquired. In addition, a head PET/MR scan was obtained voluntarily. For each patient, 2 AC maps were generated from the MR images. One was atlas-AC, derived from T1-weighted liver acquisition with volume acceleration flex images (clinical standard). The other was ZTE-AC, derived from proton-density-weighted ZTE images by applying tissue segmentation and assigning continuous attenuation values to the bone. The AC map generated by PET/CT was used as a silver standard. On the basis of each AC map, PET images were reconstructed from identical raw data on the PET/MR scanner. All PET images were normalized to the SPM5 PET template. After that, these images were qualified visually and quantified in 67 volumes of interest (VOIs; automated anatomic labeling, atlas). Relative differences and absolute relative differences between PET images based on each AC were calculated. 18F-FDG uptake in all 670 VOIs and generalized merged VOIs were compared using a paired t test.
RESULTS
Qualitative analysis shows that ZTE-AC was robust to patient variability. Nevertheless, misclassification of air and bone in mastoid and nasal areas led to the overestimation of PET in the temporal lobe and cerebellum (%diff of ZTE-AC, 2.46% ± 1.19% and 3.31% ± 1.70%, respectively). The |%diff| of all 670 VOIs on ZTE was improved by approximately 25% compared with atlas-AC (ZTE-AC vs. atlas-AC, 1.77% ± 1.41% vs. 2.44% ± 1.63%, P < 0.01). In 2 of 7 generalized VOIs, |%diff| on ZTE-AC was significantly smaller than atlas-AC (ZTE-AC vs. atlas-AC: insula and cingulate, 1.06% ± 0.67% vs. 2.22% ± 1.10%, P < 0.01; central structure, 1.03% ± 0.99% vs. 2.54% ± 1.20%, P < 0.05).
CONCLUSION
The ZTE-AC could provide more accurate AC than clinical atlas-AC by improving the estimation of head-skull attenuation. The misclassification in mastoid and nasal areas must be addressed to prevent the overestimation of PET in regions near the skull base.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.2967/jnumed.116.175398
- PMID 27339875
- Persistent URL
- https://sonar.ch/global/documents/229063
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